German Well Baby Visits

Thrifty Travel Mama | Expat Life - withaBabyWe’ve been trudging off to the pediatrician an awful lot these past few weeks.  But, thank God it hasn’t been for illness.  Nope, it’s been time for all the boys to get their check ups!

I’m not quite acclimated yet to the German well baby visit schedule.  But, I seem to have lived here long enough to forget the American schedule.  Either that or I’m totally sleep deprived.  Yeah, let’s not go there.

Waiting rooms at the pediatrician are much like the US, only with more wooden toys.

Waiting rooms at the pediatrician are much like in America, only with more wooden toys.

The typical visits that a baby will have to the pediatrician in the US are at birth, 2-3 days, and 2, 4, 6, 9, and 12 months (yep, I had to look that up).  In Germany, it’s slightly different.  Big Foot also got an examination at birth and at 2-3 days, but then he is supposed to go at 6 weeks, 4 months, 7 months, and 12 months.  These visits are labeled with the letter U and then a number, starting with U1 and going up.

Exam rooms are much the same as in the US.

Exam rooms are much the same as in the US.

What was most surprising to me, however, was not the frequency of the visits but what the doctor does (or doesn’t do) at the check-up.

I’m almost certain that the midwife or obstetrician – and not a pediatrician – performed Big Foot’s U1 check after the birth.  And, I know for sure that his hearing was not checked at the hospital.  In fact, it wasn’t checked until 6 weeks!

Pediatric Ultrasound machine.

Pediatric Ultrasound machine.

Even more strange than watching your little tiny baby have a hearing monitor shoved in his ear is watching him get an ultrasound of his hips.  It’s quite routine for babies here to get 1 or 2 hip ultrasounds in the first few months of life.  The pediatrician has a machine right there in the exam room, and performs the test himself.  He explained to me why they do this, but honestly I completely forgot since Big Foot’s sockets were normal.

Baby exams take place on this changing table underneath a heat lamp.  The scale is old skool - not digital.

Baby exams take place on this changing table underneath a heat lamp. The scale is old skool – not digital.

Immunizations don’t start until the 4-month visit.  Babies in Germany get huge combination shots with 6 or 7 diseases all rolled into one.  I asked about separating these whoppers into smaller bite-sized doses.  No dice.  It’s just not possible.

Don't forget to wash your hands!  The bathroom has a child-sized sink and potty.

Don’t forget to wash your hands! The bathroom has a child-sized sink and potty.

Germany doesn’t require all school children to be vaccinated like in the US.  As such, doctors are usually open to changing the schedule if the parent desires, but one should not expect to get away without an earful of why that decision is completely and utterly stupid.

Shot records are detailed in a little yellow immunization booklet called an Impfpass.  This is to be kept with the child’s check-up records which just happen to also be bound up in a yellow book.  Surprise, surprise, just like the Mutterpass, all these documents are the responsibility of the parent.  I must remember to take the booklets with me for every well baby/well child visit and any extra trips we make to do catch-up immunizations.  Geez, way to give a parent one.more.thing.to.do.

At each checkup, I’ve received safety pamphlets to keep with my child’s records.  The pages are filled with little pictures illustrating the dangers of having a child in your house.  Don’t put furniture in front of the window.  Put your cleaning products out of reach.  Look both ways before you cross the road.  Don’t carry a baby and a hot beverage.  Be careful when cooking and the children are around.  Don’t tie a pacifier around a baby’s neck with a string.  And on and on these little booklets go.  We get one every.single.time.

The one thing that I don’t get a lot of are questions about my children’s development.  At Big Foot’s last check (4 months), the doctor didn’t ask me anything about sleeping.  Or eating.  Or fussiness.  Or general temperament.  Or if he could roll over.  Or do jumping jacks.

The pediatrician did ask how it was going.  I said, um, okay, and tried to talk to him about how Big Foot doesn’t sleep well at night.  He brushed me off and merely said, “It’s an adaptation issue.”  I protested that the other two didn’t have “adaptation issues.”  He then smiled his aren’t-you-such-a-dumb-little-American smile and replied, “Well, 1 out of every 3 babies has it, and he’s your third.”  No other questions.  No other answers.  Mystery solved.  “Adaptation issues.”  Case closed.

