When it comes to intimate health, many women hesitate about which specialist to consult, especially if they live far from France. Midwife or gynecologist? What’s the role of each, and how do you find your way around when healthcare systems vary from country to country?
Yet gynecological health is vital. The problem is that 53% of women put off their gynecological appointments, according to an IFOP x Qare study (March 2025). Between lack of information, apprehension or difficulties in accessing care – especially when expatriating, where delays, cost and language barriers add up – medical follow-up can quickly become a challenge.
This is where an alternative, often overlooked by French women, comes into its own: the midwife not only intervenes during pregnancy, but is a true ally in your day-to-day gynecological health, even abroad.
Midwife: your versatile and accessible health ally, well beyond pregnancy
Contrary to popular belief, the midwife (or maieutician) is not just a maternity care professional. Her field of expertise is extremely broad, covering most preventive and routine gynecological care for healthy women.
The midwife’s broad spectrum of skills
A midwife is authorized to carry out routine annual gynecological check-ups (breast and genital examinations). She can also prescribe, insert and renew all methods of contraception (pill, IUD, implant, etc.).
She also plays a fundamental role in prevention: she carries out essential screening tests (cervico-uterine smear, STI/STD screening) and can treat common infections such as mycosis, vaginosis or simple cystitis. She is also authorized to prescribe certain complementary examinations (screening ultrasounds, blood tests), to accompany medical abortions (depending on the local legal framework) and, of course, to monitor physiological (risk-free) pregnancies.
The accessibility advantage of expatriation
For the vast majority of preventive procedures, no medical letter (or referral) is required. Appointments can be made directly, which means shorter waiting times than at a gynecologist’s, a factor not to be underestimated abroad. What’s more, the cost of the consultation is generally lower, optimizing your out-of-pocket expenses even with good international insurance.
Obstetric gynecologist: a specialist in complex pathologies
The gynecologist is a specialist physician, having undergone comprehensive medical training followed by specialization. His mission is to diagnose and treat more complex diseases, including surgery. He or she intervenes especially when the situation goes beyond normal physiological care.
When a specialist is needed: the role of the gynecologist
You should give priority to consulting a gynecologist as soon as the situation becomes pathological or requires in-depth medical expertise. It is essential in cases of suspected or diagnosed endometriosis or PCOS (polycystic ovary syndrome).
They are also the first point of contact for acute or chronic unexplained pelvic pain, severe or haemorrhagic cycle disorders, and, of course, for any organ pathology (uterus, ovaries, breast) or gynaecological surgery. Finally, it provides follow-up care for high-risk pregnancies and medically-assisted fertility (MAP).
Complementarity: midwives and gynaecologists are not in competition. The midwife provides preventive care and day-to-day monitoring, while the gynecologist intervenes in complex or surgical situations.
Midwife, gynecologist or general practitioner: who can provide your expatriate care?
While in France, these three professionals can carry out your annual gynecological check-up, abroad, flexibility is even more vital. The key is to choose the right practitioner:
- Tailored to your needs: If you have a history of pathology (e.g. endometriosis), a gynecologist is preferable. For a simple pill prescription, a midwife is ideal.
- Recognized by your insurance: Check whether reimbursement is better with a general practitioner (GP) or a specialist(gynecologist), and whether midwives(CNM) are included in your international health cover.
- Who you can trust: Language barriers can complicate the exchange. If possible, choose a practitioner who speaks French or English, or ask someone to accompany you.
Focus Expatriation: Understanding the different roles in different countries
When living abroad, the roles of these professionals can vary greatly. For a French expatriate, understanding these nuances is crucial to orienting yourself effectively and optimizing your healthcare coverage.
| Region / Country | The role of the midwife | Role of the Gynecologist (Ob-Gyn) | The Expat reflex |
| Northern Europe (Netherlands, UK, Sweden) | Very broad role. First contact for gynecological and obstetrical care and contraception. | Intervenes only for complications and high-risk births. | Consult the Midwife as a matter of priority for any routine follow-up. |
| United States | Certified Nurse Midwives (CNM): important recognition, but scope of action dependent on state and insurance. | Very central. Access is direct, but can be costly and insurance-dependent(Ob-Gyn). | Check coverage for CNMs and direct access to specialists. |
| Southern Europe / Asia / Middle East | Often limited to childbirth and post-partum support. | Highly centralized and medicalized. The gynecologist is the default specialist. | Anticipate delays at the gynecologist’s, who is often saturated. |
Santexpat.fr tip: Before making an appointment, find out about local practices. Your international insurance company can often help you find recognized French or French-speaking practitioners in your network.
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Securing your maternity abroad: 9moisetplus follow-up, a breath of fresh air
For expatriate mothers-to-be, distance, fear of the language barrier or differences in medical practices can be a source of anxiety. The 9moisetplus service responds to this need by offering personalized, reassuring support.
This system enables you to benefit from remote pre- and postnatal monitoring by qualified French midwives, accessible anywhere in the world via teleconsultation. This ensures continuity of French-speaking care, even in countries where access to local care is limited or practices differ greatly from our own. Advice covers pregnancy management, breastfeeding, postpartum care and birth preparation to French standards.
An invaluable service for securing your international maternity career and benefiting from the benevolence of a professional trained in French practices.
So, who to consult? A practical guide to decision-making
This summary table will help you make the right decision for your needs:
| Need / Situation | Priority Consultation | Justification |
| Contraception (initiation or renewal) | Midwife | Routine procedure. More available, less costly. |
| Smear tests / STI screening | Midwife | Basic preventive action within its remit. |
| Common infections (mycosis, simple cystitis) | Midwife or GP | Simple treatment, no need for a specialist. |
| Endometriosis / Severe cycle disorders | Gynecologist | Complex pathology requiring specialized diagnosis and follow-up. |
| Acute pelvic pain / Abnormal bleeding | Gynecologist | Need for medical diagnosis and possible surgery. |
| Normal, risk-free pregnancy | Midwife | The professional best suited to physiological monitoring. |
| Pathological pregnancy / Scheduled Caesarean section | Gynecologist | Specialized medical follow-up is imperative. |
What you need to know for your intimate health abroad
- The midwife is your first port of call: she takes care of most of your regular gynaecological check-ups and preventive care.
- The gynecologist is a specialist: reserve him or her for complex pathologies or high-risk pregnancies.
- Expatriation demands adaptability: practices vary widely. Find out about the role of local Midwives and GPs.
- Secure your maternity: Remote services like 9moisetplus offer valuable continuity of care.
Taking care of your gynecological health is all the more important when you live abroad. Knowing what each person’s role is means you can be sure of optimal care, tailored to your situation and your international coverage.
