“It was marvellous to have her there.” You're about to have a baby, you're a long way from your own country, your French seems to be going to pieces, you're feeling very anxious and then Vivienne Rion, a British midwife working in the Var, comes on the scene. Jill Penton-Browne has been talking to her.

That tribute to Vivienne came from Rachel Bugga, a Sussex girl married to a Norwegian yacht captain and living in Cogolin. "Let me say first of all that I was very pleased indeed with the care I got but there were things that needed explaining and that was what Vivienne could do. It was marvellous to have her there." Charlotte Cheke, another recent mother and also British, was fully in agreement. "It really does help to be able to speak your own language at such a time. Vivienne has a very reassuring manner and her presence made a big difference." How does Vivienne herself react to these compliments? "Of course, most of the mothers I deal with are French but they call me in when there's someone who speaks English. I try to get them to understand our system and to feel comfortable with it."

"I'm very lucky"

So how did a girl born fifty-six years ago in Droylesden near Manchester end up delivering babies in the South of France? "As a small child I decided I wanted to be a nurse. At six years old I joined the St. John's Ambulance Brigade - remember them? My mum lied about my age. I think you had to be seven. Anyway, after school I trained at the Tameside General Hospital. After I'd had two children myself I went into midwifery. Why? I felt I wanted to help other women through that very special experience of childbirth." Nearly forty years on Vivienne looks back with real nostalgia at the hospital world she used to know. "Things have changed my old friends tell me. In our day there was an almost military discipline. Today, though, there's much more paper pushing. You get some of that here, too, but I'm very happy in the French system."

When Vivienne was forty a lot suddenly happened. "I got divorced. As my kids were practically grown up I went for a complete change and got a job in the maternity wing of a big hospital in Saudi Arabia. It was interesting professionally but very hard work. We were notching up 5000 births a year - that's compared with around 500 where I work now." In Saudi she met her present husband who's French. Eventually they went back to France, first to Paris and then to the Var. "Until just the other day I was working at the hospital in Saint-Tropez. Now we've moved to new premises in Gassin where we've got a public hospital combined with a private clinic. It's convenient for commuting - we live in Draguignan - and it's still quite small-scale which I like. I'm very lucky, I think, to live here and be able to do a job I like so much."

"A very medicalised system"

What advice would Vivienne give to a woman who finds she's expecting a baby here? "Well, let's start with something very practical. Make sure you've got the necessary insurance cover, whether it's with la Sécu or with a private insurer. Then check out you've got any medical records which might be relevant. Remember you'll be going into a very medicalised system. You'll be followed by an obstetrician from the beginning of your pregnancy and you'll have a whole series of scans to check out the baby's progress. The midwife is there in the immediate run-up to the birth and, obviously, at delivery. What I think surprises British women, for example, are the somewhat casual follow-up procedures. In the U.K. there's a very good structure of community midwives who do home visits. We don't have that here although I make myself available informally to anyone who needs advice before and after the birth. I always make it clear that if they've got a worry they should take the initiative and go to the doctor."

In recent years we've heard a lot - especially in the U.S. and the U.K. - about the freedom women should have to manage their own pregnancies and birthings. In France these ideas have not had much of a welcome from the medical establishment. Doctors and midwives always know best seems to be the basic idea. "Tell me about it!" groaned Kate Palthey, an American living in Plascassier, who's had four babies here. "Take the matter of the epidurals - that's the anaesthetic given to relieve labour pains - which just didn't work for me, not once. But they didn't want to believe it. And they turned my husband out of the room when I most wanted him to be there.

"A more or less natural way"

What does Vivienne make of such stories? "I suppose it all comes down to the conviction that the experts - the doctors, the midwives - are the ones to manage a birth. I think most French women still accept this and you don't get them coming in with American-style birth plans and demanding pools and such things." What about what they call "elective C-sections", increasingly common in the U.S. and catching on in Britain, where simply to avoid pain or to schedule the birth more precisely a Caesarean is carried out at the wish of the mother (examples: Liz Hurley and that Mrs Beckham)? "Very rare indeed in France. A C-section is a serious operation and there's no way it would be authorised just on a woman's say-so. Yes, we often induce birth by normal vaginal delivery but that's all. To be frank, I like to feel that when I'm holding a newborn he or she has arrived in a more or less natural way without the aid of a knife."

In a later issue we'll be carrying a more specific feature on childbirth. Meanwhile Vivienne Rion is happy to talk down the line in English to any woman who would like advice...

From Reporter Issue 103