On the plus side, I don’t pay anything for my boys to go to the doctor.  Ever.  Not for well visits, not for sick visits, not for shots, not for tests, not even for after hours urgent care or ER visits.

So even though our pediatrician is a piece of work (and he’s our second one in two years so I’m not keen on trying another), at least the coverage is very good.  Now if I can just keep our trips to his office to a minimum – and the kindergarten sickies at bay, I’ll be one happy mama.Signature-Marigold

Pregnant in Germany: The Midwife Follow-Up Report

It feels like I have been out of the blogging routine for far too long.  It’s only been a few months, but so much has happened during that time.  I’ve got several updates, trip reports, and reviews to get out of my system before moving on to new stuff.  All the while, I’m doing my best to keep up with life and little boys and the adventures that come with the privilege of being a mama to three. 

Hopefully all your “what about…” questions will be answered very soon, starting with an update on my thoughts regarding what I consider a very positive aspect of the social health care system in Deutschland.  Take it away!

As I mentioned in a previous post, all pregnant women in Germany are entitled to midwifery care before, during, and after the birth of their child(ren).  Though my experience with one of the midwives at the hospital was less than stellar, I definitely lucked out with my ante- and post-natal care.

My midwife (let’s call her Maya) was of great help to me before Big Foot arrived.  She spoke great English so I didn’t have to stress about my German skills which seemed to rapidly disintegrate as the pregnancy progressed.  She came to my house so I could spend more hours at home than in a doctor’s office.  She brought a wealth of experience not only about the German system but also of the British system which seems to be a hybrid of the American way and the German way.

When I experienced a host of unexpected and severely unpleasant symptoms, Maya prescribed homeopathic and natural remedies.  She also presented me with free samples and coupons.  I think we might have been made for each other!

Maya also offered me suggestions on what to do and where to go when I realized I would need to be induced.  She told me which hospitals would be likely to cave to my sob story, and which doctors were better for situations that might arise such as a breech baby.

After Big Foot was born, I emailed Maya from my phone while waiting to be released from the hospital.  She set up a time to visit me the very next day which just happened to be a Sunday.  After that, she dropped by every other day for the first week and once a week after that.  In all, Maya came to my home for seven post-natal visits.

Each time she arrived, Maya would ask all sorts of questions about how I was doing, how Big Foot was faring, and how the family was getting along.  She really listened to me and cared about my answers.  She offered advice when I needed it without being pushy.

She checked my recovery, weighed the baby, and even did the heel prick test (similar to the test performed in the UK to check for hidden health conditions) so I wouldn’t have to make a trip to the pediatrician.

In the last two visits, Maya showed me some exercises I could do to wake up my abdominal muscles and strengthen my floppy midsection.  She left me with a poster detailing additional moves but not without first demonstrating each one to make sure I understood and could perform them correctly.

Maya mentioned to me at our final meeting that I still had several visits left in my quota.  Apparently, I can call her at any time up until Big Foot’s first birthday with questions, concerns, etc., and her services would still be covered by my insurance.  Wow.

I can’t say enough good things about my experience with a midwife, compliments of the health care system in Germany.  The only thing that would have made the whole shebang better was if she cooked, cleaned or babysat the older boys.  I guess that’s asking a bit much, but hey a girl can dream big, right?

Anyhow, despite my hospital horror show, it’s good to know that will remain but a lone dark spot in a mostly brilliant albeit baffling German birth experience.

The Terrible, Horrible, No Good, Very Bad Birth

Disclaimer: This is NOT a short post!

Ever heard of the children’s book Alexander and the Terrible, Horrible, No Good, Very Bad Day written by Judith Viorst?  It’s a classic tale of an entire day gone awry for a little boy named Alexander.

Alexander, dude, I can so totally relate.  I had a day like that, only so much worse.

