By Gabrielle. Image via The Glow.
I’m fascinated with birth cultures. (Have you see Babies? So, so good.) So when Fiona offered to answer a few questions about the birthing system in Berlin, I couldn’t wait to share her with you. From the amount of scans during a routine pregnancy to weight gain scrutiny and a delightful post-natal leave program, it’s all interesting stuff. And just wait until you hear of the area’s medicated birth philosophy. Friends, I truly hope you enjoy this interview! Welcome, Fiona!
Q: Describe the moment you knew you were pregnant! How did you tell your first born?
A: When our first-born turned two, we decided it was a good time to try for a second wee little one. I had not had a period since giving birth as I took the mini-pill immediately afterwards whilst breastfeeding and stayed on it, so I had absolutely no idea how long my cycle would take to get back into any sort of rhythm. A few weeks after I stopped taking the pill, I had pains in my side one night that just seemed really strange, so I went to the doctor the next morning and she gave me a pregnancy test to take. I was surprised and so so happy to see a very faint, but certainly there, second line! Wow, I had not expected to get pregnant so fast!
Because I had had some unusual pains she did a scan but could not see anything just yet as it was so early in the pregnancy. I rang my husband and then my parents and siblings with the exciting news and then a day later, started getting morning sickness (which luckily didn’t last long!). We decided not to tell our little boy until he could see a bump as we felt that nine months is so long for us to wait – so it must feel like an eternity to a two-year-old! When we did tell him we used a little book to explain what was happening and it ended up being his bedtime story for the last two months before his sister arrived. I don’t think he really understood, but he was excited by our excitement!
Q: Talk about your doctor’s visits – what is the process in Berlin?
A: We live in Berlin, Germany, as my husband is from here, but I grew up in Ireland and so I find it fascinating how even within Europe cultural differences can be so large. One of the biggest aspects of these cultural differences that I have experienced is the attitude to and process of child-bearing and rearing.
In Germany, the medical system is such that a pregnant woman will go to her gynecologist every four weeks until week 30 and then every two weeks after that. Once she goes overdue, she will visit the doctor or midwife every other day. The minimum number of scans during a pregnancy is three: initially to check for a heartbeat, then at week 22 for a full 3D-scan, and then again around week 30. But, I don’t know anybody here who has only had three scans – I had six in my first pregnancy and about 15 in my second, and I think around five or six scans is usual.
When I compare this to Ireland, where most pregnancies are only scanned a maximum of twice, it does seem that the doctors here are very careful. At the standard check-ups every four weeks, blood is also taken, the baby’s heartbeat monitored, and weight gain checked. I got given out to by the doctor a number of times for gaining too much weight (around 16 kg – perhaps a little too much as I just loved eating chocolate whilst pregnant but in no way medically dangerous!). Luckily I didn’t let it get to me too much, but I know it is a sensitive issue for a lot of women and doctors saying that certainly wouldn’t help!
Another big difference to Ireland is that almost everybody here finds out the gender of their baby as soon as possible, whereas in Ireland it is typical to wait until the baby is born to see whether it is a boy or girl. We had decided to not find out with our first boy and people here thought we were mad because we couldn’t get everything ready in the right colours! With this pregnancy, I also didn’t want to find out but in the end we did know it was a girl before she was born.
In addition to the doctor’s visit (or instead of every second one if the woman so wishes), a pregnancy is also supported by a midwife who visits before the birth to discuss plans and does have a little bit more time than the gynecologist to go through everything. She then also visits regularly for approximately eight weeks after the baby is born to weigh the baby, check on the mother’s recovery, help with breastfeeding, etc. and I found that to be invaluable after both babes! The same midwife is, however, not present at the birth unless this is paid for privately.
Q: Why do you think medicated births aren’t the norm in Berlin?
A: This is such a difficult question to answer. I mean, Germany is such a technically-forward and “organized” country, for want of a better word. The trains really do come on time, the social system is excellent, the medical care for pregnant women fantastic. But when it comes to giving birth, it is back to nature in most cases! A lot of women chose to give birth at a Geburtshaus (midwife-run birthing centre) where there are no medical pain relief options (natural and homeopathic remedies are available as far as I am aware), some chose a home birth and a lot, like me, go to a hospital.
Unlike in Ireland or the UK, gas and air is not available in the hospitals. I have heard that in one hospital in Berlin they are now introducing it so I will be going there with my next one! But up until now this has not been an option. With regards to an epidural, this is theoretically possible and some hospitals do seem to “allow” it more easily than others, but my own experience is that everything will be done to convince the laboring woman that she does not need it. I also experienced that midwives and doctors tend to focus on the risks associated with an epidural and it seems to be a little frowned upon, which is so crazy in my book!
Growing and delivering a baby is such an amazing thing no matter how the baby is born – surely we need to understand and support each other and not frown upon how others chose to birth their babies! So, although I don’t know the statistics, most women I know here have given birth naturally without any pain relief. Interestingly, Germany has the lowest birth rate in the European Union and Ireland the highest. Of course, there are many factors that play a role in this, such as religious backgrounds, working and family cultures, etc., but I can’t help but think that perhaps if childbirth was made a little more bearable perhaps more children would be born!
Q: How was bed rest? How did you cope with having an older child? Where did you find the most support?
