Welcome back to the International Birth Stories series. If you’re just joining us, make sure you check out the other testimonies in the series: Senegal, Spain, Switzerland, Japan, England, Djibouti, Northern Ireland, Brazil. This week we have Chamisa, with a birth story from Germany.
Intro: What brought you to Germany?
The hospital where I gave birth was public. In the town where I lived, we did not have any private hospitals. I did not pay a dime for my son’s German birth. Granted, I did not have a c-section (but I did have an epidural), and I stayed less than 24 hours. German insurance pays for a shared postpartum room; mothers can elect to pay a bit more for a private room. Also, all well-baby checks (and postpartum midwife checks) are completely covered as are sick visits and vaccinations.
1.) What surprised you about prenatal care in Germany?
Prenatal care in Germany is set up to allow moms-to-be the freedom of choice. The mother is free to choose a gynecologist, a midwife, or both to oversee the pregnancy. This isn’t necessarily all that different from America; women in the US can do the same as long as that provider accepts the mother’s insurance or the mama is able to pay out of pocket. However, I was surprised to learn that for a hospital birth, the doctor (gynecologist) has nothing to do with the actual labor and delivery. He or she is responsible for making sure the mother is healthy before birth, and a professional at the hospital takes over shortly before the due date. If a woman chooses a midwife, all the prenatal visits can be conducted either at a birth center or in the patient’s home. On another curious note, ultrasounds are routine and occur often throughout the pregnancy. In the US, unless a woman is high-risk or pays out of pocket, pregnant mothers often only receive one ultrasound at twenty weeks. I received six or seven, and they were performed by the doctor, not an ultrasound tech.
2) What surprised you about giving birth in Germany?
An unexpected bump in the road was discovering that the mass exodus of Germans every August known as “summer holidays” affects mothers who happen to have due dates during that time. I was hard pressed to find a midwife available for an August due date, and the hospital was noticeably short-staffed during my stay.
Also, convincing a doctor in Germany to induce labor before your due date is next to impossible unless you have complications… or beg. I somehow found myself with an extremely kind hospital obstetrician who agreed to put me on the drip just one day after my due date, but only because I had already had two other inductions.
And, for all the mothers who need, desire, or can’t live without epidurals – beware. German hospitals don’t give out epidurals like candy. In the US, the mother is encouraged to sign all the consent forms for an epidural before going into labor so that (ideally) at the exact minute she wants one, she can have it. In Germany, doctors and midwives purposefully do not give the mother any information or paperwork for an epidural in advance for the express purpose of delaying the intervention as long as possible in order to (hopefully) avoid giving it to her. The bottom line – if you want an epidural in Germany, you’re going to have to fight like mad to get it.
3) What surprised you about post-natal care in Germany?
I gave birth to two babies in the US, and one baby in Germany. In America, I had virtually no post-natal care other than the standard well-baby visits and a routine check-up with my ob/gyn at six weeks postpartum. If I had questions or concerns, either Google held my hand, or I wrangled a last-minute appointment from an already-overbooked pediatrician. Imagine my surprise when I learned that every mama in Germany is assigned a midwife that visits the mother and baby at home for as many visits as it takes to establish a healthy start to the little one’s life. I had an awful birth (which could have happened in any country – it’s not Germany’s fault), but the fantastic post-natal care nearly made up for it. My midwife ensured that I was healing properly after the birth and that my baby was adapting well to life outside the womb. She brought a scale to my house to weigh my son and answered all those questions that new moms always worry about (even when they already have multiple children!). She also went over exercises to help me get my body back into shape and encouraged me to join a post-natal fitness class, something that all German health insurance companies cover for moms. Amazing.
4) Overall impression of German pregnancy and birth culture
One of the most striking differences between Germany and America is the trust that Germans place in the hands of the mother. I got the distinct impression that Germany gives mothers more freedom to choose in their pregnancies and childbirth. From being responsible for your own medical records to selecting where and how you want to give birth to experimenting with any and all labor positions, much confidence is placed on the mother and her instincts or convictions. I believe part of the reason why this is possible in Germany is the lack of lawsuits. The threat of malpractice and the high cost of provider insurance premiums in America prevent many doctors from the possibility of allowing their patients to choose the way they want their birth to be. Risk exists in any birth; but, in Germany, that risk generally seems to stay in medical realm and out of the legal arena.
But, perhaps the most amazing difference between birth culture in the US and Germany is a beautiful thing called parental leave. Legally, the mother can take up to three YEARS of maternity leave, and her employer must allow her to return to her position. Also, if the employee and employer agree, one of those three years can be saved and taken when the child is between the ages of 3 and 8. Granted, most of those three years of leave would be unpaid. But, paid benefits do exist. The mother receives 14 weeks at 100% of her salary, starting 6 weeks before her due date. After the 14 weeks are up, she is entitled to 12 months at about 65% pay. To sweeten this deal even further, if the father wants to take leave as well, then the couple has 14 months that they may divide among themselves. Again, these 14 months would be at 65% pay. Seriously, awesome.
Chamisa blogs about the marvels, miracles, and mishaps of a life spent traveling on the cheap with her husband and their three boys in tow at Thrifty Travel Mama.