I’ve often been asked about my experience giving birth in Germany over the past eight weeks (eight weeks!  already?!).  Was it good?  Bad?  How did it compare to the two other births in the US?  As the title of this post suggests, it was H-E-double-hockey-sticks.

The terrible awfulness actually began with my due date landing smack dab in the middle of August.  Though some people may try, it’s not like you can really plan these things.  And, even if I did plan it, I would never have known to avoid the month of August.

August is the one and only month a mama should absolutely positively should avoid if ever giving birth in Germany.  It’s holiday time – and I mean holiday in the British sense, not in the Christmas-St.Patrick’s Day-Easter sense.  Doctors, midwives, friends, anesthesiologists, firefighters, garbage collectors, telemarketers, nose pickers, etc. all skip town to lay on a beach somewhere in Italy until they’re crispy.

While my friends fried themselves in the sand of faraway countries and continents, I was left to wonder what in the world I was going to do with the existing children while I popped out the next sibling.

As my due date approached and the baby made absolutely no signs of making an early or even on-time appearance, I began to realize I would have no other choice but to have my labor induced on the last possible day of the month when I’d have reliable childcare for Screech and T-Rex.

Yeehaw – I just love partying with Pitocin.

By the way, convincing a doctor in Germany to induce labor before your due date is next to impossible unless you have complications.  I somehow found myself with an extremely kind hospital obstetrician who agreed to put me on the drip just one day after my due date… but only because I had already had two other inductions and I managed to put on a rather impressive puppy dog face.

On the morning of the appointed day of dread, everyone in the house got up as usual.  I knocked some breakfast back, kissed T-Rex & Screech goodbye, and walked myself to the hospital, sniveling the whole way.  You’d have thought that would’ve put me into labor.  But no.  Apparently, I’ve got a bomb-proof amniotic sac.

Doc Sci dropped the boys off at our neighbors house and then hopped on his bike to meet up with me in the labor & delivery ward.  Upon arrival, I was given an ultrasound, a nasty needle in my arm, and the depressing news that I was only 2 cm.  I was not, however, given a hospital gown or a label on my wrist with my name, blood type, and favorite flavor of ice cream.

The king-sized bed and that blasted CTG.

I was then shown to my room.  It was twice the size of the rooms in the hospital where I had Screech and T-Rex, complete with a king size birthing table, a jacuzzi, mood lighting, and a minibar serving up your choice of regular Pitocin, extra-strength Pitocin, or no-pain-no-gain Pitocin.  I voted for the full-on, let’s-get-this-pain-train-a-rollin’ cocktail, but the midwife and doctor wanted me to start with the wussy stuff.

Speaking of doctors and midwives, I was assigned two midwives (a “real” one and a student) and a doctor.  Predictably, I saw the student the most.  In Germany, it’s the midwife that runs the show, but if you’re in the hospital you do need the doctor for a C-section, rupturing membranes, or other serious matters.

I was ordered by said midwife to lie down on the bed in order to record 30 minutes of baby heart rate and mama contraction data on the monitor (known in Germany as the CTG).

Well, thirty minutes turned into hours.  Doc Sci and I asked every hour (or more) when my water would be broken, when the Pitocin would be turned up, when I could walk around, when the pain hurricane would let loose.  “Just wait a little longer,” we were told.  “The doctor wants to see more data on the CTG.”  What is this thing telling the doctor?  My fortune?  Winning lotto numbers?

I had hoped the doctor would break my water upon arrival.  But it’s rare that doctors will rupture membranes at only 2cm.  I needed to dilate more, and I needed Pitocin to help me dilate.  Such a sick and vicious cycle – all charted on the CTG, of course.

Defying all natural birth common sense, I was never given the chance to get up and walk around to get the contractions going.  I was just supposed to lie down and take it.  Er, I mean give it… to the slave master CTG.

Lying down. all. day. long.

