Pregnancy, German style
Monday morning, as I sat in the waiting room of my Frauenärztin, or women doctor’s office, it occurred to me that these prenatal visits have become part of my routine here in Germany, and not always a purely pleasant one. At that moment, for example, my face was a little flushed. Not from the embarrassment of having to make my way through the crowded office clutching my urine sample (I got used to that months ago), or from being weighed in a public room (ditto), but from the almost-as-standard slap on the wrist from one of the receptionists/nursing assistants, regarding one of my countless infractions at this clinic. This time, I had only a €50 bill on me to pay for an unexpected, €10 “office fee”. That I had nothing smaller—and that the assistants couldn’t make change--appeared to irritate them more than if I had refused to pay the fee. “Don’t forget to pay next time,” one of them said tersely, as she handed me my plastic white cup. “I NOT forget!” I assured her. A bit later, flipping through a copy of German Vanity Fair in the waiting room, I turned another shade darker, and sighed out loud. I forgot to bring the mesh netting! Even though they always have a big roll of this white material, which is used to secure the CTG stethoscope-like monitors on the belly to record the fetal heart beat, the assistants regard it as valuable, and expect you to return for each appointment with the same swatch. To an American like me, this feels roughly equivalent to being expected to return each week with the same plastic cup. Well, yesterday was my 5th CTG, and I had only remembered to recycle my mesh twice. As I feared, the assistant rolled her eyes when I told her I needed a new cut. “I’m sorry,” I said, “it’s all very different in America.”
Yes, between the U.S. and in Germany, there are lots of differences in prenatal care and in being pregnant in general. And while none of these differences has me worried about the impending birth of baby #2, they certainly have amused, bewildered, pleased, and sometimes irritated me.
Prenatal care
The best word to describe prenatal care here in Germany could be “thorough”. Whereas in Atlanta my typical check-up lasted five minutes and involved only a scale, a stethoscope, a measuring tape, and a condescending doctor with a bow tie, the pre-natal visit in Germany is much more elaborate, high tech and time consuming. I’ve had more ultrasounds than I can count, way more pelvic examinations than I had allotted for my lifetime, four separate blood tests for Toxoplasmosis (the disease spread by domestic cats), and numerous blood checks of my iron levels. And then there’s the bane of my existence, the CTG. After 20 weeks of pregnancy, each prenatal visit requires a 30-45 minute monitoring of the baby’s movement and heartbeat while the patient lies completely still on a cot. At first I tried to make Leo suffer through these ordeals, but not even Baby Einstein on the portable DVD player could keep him happy after the second CTG. Now I schedule appointments for when he’s at his daycare, and bring something in English to read. When I mentioned to the doctor that I had never had a CTG for my first pregnancy in the States, she seemed embarrassed and a little defensive. Since then I’ve heard that the usefulness of the practice is now questioned in the German medical community, but it remains standard procedure. But while they might be high-tech with their care, the general philosophy is, at the same time, very anti-modern medication. This aspect of my care didn’t surprise me, having been exposed to German pediatrics and administered Leo’s prescribed tinctures, fruit gels, salts and pomades for his kiddie colds and infections. For headaches- only water; for trouble sleeping- only warm milk; for a baby kicking too much at night- try a lullaby; for heartburn, eat almonds; for low iron, eat beets and drink a brown liquid called “herb blood”. Luckily I know about the effectiveness (in moderation, of course!) of acetaminophen, Tums, steak and yoga for these same pregnancy woes.
