Pregnant in Germany: Doctors and Midwives

I recently realized I’d been mum about the latest happenings in the German pregnancy process.  This is mostly due to the fact that I feel like I am constantly learning the system and have yet to fully understand it.

Another reason, though, is my knowledge and experience seem to be composed thus far of bits and pieces, nothing that flows like a story should.  Or a blog post, for that matter.

But, instead of keeping silent, I’m just going to give you what I’ve got, the scraps and squiggles of what might become a clear picture after the birth.  Today, I’ll just focus on two caregiver roles: Doctors and Midwives.

Doctors

The doctor that a pregnant woman visits in Germany is only the “gyn” part of the ob/gyn that Americans are used to seeing.  In truth, it seems she is more concerned with the care and condition of the uterus than the birth of the baby.  These gynecologists do not deliver babies.  And, my midwife went so far as to say you don’t want these doctors with you in the delivery room anyway because chances are they haven’t been to a live birth in years!

Every time I have been to the doctor, she has wanted to do the sans pants dance.  The prevailing opinion in Germany is that if you don’t do these kind of exams, then what are you doing?  Nothing!

When I told my doctor this wasn’t necessary every visit, she replied that Germans having babies in America do not like it when American doctors don’t do a single thing in most prenatal visits.  I see both sides, but my pants and I like each other, and we’re sticking together unless absolutely necessary.  Sorry, doc.

I should also mention that just because the gynecologist taking care of the prenatal care doesn’t attend the birth, it doesn’t mean that the mama won’t have any doctors at the birth.  The obstetrician is determined by the patient’s choice of hospital (and also the type of insurance).  I’ve gone on two of three hospital tours already, but I’ll save that experience for another post.

In my research, I’ve read (sorry, I cannot remember where!) that in Germany a midwife can attend a birth without a doctor, but a doctor cannot attend a birth without a midwife.  Really?!  The first statement doesn’t surprise me, but the second one is quite foreign to my American experience.

In terms of cost, just like any other doctor I visit in Germany, I must pay 10 euro every quarter (three months) as a kind of co-pay to visit the doctor.  Some doctors charge for ultrasounds (mine doesn’t) and tests that aren’t deemed absolutely essential.  But prescriptions and necessary procedures are covered at 100%.  This included my RhoGAM injection (not optional) which previously cost me almost $500 in the US.

It may be more expensive to live in Germany, but it sure is cheap to have a baby here!

Midwives

In Germany, every pregnant woman is entitled to midwifery care.  This includes before, during, and after the birth.  The mama can choose her midwife and, if she wants, can have three different women for the three different types of care.  Most women, however, only have one or two midwives.

As is the case in the US, malpractice insurance has skyrocketed forcing many midwives to abandon the practice of attending births.  When I looked for a midwife for the birth, I was only able to find midwives who did home births or worked in free-standing birth centers.  Only a select few still accompany women to hospitals for birth, and only one of the three hospitals in my city allows this practice anyway.

That’s not to say that every mama won’t have a midwife.  They will.  But the midwife provided will be a staff member of the chosen hospital and will be a brand new face on the “birth day.”  As in the US with labor and delivery nurses, the woman will have no choice in which midwife is assigned to her.

However, a choice for before and after care still remains.  I’ve selected a midwife who speaks excellent English and who will travel to my house for ante- and post-natal appointments.  This service is covered by my insurance, and I don’t have to pay any extra for the home visit.  Score!

Starting at 30 weeks, pre-natal appointments are supposed to be every two weeks.  The midwife is allowed to alternate with the doctor on these visits, so that the patient only has to go to the gynecologist once every four weeks.  Since my doctor has a horrendous waiting time (sometimes up to two hours!), I am a super big fan of this arrangement!

After the birth, the midwife comes to your home every day or every other day for the first week or so.  She asks how you are, answers any questions, assists with nursing, weighs the baby, and helps with any concerns.  After that, the frequency of visits decreases over the next few weeks until the midwife has determined that all is well with the new baby’s arrival.

When I’ve completed my third hospital tour, I’ll post on what I’ve discovered about the system here.  Until then, I’m studying for my driver’s license exam and going to Berlin for one last travel fling before the baby makes his debut.

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5 thoughts on “Pregnant in Germany: Doctors and Midwives

  1. Pingback: Pregnant in Germany – Hospitals « Thrifty Travel Mama

  2. Pingback: Pregnant in Germany: The Midwife Follow-Up Report « Thrifty Travel Mama

  3. I think it’s great at you pick up on how the gynocologist’s in Germany insist on a full examination every time you go for an appointment. I am from England and I had my first baby in London. I Am now pregnant in Germany and I have experienced a totally different system. In England it is only midwives that lead the show, no gyn no doctors unless there are complications. I personally prefer this as I find midwives are more caring for the mother and baby and not just concerned like you mentioned with the cervix and uterus only! I refused to have an internal scan and a thorough examination with my gyn and because of this she refused to give me my Mutter Pass. I tried to explain that this what something I wasn’t used to but it didn’t work! Anyway, I met my midwife for the first time 2 days later and she happily gave me my mutter pass without all those not so pleasant and uncomfortable checks! She said it is not the law that you have to have a gynocologist in Germany and you can do it all with just a midwife! This is a route I am taking and I will just have my scans when I visit family in England. Apart from the examinations and scans this is all the gyn does anyway.

    • Hi Hannah,
      Wow, I am surprised that the gyn wouldn’t give you a Mutter Pass! Okay, some part of me isn’t surprised because they like rules here :). I know what you mean – those exams are so invasive and seem quite unnecessary if you have no risk of infection or complications. Awesome that you found a great midwife and can go that route. Will you deliver here or back in England?

  4. I’m so lucky to have stumbled upon your website. I’m American and I moved to Germany to live with my German husband. We are having twins and this is our first pregnancy. I talked to my friends that have recently given birth in the U.S. and the way that they do things here is very different than what is done in America. I’ve had an ultrasound at each of my prenatal visits. My german is very limited and I was lucky to find a gynaecologist who speaks some English. She has been great and I trust that she knows what she is doing. I didn’t know that I needed to find an obstetrician and a midwife. I’m only twelve weeks pregnant so we still have time to get all those things done. Thank you for posting about your pregnancy journey!

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