Well, except for lunch.  The staff needed a lunch break, and they didn’t want pesky patients ruining their schnitzel unless it was an absolute emergency (and apparently getting my baby out RIGHT THIS MINUTE did not count).  In order to keep us from buzzing the midwife in between her bites of bratwurst, we were sent off to the patient kitchen in another part of the hospital to have our lunch.

The kitchen was deserted.  No one paid any attention to what, if anything, I ate.  A stein of Bavarian beer and a basket of pretzels was supposed to be waiting for us.  Instead, we got water, bubbles or no bubbles, because the hospital was crazy busy and didn’t know to send a lunch up for me.  Good thing Doc Sci happened to bring some sandwiches and snacks.

When we had had enough of being bored and ignored, we went back to the labor and delivery ward.  Empty.  Still working on the schnitzel apparently.

Lunch finally was delivered a few hours later – bread, butter, cheese, cold parboiled carrots, and tea.

Well that’s all fine and dandy ya’ll, but I’m here to have a baby and I would like him to come out NOW.  It was like the Soup Nazi worked there.  No baby for you.  Come back, one hour.

And come back I did.  Time and again.  Begging and groveling like a total loser.  Oh please oh please oh please send the doctor in.

At half past four, I finally made the cut.  The doctor showed up and agreed to break my water.  Too bad I was still only 2cm.

I’ve had my membranes artificially ruptured twice.  I couldn’t feel anything either time except for whoosh and gush that comes afterward.  But, you know things can’t be that simple in a culture where pain is noble.

Instead of the crochet hook, I got fingernails on a chalkboard.  Doctor Does-It-Hurt-Yet scratched a hole in my membrane.  Let’s put things in perspective.  After 8 hours of Pitocin pulsing through my veins, I could barely feel the contractions (and by this time the drip was turned up as high as they would allow it to go), but I felt every last scrape of her nails.

Doctor Does-It-Hurt-Yet’s partner in crime was the Merciless Midwife, a.k.a. the second shift queen of nastiness.  She again gave me the bit about lying down for 30 minutes of CTG recording.  After 8 hours of that mantra I was done being told to stay horizontal when vertical is what you need to speed things along.  I informed her that I would be getting up to use the bathroom, and she retored, “Well, it’s your birth – do you what you want.”

Oh, GOOD!  We’re finally getting somewhere.  Now that I can do what I want, I’d like to get in the birthing tub.

That big teacup is the birthing tub.  Water birth is very common in Germany, and all the staff are trained to deliver babies in the water if the mother so chooses.

From that point on, things started to really heat up.  I was the frog in the pot that just kept getting hotter, and I was about to be boiled alive.

Sitting in the birth tub, the contractions became too intense to handle.  I felt like my tailbone was being smashed to bits.  And that’s because it was, only I didn’t know it yet.

I admitted to Doc Sci that I just couldn’t take the pain anymore.  It was time for an epidural.  What I failed to explain to him, however, is that German hospitals don’t give out epidurals like candy.

In the US, the mother is encouraged to sign all the consent forms for an epidural before going into labor so that (ideally) at the exact minute she wants one, she can have it.  In Germany, doctors and midwives purposefully do not give the mother any information or paperwork for an epidural for the express purpose of delaying the intervention as long as possible in order to (hopefully) avoid giving it to her.  The bottom line – if you want an epidural in Germany, you’re going to have to fight like mad to get it.

And fight – and scream – I did.  Remember Miss Merciless Midwife?  Here’s a little exchange I had with her…

“Hi, how are things going?”
“I want an epidural.”
“Are you sure?”
“Yes, I want an epidural.”
“Do you feel a need to push?”
“No, I feel a need to get an epidural.”
“Do you want me to check you?  Maybe you’re 10cm.”
“No, what I want you to do is call the anesthesiologist.”
“Okay, I can do that.  But let’s just give it a little time and see how you’re doing.”
“The only thing you’re going to give me are DRUGS!”

At this point, I start shaking uncontrollably because my body does not handle adrenaline very well.  Here I am, scantily clad, convulsing, shrieking, and begging for a fix.  If it weren’t for the swank hospital suite on my insurance company’s dime, I could’ve very well been in some back alley in the Bronx.

