Birth Around the World: Having a baby in Germany

I just discovered a fascinating (English-language) German newspaper series about Motherhood in the Fatherland. In The Local, Sabine Devins, a Canadian ex-pat and expectant mother, explains what it's like to have a baby in Germany.

The author's growing belly

The series has 6 parts:

• Baring all at the OB/GYN (2 Jun 2010)
• Morning sickness? There's a tea for that (30 Jun 2010)
• The name game (3 Aug 2010)
• Very superstitious: Evil eyes, birthmarks and blindness (2 Sep 2010)
• The midwife: Your best friend in natal care (5 Oct 2010) 
• Hospital, birthing house or at home? Delivery options in Germany (5 Nov 2010)

Below are short excerpts from each.

Baring all at the OB/GYN

"When you move into the examination room, there is probably some sort of screen for you to undress behind, but don't expect it to be private. If you've lived in Germany for awhile you'll know Germans aren't particularly shy about nudity. After disrobing, you walk over to the doctor's chair in all your glory. This can disturb some expats on their first trip to a German obstetrician. Unlike a visit at home, I was not shielded from the sight of the examination by a paper towel. I sat in a chair and the exam began. Oh right. The chair.

"While there is an examination table in most offices, for some visits you're in a chair specially designed for gynaecological purposes. You sit down and recline, but you're still face-to-face with the doctor, while all of those medical instruments remain in plain view. As is what he or she is doing down there. Oh — and German doctors seem to like to make conversation."

Morning sickness? There's a tea for that

"If I were back home in Canada, I’d probably walk into a pharmacy and purchase a suitable medication thought safe for pregnant women. But in Germany doctors and chemists encourage a more natural remedy. Yes, to cure what ails during pregnancy, there's a tea for that.

"'It's a tea-drinking culture here,' the pharmacist at my local Apotheke explained. 'It’s very old, dating back to when monasteries were also healing places for the sick, and now it’s practically a tradition to turn to tea first.'...

"After discussing digestive issues with my obstetrician-gynaecologist, she wrote me a prescription, but told me to try fennel tea, or Fencheltee, first. I have yet to fill the prescription and will probably stick to the tea.

"Against the leg cramps that I'm waiting to start any day now, I'm to drink chamomile tea, or Kamillentee. To combat the increased mucous my body produces ('A totally normal thing,' says my doctor), I drink the occasional cup of thyme tea, or Thymiantee.

"There is even an herbal tea mixed specifically for pregnant women, appropriately called Schwangerschaftstee, or “pregnancy tea.” I got my leafy mixture at my local Apotheke, where the pharmacist explained that the particular brand, mixed by Bahnhof Apotheke, came highly recommended by Ingeborg Stadelmann, midwife and author of a well-known German guide to pregnancy. You can also find the tea at organic grocery shops and local drug stores."

The name game

"When Baby is born, residents must head down to their local Standesamt (civil registry office) to officially register the vital details of their new addition. There German parents find themselves at the mercy of bureaucrats who decide whether the name they put on the birth certificate will get the stamp of approval.

"Many of my Canadian friends are choosing gender-twisting names like 'Charlie' or 'Devon' for girls. But here in Germany, if a name does not properly reflect the baby’s gender, parents had better have a feminine name that lends itself to a gender-bending nickname to put down on the books instead.

"Also verboten are names that could cause future humiliation to the child. Along the same lines, babies cannot be named after corporations, though I did recently overhear a new mother introduce her daughter Nike in my OB/GYN’s office. Apparently the bureaucrats will make an exception for babies named after a Greek goddess who also happens to represent a sports equipment company."

Very superstitious: Evil eyes, birthmarks and blindness

"Here in the Fatherland, it's bad luck to celebrate an event before it happens, especially a birth.

"While North American mothers would begin receiving gifts a few weeks before their due date, German friends and family won’t bring presents until after the newborn arrives. I have yet to encounter a shop that offers gift registries for mothers-to-be planning a baby shower. It's just not done here.

"That's why my Oma Eva was horrified when I told her my Vancouver family members wanted to host a little baby shower when we visited in July. 'You can't do that!' she yelled into the phone. 'It's bad luck!'"