Pregnancy culture
In a word, pregnancy is “serious” to Germans. Though no native has confirmed this for me, I think this sentiment of stern respect reflects remnants of past political views on motherhood. While German women are no longer awarded medals for outstanding fertility as they were in Hitler’s day, the government does actively support the development of families through tax incentives, modest cash stipends that increase with each successive child born, and, in comparison to the U.S., very generous maternity leave options for women. Although Germans laugh about their country’s negative birth rate, these jokes are actually based on old statistics. The hosting of the 2006 World Cup boosted fertility rates by double digits, as did a recent change in a national law making it even more profitable to have kids. Now, Italy (yes, catholic Italy!) and Portugal lag behind their northern neighbors in reproductive terms. But although pregnancy may be serious in Germany, it is not idealized like it can be in America. When I was pregnant in the U.S. with Leo, not a day would go by without kind looks from a cashier at my bump, inquiries into my due date by people walking down the street, and even questions about the baby’s sex, probable name, and whether or not we were registered at Babies R’ Us. It seemed like we were all day-dreaming about the little treasure soon to be delivered by the stork. Here in Germany, on the other hand, not a single stranger has asked me ANY of the above questions, and nobody smiles at me for being pregnant. Rather, they’re more likely to avert their eyes if I attempt to make contact. Also, in Germany, pregnancy is not for the faint hearted—but then again, as Fernando and I are both learning, being German is not for the faint hearted. Painkillers and anesthetics during labor are frowned upon, and the epidural is the stuff of urban legends, said to cause paralysis, infant retardation, and death. Again, statistics tell a slightly different story: almost 30% of patients at the hospital we’ll be using in Hannover receive the epidural for pain management. But to the German mindset, natural childbirth is the only “real” kind. And to a significant minority of German women, the only really true childbirth is that which takes place at one’s own residence! Three women acquaintances here, all experienced in it, have tried to convince me of the benefits of a homebirth with a Hebammen, or midwife. Ummm, nice idea, but we’ll stick to the hospital.
Late prenatal and postnatal care
The situation seems good, and again, very different than in the States. Expecting mothers are required, by law, to leave their jobs six weeks before their due date, and then receive 80% of their salary for the next six months off (their spot at work is reserved for three years, a period called “Parents’ Time”, though only the 1st six months are paid leave). Granted I’m not in their situation, but six weeks to prepare or at least rest a bit before the birth would seem a welcomed gift. Then, once the baby is born, women here call up their personal Hebammen, who is kind of like a cross between a midwife and a home nurse. She visits daily for the baby’s first ten days to check on both mother and child, and then comes on request for eight weeks after that. The Hebammen, available to any new mother in Germany at no cost, is then required to maintain subsequent contact with the mother for as long as the baby is breastfed. I picked out my “free” nurse, Anja, from a little pamphlet and have met with her a couple times. She is young, enthusiastic, carries a black leather purse reminiscent of a country veterinarian, and speaks good English. Her biggest passion is delivering babies at home, a skill she honed through field work in Africa. Luckily, she doesn’t seem to be holding against me my wish to deliver in a hospital, and Leo was fond of her immediately. So despite these months of tedious appointments, misunderstandings at the receptionists’ desk, and no talk of baby names or shower gifts, we’re thinking, and hoping, that everything will turn out fine.
Yes, between the U.S. and in Germany, there are lots of differences in prenatal care and in being pregnant in general. And while none of these differences has me worried about the impending birth of baby #2, they certainly have amused, bewildered, pleased, and sometimes irritated me.
Prenatal care
The best word to describe prenatal care here in Germany could be “thorough”. Whereas in Atlanta my typical check-up lasted five minutes and involved only a scale, a stethoscope, a measuring tape, and a condescending doctor with a bow tie, the pre-natal visit in Germany is much more elaborate, high tech and time consuming. I’ve had more ultrasounds than I can count, way more pelvic examinations than I had allotted for my lifetime, four separate blood tests for Toxoplasmosis (the disease spread by domestic cats), and numerous blood checks of my iron levels. And then there’s the bane of my existence, the CTG. After 20 weeks of pregnancy, each prenatal visit requires a 30-45 minute monitoring of the baby’s movement and heartbeat while the patient lies completely still on a cot. At first I tried to make Leo suffer through these ordeals, but not even Baby Einstein on the portable DVD player could keep him happy after the second CTG. Now I schedule appointments for when he’s at his daycare, and bring something in English to read. When I mentioned to the doctor that I had never had a CTG for my first pregnancy in the States, she seemed embarrassed and a little defensive. Since then I’ve heard that the usefulness of the practice is now questioned in the German medical community, but it remains standard procedure. But while they might be high-tech with their care, the general philosophy is, at the same time, very anti-modern medication. This aspect of my care didn’t surprise me, having been exposed to German pediatrics and administered Leo’s prescribed tinctures, fruit gels, salts and pomades for his kiddie colds and infections. For headaches- only water; for trouble sleeping- only warm milk; for a baby kicking too much at night- try a lullaby; for heartburn, eat almonds; for low iron, eat beets and drink a brown liquid called “herb blood”. Luckily I know about the effectiveness (in moderation, of course!) of acetaminophen, Tums, steak and yoga for these same pregnancy woes.