After my scary self convinced Merciless Midwife to actually call the anesthesiologist, I had to wait about an hour for him to arrive.  The hospital was incredibly busy due to – as I mentioned previously – lots of staff members being on holiday.  Plus, Germans generally like to use fewer staff to do more work.  I later found out that there was only one anesthesiologist there that night for the entire hospital which just happens to be one of the largest in the whole of Germany.  Brilliant.

Because I couldn’t stop shaking, I was given drugs to stop the contractions so I could sit still enough for the big poke.  Then I was given Pitocin again to restart the contractions.  Back and forth between two extremes, and yet in all of this the baby was not coming down and out.

I wanted to avoid an epidural if at all possible.  I somehow managed to get Screech out without one, and the recovery is a million times faster.  But if you need it, you need it, and better to get it over with and the baby out as soon as possible.  When I had an epidural with T-Rex, and it was glorious.  After more than 18 hours of induced labor, I fell asleep for two hours, woke up, pushed for 10 minutes, and that was the end of that.

However, this epidural was NOT the heaven I remembered.  I still could feel every. last. contraction.  I was breathing through each one, shaking from the adrenaline, and in a world of hurt.

Before the anesthesiologist left, he instructed me to wait 15 minutes and assured me that the drugs should work by then.  But, the crash, bang, boom happening at the end of my spine was not letting up.  I had to once again beg, grovel, and plead with Merciless Midwife to call him back.  And what did she tell me?

“Just wait a little longer.”
“How much longer?
“Five minutes.”
“… Okay, it’s been five minutes.  It’s still not working.”
“Just wait a little longer.”
“What is this, a prerecorded speech?  How much longer?”
“I don’t know.”
“THEN CALL HIM!  In case you somehow missed it, the epidural is NOT WORKING!”

I told you she was real special.

When she finally called him, he had gone home for the night, and the next anesthesiologist had to be briefed.  The new guy gave me something else which did end up working after another 20-30 minutes.

But by then, I had had it.  It was almost midnight, and all I could think of was how ridiculous the whole ordeal was.  The staff was not interested in helping me get this baby out at all.  The last hours were spent in a freakishly awful pendulum of pain and progression (though mostly pain and little progression).  The whole point of me being in the hospital at that time was to get the baby out.  And he was not coming out.

I looked at Doc Sci with all seriousness and said, it’s time to do a c-section.  I can’t handle this any longer, pain or no pain.  I’m giving up.  Yep, I’m a wimp.  A wimp who wanted to see my new baby and get home to my kids and away from this sick hospital circus.

We called the doctor (she actually came!) and asked her to do a c-section.  Shocking my socks off, Dr. Does-It-Hurt-Yet agreed and said it was no problem.  But… she wanted to check me first.  Surprise, surprise, I was ready to push.

Pick-your-poison pushing positions.

In the US, I included a request in my birth plan to push in some position other than the standard flat-on-your-back approach.  The doctors told me flat out they were uncomfortable delivering babies any other way.  In Germany, my hospital room came complete with a smorgasbord of pushing options.  However, given that I had an epidural and wasn’t able to stand up, I couldn’t take my pick.  The midwife and doctor both wanted me to push while lying on my side.  It was one of two moments that saved me from utterly despising their total existence until the end of time.

As precious baby boy #3 sailed his way into the world, he was abruptly shoved back the way he came.  I’m sure if he could consider it rude, he would’ve.  But, it was brilliant from my perspective since that one nasty smack from the midwife saved me from blasting open a wider escape route for the dear little bub.

And when he finally, finally came out, he was, as the Germans say, looking at the stars.  Sunny side up and screaming his little head off.  And, speaking of his head, the poor thing must have been so sore from banging against my tailbone.  all. day. long.

Well, even if he was sore or misshapen or madder than a wet hen, I couldn’t tell.  All I could see was a beautiful baby boy – here at last!

