The United States is a melting pot of different cultures. Polio is a typical example of the importance of immunization in all cultures. Polio enters the mouth, multiplies in the intestine and is excreted in the feces. While in the intestinal tract, the virus enters the bloodstream and can infect the central nervous system. Most people who get polio do not even know they are infected. Some have mild flu-like symptoms. An even smaller number get meningitis or paralysis. Meningitis and paralysis occur when polio virus infects the central nervous system. We want all our children and adults to be protected as we move from one culture to another.
Routine vaccinations are all free of charge in Japan, if you have coupons provided from municipal health centers.
Shots are available at the time of group baby checkup at your local health center or local pediatric clinics/hospitals.
The free coupons are mailed to your house from the local municipal health center. You will have to make an appointment with designated local pediatrics to have shots.
The coverage rates of six vaccines (BCG, polio, DPT, measles, mumps and varicella) and the prevalence of these diseases in Japan were investigated. It was found that 82.2% of children had been inoculated with BCG before their first birthday, and 85.4% were given two doses of polio vaccine before their second birthday. The high acceptance rates of these vaccines seem to be attributable to mass inoculations at health centers. On the other hand, the median age when the first dose of DPT vaccine was given was as late as 22 months. Mass administration of this vaccine during infancy should be performed since about one-quarter of the patients with diphtheria, pertussis or tetanus were less than one year old. The cumulative percentage for measles inoculation failed to reach 60% by the second birthday. Considering that the incidence of measles has not yet been satisfactory lowered and that infants under 23 months of age account for about one-half of this incidence, more children less than 18 months old should be immunized. The ineffective rate of varicella vaccine was found to be 18.2%, although more research is needed of its effectiveness.
If you get pregnant in France and you want to have a baby within the French social security system, then the first thing to do is to go to your doctor and fill in a déclaration de grossesse. You can choose any doctor as long as he/she is linked to the state health scheme (conventionné). You may not have the gynaecologist who has followed your pregnancy at your birth. Bear this in mind when choosing your gynaecologist at the beginning of your pregnancy.
Usually the local doctor can recommend a gynaecologist who carries out all the monthly checks. This includes monthly blood tests to check for toxoplasmosis, measles etc. You take the blood tests to a laboratory of your choice – to find one look under Laboratoires d’analyses de biologie médicale in the yellow pages. It is also a good idea to get your blood group identified at the same time. You will also have three scans (écographies) during your pregnancy. Very early on they will be able to determine the sex of the child, but if you don’t want to know you should tell them.
Whatever your age, the baby is now automatically checked for Down’s syndrome and other genetic disorders (nuchal fold and blood tests) and you will be offered an amniocentesis – amniocentèse – if you are considered high risk due to the results of the preliminary tests (which is reimbursed by the social security).
Towards the later stages of pregnancy you will also have to meet the anesthetist who will talk to you about the kind of pain relief you are likely to require – note that for deliveries in France pain relief tends to be all or nothing: epidurals (péridurales) are freely available and popular, even encouraged. The French are not big on natural childbirth, and very few women opt for a home birth, though this is an option provided you can find a midwife who is willing to do so.
A midwife is called a sage femme and once your pregnancy declaration is in the system you should sign up for pre-natal classes (séances de preparation à l’accouchement) at the hospital where you will give birth. It is a good idea to attend these courses, even though you may not be expecting your first baby, partly to have a contact to call in case of problems and also because it familiarises you with the appropriate French vocabulary.
You will give birth in a clinic or a hospital. The average stay is five days and eight to ten for a cæsarian. Don’t forget to bring all your social security papers with you to the birth; the whole system thrives on bureaucracy and the first thing they ask you for is your social security status.
If you want to breastfeed your baby you must tell the midwives and doctors at the hospital beforehand, who, in most hospitals and clinics, will help you and give you a list of names and addresses of mothers who are breastfeeding in you area. You may find that some people around you will not approve of breastfeeding.