Pregnancy culture
In a word, pregnancy is “serious” to Germans. Though no native has confirmed this for me, I think this sentiment of stern respect reflects remnants of past political views on motherhood. While German women are no longer awarded medals for outstanding fertility as they were in Hitler’s day, the government does actively support the development of families through tax incentives, modest cash stipends that increase with each successive child born, and, in comparison to the U.S., very generous maternity leave options for women. Although Germans laugh about their country’s negative birth rate, these jokes are actually based on old statistics. The hosting of the 2006 World Cup boosted fertility rates by double digits, as did a recent change in a national law making it even more profitable to have kids. Now, Italy (yes, catholic Italy!) and Portugal lag behind their northern neighbors in reproductive terms. But although pregnancy may be serious in Germany, it is not idealized like it can be in America. When I was pregnant in the U.S. with Leo, not a day would go by without kind looks from a cashier at my bump, inquiries into my due date by people walking down the street, and even questions about the baby’s sex, probable name, and whether or not we were registered at Babies R’ Us. It seemed like we were all day-dreaming about the little treasure soon to be delivered by the stork. Here in Germany, on the other hand, not a single stranger has asked me ANY of the above questions, and nobody smiles at me for being pregnant. Rather, they’re more likely to avert their eyes if I attempt to make contact. Also, in Germany, pregnancy is not for the faint hearted—but then again, as Fernando and I are both learning, being German is not for the faint hearted. Painkillers and anesthetics during labor are frowned upon, and the epidural is the stuff of urban legends, said to cause paralysis, infant retardation, and death. Again, statistics tell a slightly different story: almost 30% of patients at the hospital we’ll be using in Hannover receive the epidural for pain management. But to the German mindset, natural childbirth is the only “real” kind. And to a significant minority of German women, the only really true childbirth is that which takes place at one’s own residence! Three women acquaintances here, all experienced in it, have tried to convince me of the benefits of a homebirth with a Hebammen, or midwife. Ummm, nice idea, but we’ll stick to the hospital.
Late prenatal and postnatal care
The situation seems good, and again, very different than in the States. Expecting mothers are required, by law, to leave their jobs six weeks before their due date, and then receive 80% of their salary for the next six months off (their spot at work is reserved for three years, a period called “Parents’ Time”, though only the 1st six months are paid leave). Granted I’m not in their situation, but six weeks to prepare or at least rest a bit before the birth would seem a welcomed gift. Then, once the baby is born, women here call up their personal Hebammen, who is kind of like a cross between a midwife and a home nurse. She visits daily for the baby’s first ten days to check on both mother and child, and then comes on request for eight weeks after that. The Hebammen, available to any new mother in Germany at no cost, is then required to maintain subsequent contact with the mother for as long as the baby is breastfed. I picked out my “free” nurse, Anja, from a little pamphlet and have met with her a couple times. She is young, enthusiastic, carries a black leather purse reminiscent of a country veterinarian, and speaks good English. Her biggest passion is delivering babies at home, a skill she honed through field work in Africa. Luckily, she doesn’t seem to be holding against me my wish to deliver in a hospital, and Leo was fond of her immediately. So despite these months of tedious appointments, misunderstandings at the receptionists’ desk, and no talk of baby names or shower gifts, we’re thinking, and hoping, that everything will turn out fine.
posted by J&F at 5:31 AM
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