–  –  –  –  –  –  –  –  –  –

You’d think that would be the end of the story.  And that would be lovely if it were true.  But no – there’s more…

A (much) nicer midwife measured and weighed him, and gave him back to me sans bath and still covered in stinky white stuff that no one in the hospital ever bothered to wash off (!).  We were then moved to a temporary holding cell (hang on to your hats, it’s about to get prison-like) where my awesome, amazing, and exhausted husband was forced to try and get some sleep on a stool.  No back.  Extra grease on the wheels.

The holding cell – red light special.

Around 330am, I was finally given a room.  Only the maternity recovery ward was full (see? August is a terrible time to have a baby in Germany!!), so I was wheeled to a room in another ward on the other side of the hospital.  What I didn’t realize at the time was this ward was full of sick women, and only one (ONE!) nurse was on duty.

Oblivious to what I was getting myself into, I sent a weary Doc Sci home around 4am.  Our sweet neighbor was staying the night with the kids, and I wanted her to have at least some normal sleep in her own bed.  Oh, and Doc Sci was not allowed to stay in the room with me unless we paid for a “family room” which cost almost double the price of a single private room.

The single private room. Doc Sci must have taken this without my knowledge!

I buzzed the nurse, and asked her to remove the epidural that was still in my back and also the “baggage” that comes along with getting said epidural.  She said no.

No?

NO, she would not call the anesthesiologist (only he could remove the annoying little thingie shoved in my spine) because he wouldn’t come anyway since he had other important things to do.  NO, she would not help me try to stand up because she was alone and didn’t want to have to help me up if I fell down.  NO, I could not go back to the labor and delivery ward.  NO, she would not do anything at all because there were other people more in need of her than I was.  NO, I could not believe this was happening.

So there I lay, alone, in a small room with a tiny new baby.  I was unable to open the window, get something to eat, use the bathroom, or change the baby.  I was stuck in bed incredulous at this frustrating turn of events especially after all that I had been through in the past 24 hours.

Thank God, I had my phone next to me, so I called Doc Sci.  But, there was nothing he could do either.  He couldn’t leave the boys, and he couldn’t ask the neighbor to come back until a more decent hour.  I decided right then and there I was going home at the first possible instant.

If I had possessed the ability, I would have scooped up the baby and gone home in the middle of the night.  But several items of business had to be taken care of first, so I pestered the nursing staff every hour in order to get everything I needed to be discharged.  At 3pm, I was ready.

The new baby’s hospital bed. It must be taken everywhere you go inside the hospital – bathroom, shower, kitchen, etc.

I’m used to the high security hospital wards in the US, but from my experience in a German hospital, I’d guess baby stealing and switching is only an American fear.  Doc Sci did not need to check with anyone or show any ID before coming in my room.  When he walked the baby over to the pediatric nurse station to get more diapers, no one stopped him or asked where he was going.  Upon checkout, no one verified that the baby I left with was actually mine.

Sheesh.  Good thing I’m sure.  I think.

So, there you have it.  The Terrible, Horrible, No Good, Very Bad Birth that left me with a handsome, healthy boy we’re calling Big Foot.

Welcome to the world, Big Foot!

Herzlichen Glückwunsch!

Household Notebook

I finished my Household Notebook – yay!

Well, “finished” as in as complete as any project done by a perfectionist could possibly be.  I’m doing my best to let it be what it was intended – a tool that our family USES – and not merely a piece of art that adorns my desk.

So, what exactly is a Household or Family Notebook? 

Our family’s Household Notebook – turquoise!

I suppose it’s not the same for everyone; but, for us it’s a collection of documents to manage our family “business” better.  It will help me be even more organized, and it should provide valuable information for Doc Sci or anyone else who might need to take over daily affairs for some reason.  It should also provide quick access to vital information during an emergency situation.

I started out researching what other people had in their notebooks (using Pinterest and Google, of course).  I made a huge list of ideas, and then I narrowed that list down to 15 categories.  In those 15 categories, I wrote down items that were appropriate to the category and would be referenced or used frequently.  I then searched for existing templates that I could use as a springboard to design my own documents.

