Growing A Family: A Tale From Berlin

May 28, 2014

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?

P.S. – Find all the stories in this series here. Do you have a story about birth, pregnancy, adoption or infertility? Send your story to me, will you please?

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Une revue de mai | Le pamplemousse picoté
May 30, 2014 at 1:01 pm

{ 22 comments… read them below or add one }

1 Suzanne May 28, 2014 at 11:33 am

I am really curious to know if she still feels the same way about epidurals after the second birth. Or maybe that isn’t important anymore and what she feels is that mothers need to be heard no matter what.

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2 Fiona May 29, 2014 at 5:00 am

Hi Suzanne, I don’t have a tendency towards epidural or not, I just think that having been in a situation where I really needed some medical intervention and didn’t get it that it should be the woman’s choice. I felt quite scarred by my first birth experience and it affected my relationship with my son for quite some time because I couldn’t deal with the birth and I just don’t think that should have happened!

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3 happy May 28, 2014 at 11:47 am

Great perspective. Love hearing about how the German and Irish systems are similar and different from the American system. Look forward to more posts like this one. As an American, I had my first child in America and second in the Middle East. I found the second birth experience no better and no worse than the first – it was just different (and much, much cheaper). Certainly the U.S. system could learn something about the cost of medicine from other parts of the world.

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4 Christina May 28, 2014 at 2:17 pm

I agree that we could learn something about cost of medicine from other parts of the world, but before that happens, we have to change our legal system…Tort Reform. In the U.S., we can sue anybody for anything, so those in the medical fields have to protect themselves from the tiniest mistake with huge insurance costs. Those costs transfer to the individual receiving care…dental, medical, eye, whatever. In other countries, ding-dongs trying to get rich fast, passing on blame, or simply avoiding the fact that not everything goes perfectly every time are not able to crowd the legal system, and often times they have to pay for the legal costs of the other party if they lose. If we changed our system, we would save lots of money all the way around!

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5 Lisa May 28, 2014 at 12:19 pm

This is really fascinating! It’s interesting to read about the hesitation to intervene with pain relief in Europe as I’ve heard it to be the other way around from friends who have delivered in the US. And it’s wonderful that Germany provides so much PTO for new parents if you ask me.

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6 Paige Evans May 28, 2014 at 12:40 pm

This was so interesting to read! We are a US Army family living on a base in Germany and we are thinking about having a baby (our 3rd). I’ve heard epidurals aren’t offered here and though I had one for my son and didn’t for my daughter (not by choice but by the time I got to the hospital she was ready to make her debut!) having the option for an epidural makes such a difference! So many interesting things she said that I’ve seen that are true. Germany is so advanced in so many ways, you’d think they’d have a miracle potion that would make childbirth a breeze :)

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7 Meike June 1, 2014 at 12:13 am

I am German and about to have my second baby. I have no idea what the situation is like in Berlin, but around here (the North West) epidurals seem to be totally standard in hospitals. Many of my friends had one! I think it’s also interesting to know that every third child here is delivered by c-section.
In Germany there are several hospitals that offer alternative methods of pain relief as well and many independent midwives assisting women with homeopathic remedies, which I think is great.
On the other hand, I agree that the high number of ultrasounds and checkups might be a bit too much.

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8 Sweet Mama M May 28, 2014 at 3:32 pm

I love hearing about how different birthing practices are in countries other than my own! I’m from New Zealand and my birthing experience was definitely different to that of most American birthing experiences and different to the German experience as well! I’d love to share that with your readers if you’re interested!

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9 Meike June 1, 2014 at 12:54 am

Yes, please, I’d love to hear!

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10 Maike May 28, 2014 at 3:39 pm

Boah, I feel this post was only written for me. Because I am a German mother of two (both born in Berlin), with an Irish boyfriend (father of both), I had my first baby in the birth house (no doctors, no medication) and the second one in the hospital (emergency c-section) and I just looove to compare cultures and chatting about child birth.
(I might even know Fiona, because Berlin and the English speaking community here is sometimes like a little village. Sometimes.)

I love about Germany that there is such a variety of choice where you want to give birth and that it is all part of a very secure system and the midwives that I had were all absoulutely fantastic (I would have been lost without them) and paid by normal insurance.
But like a lot of good things all this seems to end soon because health insurances here refuse to pay midwives enough to make a living, so more and more quit and it is getting harder and harder to find one.

And it is true, I couldn’t relate to a lot of the birth sories here on Design Mom, because most of them were very ‘doctor driven’ and very little on the natural side, when it seems to me that most births don’t need doctors and medication, although of course, there is nothing wrong with doctors and medication.