A: The early pregnancy with number two was a busy one, as it is for everyone I am sure! My husband and I were both working full-time (we are both engineers and work together), I was travelling for work regularly, and of course we had a two year old! From about week 22, I started getting stitching pains down below at the end of a day and did mention this to my doctor at the next visit. She checked me and said that my cervix was shortening and I should take it a bit easier in the coming weeks. Another month passed and the pains became more regular, so she reduced my working hours to five hours a day. A reduction of working hours is quite typical in Germany during pregnancy if there are any issues or the job involves standing a lot, carrying heavy things, etc. and the salary is paid in full.
In week 28 I started having mild contractions and was put on magnesium and bed rest. I was allowed to get up to go to the toilet, make myself some food a few times a day, and go to the doctor for a check once a week, but other than that had to lie down entirely for the next eight weeks! Because I had been working, our son was in kindergarten and my husband was able to work short days for those eight weeks to be able to pick him up every day. I was scanned weekly and around week 32 it seemed she was going to come within the next 72 hours, so I was given steroids to speed up her lung development.
It was a very worrying and lonely time (we would love to have had some family around!) and it was hard on my husband taking care of our boy on his own every evening and at weekends, but we had to fight for every day for her to stay inside…and we did. Somehow and against any prognosis that we had, our little girl was still inside at 36 weeks and I was allowed to do everything normally again. At the 36 week check-up I was 3-4 cm dilated! She was sure she wouldn’t see me again the following week. But she did, every week until the due date, and then every second day after that until 41 weeks! To this day we have no idea how we were so lucky, but of course so thankful and grateful for how it worked out in the end.
Q: Tell us the story of your daughter’s birth…how quick was it?
A: Boy, it was quick! Because I had been dilating for weeks without any contractions showing up on the ECG, my doctor had warned me that as soon as I felt anything to immediately go to the hospital. So, on a Friday night a week after the due date, I had just turned out the light to go to sleep when my waters broke. It was just after 11:00 pm. We immediately rang a good friend who had been on standby for weeks to look after our boy when the baby came, and the hospital to say we would be arriving in shortly. Berlin is a big city by European standards, and so our friend arrived around 11:30 pm and we set off for the hospital. It is only a short drive but I was having strong contractions when we arrived so it took quite a while to walk from the car park into the hospital and make our way up to the labour ward. I have heard in some countries the laboring woman is met with a wheelchair – is that so in the US? I would have loved it!
We got up there on the seventh floor at around 12:00 am. The midwife on duty saw me having a contraction in the corridor and immediately got me into a room to be checked. Guess what, I was fully dilated! She rang a doctor, rushed me into a delivery room, and told me to get undressed. Of course, my husband and I were totally shocked as our first boy took over 20 hours to be born!
Because I had been denied an epidural during my first birth, I had pre-programmed my mind to say, no matter what, “I am having an epidural.” So I said that. And the midwife responded, “No, you are not. You are having a baby.” I still didn’t believe her and asked for the bathtub in the delivery room to be filled. She then said, “Listen to me. By the time that bathtub is full, your baby will be here. At the next contraction –push.” So I pushed. I think it took three more contractions and our beautiful darling girl was here. Healthy and tiny and gorgeous and oh so worth every minute of bed rest!
Q: What advice or comfort would you give other pregnant women just before delivery?
A: I would advise to be strong on what you want. If you feel that you need pain relief, insist on it. When delivering my first baby, I was talked out of getting an epidural (to put it nicely!) and still feel very emotional when I think of how helpless I felt in that delivery room. It is your body and your baby. You decide what you need.
Q: How is the maternity leave in Berlin? Is your partner able to share in the leave, as well?
A: We are so lucky here! We have a legal maternity leave of six weeks prior to and eight weeks after giving birth, during which time a woman is not allowed to be employed and receives full pay. After that, a couple has up to 12 months paid parental leave to take, and another two years unpaid, but this is less common in the former East Germany. In the former West Germany it is more common for mums to take more than the first year off work and daycare for under-three’s is not nearly as widely available as here in Berlin. I know it must sound funny to refer to “East” and “West” as it has been a united Germany for over twenty years now, but there are still a lot of differences – perhaps in the next generation this won’t be the case so much anymore.
The paid parental leave can be split any way that the couple choses, and is paid at approximately 65 percent of the pre-birth income of the respective parent. So, I was off work for the first 11 months of little E’s life, and my husband then took three months off. He has just this week gone back to work, and little E has started with the same child-minder that took care of our son before he went to kindergarten. We are also lucky when it comes to this: the child-minder and kindergarten is state-subsidized, and parents pay an income-based contribution, which it not so high and manageable for most. And in Berlin (not all of Germany), daycare from age three is free! I am sure this makes the juggling that is combining a family with a career a lot easier than in other countries – although it is still a juggle and I am always so interested in hearing how other families manage! – and is surely another reason why birth rates here should be higher than they are!
Q: Please finish the sentence: I really felt like a mom as soon as…
A: I held her. And that was a big relief, because I hadn’t immediately felt that with my son. And the next morning, when my big boy met his little sister for the first time – my heart almost burst!
Thank you, Fiona. For this, especially: “Growing and delivering a baby is such an amazing thing no matter how the baby is born – surely we need to understand and support each other and not frown upon how others chose to birth their babies!” AndI think your advice to mothers – and all of us, for that matter – to “be strong on what you want” is an absolutely perfect way to live. Thank you for adding your beauty to our day!
Friends – and especially those who live in a spot where birth practices are kind of unique – I’d love to hear about your own cultures as it relates to how your babies are delivered and welcomed. Will you share your stories, too?