When poking around online, I noticed some people had four binders instead of one.  Other people used their binders exclusively to pay bills and didn’t include anything else like meal planning or personal health records.  I didn’t want my notebook to be a replacement for a file cabinet – but, I also didn’t I want my desk to be overwhelmed with a library of resources.

Ultimately, a Household Notebook needs to be something useful for that particular household.

So, what’s in my notebook?

Categories.

My 15 categories and a few examples of the documents in each are as follows…

  • Contact Info
    • Emergency phone numbers
    • German & American contact numbers
    • “In case of emergency” document
  • Planning
    • 2012 and 2013 at a glance
    • Important dates (birthdays, anniversaries, etc)
    • Yearly calendaring list (everything from dentist appointments to dryer cleanings)
    • German and American holidays including daylight savings schedules (they’re different for the two countries)
    • Doc Sci’s work schedule and my weekly schedule
    • Party planning checklists
  • Home Management
    • Deep cleaning checklist
    • Storage unit contents – Germany and USA
    • Stain removal guide
    • Garment care symbols
  • Meals
    • Grocery lists for regular grocery stores
    • List of items only available at specialty shops
    • Meal planning sheets
    • A list of staple meals
    • A list of meals to try (and space to write the verdict)
    • Restaurants to try (and space to write the verdict)
    • Seasonal produce guide for menu planning
    • Stockpile inventory
  • Family
    • Children’s current sizes and measurements
    • Chart with American and European sizes, including shoes
    • Children’s daily schedule and routine
    • Babysitter notes for nights out
    • Birthday party ideas
    • Chore chart ideas
  • Health
    • Medical history for each family member
    • Physician phone numbers
    • CPR instructions
  • School
    • School contact info and phone list
    • Home school weekly planning sheet
    • Home school year overview
  • Money & Finance
    • Family budget
    • Wallet contents including card numbers & contact numbers
    • Password log
    • Yearly schedule of the best time to buy household items
    • Auto insurance coverage details
  • Travel
    • Ideas for local family outings (not overnight)
    • Vacation destination idea list (overnight)
    • Packing lists
    • Before-we-leave checklist
    • Frequent flier mile information for all family members
  • Expat Living
    • Copies of passports
    • Resources for renewing visas
  • Projects
    • Generic to do list
    • Generic project work sheet
    • Generic week at a glance schedule for completing a project
  • Holidays
    • Thanksgiving guest list, meal planner, and grocery list
    • Thanksgiving week planner
    • Christmas card labels
    • Gift gift lists
    • Christmas cookie swap party planner
    • Christmas guest list, meal planner, and grocery list
    • Blank copy of December 2012
  • Blog
    • Ideas page for future posts
    • Yearly calendar for planning
  • Activities
    • Local public pool schedules
    • Local sport club classes for kids
    • Ideas for activities during summer and holidays
  • Lists
    • Items I frequently (and currently need to) request from the US
    • List of topics to research
    • Household items to fix
    • Generic sheet for thoughts on a particular topic

Using the documents I found online, I created my own set of documents in Illustrator that fit our family’s situation (living abroad, don’t own a home, etc.).  I also had to make sure all the pages matched and looked pretty!

My funky European two-ring binder.

After designing all the documents, I organized them into folders on my computer hard drive that matched the categories above.  That way, when I need to print out new menu planning sheets, I can just open the “Meals” folder on my computer the same as I could flip to the “Meals” tab in the notebook.

The only tabs I could find that would reach beyond the page protects had to be cut by hand. Not great for someone who can’t snip a straight line to save her life!

I wanted to print out the documents at a lab so they’d look nicer.  Unfortunately, I don’t know of any existing print labs in my city, so I had to settle for our HP Deskjet. Surprisingly, Illustrator did a great job with color, and what I saw on the screen was how it looked on paper.  Sweet!

Some reference documents went in page protectors, and some were just hole-punched and placed in the corresponding category tab.

Page protectors are very cheap here – both in terms of quality and money.