As I see it, the most important thing is that you are well informed and that you have a choice, because everything else can make you feel very powerless and that is never good. And as the midwives here say (who fight for their profession):
It matters, how we are born.

Thanks for this post, I really enjoyed reading it.

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11 Sarah May 29, 2014 at 4:33 am

As somebody who has just given birth in a birth house in Potsdam (for the non-Germans: Potsdam is so close to Berlin it can almost not be considered an independent city) wihtout any medication and with only three doctor check-ups during the pregnancy (the rest were done by my lovely midwife) I can agree that Germans tend to be more on the natural side when it comes to babys and birthing. I ALWAYS regarded this as a good thing and was mostly astounded by the high number of people (in my eyes) who would choose a medicated hospital birth over a natural experience. For me, feeling in control of my body and having faith that it could do on its own what it was meant to do felt impossible in a hospital environment where I was only treated as somebody who could possibly not only become a mother but a patient.
Anyways, my point is (I’m not quite sure I have one), it’s super interesting to have the “outside” perspective on the German birthing culture which seems so completely different than the impression I’ve always had. Thank you so much for sharing your story Fiona!
By the way: It’s funny that you consider the trains to be on time, the unpunctuality of the Deutsche Bahn is literally one of the main things Germans complain about (to be fair, we, as a community, tend to complain a lot :)).

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12 Fiona May 29, 2014 at 5:03 am

Ha! Yes I know, my German husband thinks the train system is terrible too (especially S-Bahn!), but to me it is so luxurious! It’s all relative I guess!

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13 Fiona May 29, 2014 at 5:11 am

Sarah it is interesting to hear your view on it from a German perspective, I am glad you had a birth that you wanted in a birthing house. And yes, the train system here is so luxurious to me but my husband always complains too (especially about the S Bahn!!). All the best to you and your wee little one :-)

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14 Fiona May 29, 2014 at 5:02 am

Hi Maike! I don’t think I’ve met you but you are right, the english-speaking community here is like a village! I’m glad you could related to our story!

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15 Maike May 30, 2014 at 12:39 pm

We’ll bump into each other one day, I’m sure! :-)

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16 Freida May 28, 2014 at 5:52 pm

Thank you Fiona for sharing (what lovely advice!) and Gabby for pursuing this topic… I find it fascinating! Looking forward to more :)

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17 cath May 29, 2014 at 12:47 am

I loved that story, thank you for sharing Fiona!
Maternity leave in France in the same as in Germany, interesting! Epidurals however are not at all frowned upon here, you get one if you want it, you meet with an anesthesiologist no matter what.

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18 Joanna May 29, 2014 at 5:46 am

Lovely post! Having been inspired by your growing a family/ birth photography post a few weeks ago, i actually wrote my own about my four births here in Norway. It’s in Norwegian though… ;-) Norway has very good maternity/paternity leave. 12 months with 80% pay or 9 months with 100% pay. And the parents can divide it between them, apart from the first 6 weeks, I think. The approach to births here is also pretty natural, but epidurals are quite common, although I never had one. Keep these posts coming! Love them! (Also just read your Mental health update post. Thank you for sharing!)

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19 Joanna May 29, 2014 at 5:50 am

If anyone’s interested, here is the link:
http://jojosoppogned.blogspot.no/2014/04/fdsler-og-sann.html
Google translate works, but it won’t all make sense… :-D

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20 Nina May 30, 2014 at 2:37 pm

Wonderful post! I’m so fascinated by births around the world. I never would have thought Germany would be a place where they didn’t like medicated births. Being such a progressive country I wouldn’t have thought they would take that option off the table. I like Fiona’s advice, decide what you want and do it. I think too many women are “talked into” having their babies how others want them to. That’s not right nor fair. A woman should decide how she wants to have her baby, medicated or not, hospital or at home. It’s all up to her. Love this series, keep ‘em comin’!

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21 Leslie June 1, 2014 at 9:42 am

Such a lovely story, and I (unfortunately) can relate with the epidural aspect. I live in Amsterdam, The Netherlands, and there is also a tendency to be talked out of having an epidural…I’m definitely going to push for it (pun intended) with my next child, but as Fiona experienced, you never know how it’s going to go!

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22 Luisa June 2, 2014 at 11:15 am

Loved this story! For what it’s worth, I live in Berlin and gave birth to my son here and wasn’t pressured at all vis-a-vis the epidural. In fact, after 12 hours of labor that went nowhere and IV pain relief that did almost nothing, the midwife at the hospital told me to get an epidural…which turned out to be pretty much the best thing ever! :) Anyway, just another perspective.

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