The midwife: Your best friend in natal care 

"In North America, midwifery is coming back into fashion, but isn’t the norm. Some of my Canadian friends have used a doula for physical, emotional or spiritual support before and after the birth process. But doulas are rare in Germany where midwifery is the common practise - even hospitals keep them on staff. In fact, midwives run the birthing show in the German healthcare system....

"In a previous column I wrote about my choice to see an OB/GYN for the duration of my pregnancy, but many women simply seek the services of a midwife for the routine pre-and postnatal check-ups. Not all Hebamme

"Most midwives work freelance. They usually have an in-home office or a Hebamme Praxis, where a group of midwives share an office and sometimes clients. Other midwives are employed in the birthing wards of hospitals, though they sometimes also take clients on a freelance basis...

"A regular Hebamme deals only with pre- and postnatal care; [the] deliveries will be supervised by whatever hospital or birthing centre midwife is on staff during labour. (Obstetricians are only called to attend births requiring surgery.)

"A Beleghebamme, or 'attending midwife,' will be with parents throughout the entire process, supervising pre- and postnatal care and delivery. These midwives usually have contracts with one or more birthing centres, which provides them with the insurance to legally deliver babies or specialize in home births.

"But the Beleghebamme often have an on-call fee that insurance won’t cover, according to Sue Travis, a Berlin-based midwife who hails from Australia. In Berlin, it’s usually around €350, she says.

"'For the weeks around your due date, even if she isn’t delivering your baby, the midwife’s life is disrupted. She can’t drink wine with dinner and she can’t go on holiday or even spend a day out of town in case she gets that call. The fee is just to make up for the inconvenience,' said Travis, adding that there are plenty of benefits that come with that fee.

"'If you do seek the service of a Beleghebamme, they don’t just deliver the baby, but act as an advocate on your behalf at the hospital, making sure you have the kind of birth that you want,' she said. ...

"After the baby is born, the relationship with the midwife remains important. During the postnatal period, or Wochenbettbetreuung, insurance will cover 26 visits or phone calls for up to eight weeks after the birth, "Travis says. For the first 10 to 14 days after the birth, the midwife will visit every day. During these visits, she ensures both mother and baby are in good health and advises anxious new parents on feeding and other questions....

"Finally, when mothers adjust to life with their new baby, some midwives offer a fitness class to help get their body back to 'normal,' called Rückbildungsgymnastik. (Finally the answer to how German women get back in shape so quickly after having a baby!) Babies are, of course, invited and incorporated into the class. Health insurance usually covers at least 10 hours of these courses."

Hospital, birthing house or at home? Delivery options in Germany

"In Germany there are three options: hospitals, birthing houses, or at-home births....Similar to my midwife search strategy, I got a plethora of literature about where to deliver in Berlin. It included hospital and birthing house locations, whether they employ Beleghebammen, or attending midwives, and when they host information evenings for expecting parents...

"While [hospital] delivery rooms are almost all equipped with the traditional hospital bed, many also have an alternative available to aid in more comfortable labour. I've seen delivery rooms with big jacuzzi tubs for water births, a king-sized bed allowing dads to take an active role in the delivery, birthing stools and chairs, and a curious round bed that supports a host of delivery positions....


"If I didn't want a hospital birth, I could have just as easily choose a birth house, or Geburtshaus, for a 'home away from home' setting. For many people, a birth house is a compromise between a home birth and hospital.

"These facilities offer a more intimate and private environment for the delivering mother. The births are attended by a midwife and the delivery rooms are cosily furnished for a homey feel, with a few extra tools to help with delivery. As with some hospital rooms, birthing houses are often also equipped with big tubs for delivery, or just helping women relax during the process. Mothers can also choose birth stools, various positions in bed and using other specialised equipment to help them deliver as comfortably as possible.

"Birthing houses intend for women there to have natural births, so they are less likely to administer Pitocin and they don’t do epidurals. There is also no option to overnight at a birth house. Women who deliver at birth houses do so only on an outpatient basis...

"Home births are also an option in Germany and, like hospital and birth-house deliveries, are covered by medical insurance....Not all midwives attend home births, so it may take some time to find one. Mothers who want a home birth can also find a midwife practise or birth house that has the insurance to deliver in-home...

"Women who plan on a home birth will have to do a little more preparation, as they'll be expected to have all non-medical supplies on hand. Most midwives have their own foetal heart rate monitors and basic medical kits containing clamps for the umbilical cord and stitches, but they will expect parents to gather a checklist of other supplies."