I bought a plastic envelope to put in the back of the notebook to hold takeout menus and other small scraps of paper that didn’t fit anywhere else.  Unfortunately, it was too big, so I’ll have to check a few other stores for smaller pouches.

My too-big plastic envelope.

I have a few finishing touches to put on the notebook (for starters, filling in the budget and phone numbers by hand).  After that, I’m looking forward to how this notebook will help streamline my “mama” job and make life easier for Doc Sci when I’m out of it for a few weeks.  I think my Household Notebook will be a great tool for our family in the years to come.

p.s. – I’ve made a Pinterest board with links to all the documents I used for ideas.  You can view the board and links here.

How about you?  Do you have a household notebook? Why or why not?

Pregnant in Germany – Hospitals

I must admit, I’m excited about some aspects of German maternity care (postnatal, in-home midwife visits for instance).  But there are some I am dreading.  Choosing a hospital is one item I’m chalking up as loathsome on my to do list.

I’ll be forever jaded by my first two birth experiences.  Both were at the same hospital, a fancy schmancy building with eleven floors dedicated solely to women and babies.  When I was there, I never felt like I was in a hospital.  It was more akin to a five-star hotel.

In the US, doctors have hospital privileges only at certain facilities.  Patients can either choose a hospital and then find a doctor with privileges there.  Or, patients can choose a doctor first with the realization that they cannot choose a hospital outside that physician’s privileges.

In Germany, the mother chooses the hospital where she wants to give birth (birth houses and home births are also options, but I’m not including them in this post).  As I mentioned previously, the doctor that the mother visits for prenatal care will have nothing to do with the actual birth.  Instead, the hospital staff (midwives and physicians) run the show.

Within my city, I have three hospital choices.  For the sake of ease, I’ll just name them hospitals A, B, and C.  But, that’s where the easiness ends.  Making this choice is no walk in the park.

Why?  Because they each have their pros and cons, not only in my opinion but in the opinion of others who have experienced the staff and facilities personally.

To choose a hospital, it’s best to visit all of the options first, and then make a decision.  Each hospital has an Infoabend, or information evening usually once per month.  During this time, visitors can listen to a little talk about why this particular hospital is amazing, (hopefully) go on a tour of the labor/delivery and recovery facilities, and ask questions of the staff.

Over the course of a few months, I attended the Infoabend for hospitals A, B, and C.  All three hospitals had pregnant women climbing stairs to go from the lecture hall to the labor ward – something that would never happen in the US.  Hospital A at least offered water to the women during the lecture.  Hospitals B and C did not.  All three hospitals gave the talk in a large room without sound amplification… or air conditioning.

And so we come to one of my biggest concerns.  Giving birth in the heat of summer with no air conditioning is an emergency c-section waiting to happen… for me anyway.  I know women all of the world do it regularly, but I’m a wuss.  I don’t want to pass out from pain AND heat.

Hospitals B and C had decent air conditioning in Labor & Delivery (L&D).  Only hospital B seemed to have it in the recovery rooms.

I’ve considered that getting in a birthing tub during labor might help with the August heat problem.  Thankfully, all three hospitals have birthing tubs, but only Hospital B has tubs in every room that are big enough for giving birth.  In Germany, it’s totally normal to have a water birth, and no midwife or physician would bat an eye at a woman’s request for one.  Not so in the US.

And, speaking of rooms, these hospitals are very small compared to my previous eleven-floor, swank, not-really-a-hospital experience.  Not one facility here has more than six L&D rooms.  SIX.

Another major concern for me is whether or not the staff in these small hospitals speak English.  I asked at hospitals A & B.  Both assured me that most do speak at least some English.  I didn’t ask at hospital C because I would only go there kicking and screaming… or unconscious.  Hopefully, the limited German I know and feel like remembering in labor coupled with the staff’s English will be enough.  Please, God, let that be true.

So, what about after the birth?  Another unpleasant subject, unfortunately.  Health insurance in Germany only pays for a three-bed recovery room.  If a hospital only has rooms for two people, then that is acceptable.

But, keep in mind this means that it will be the mother and her child plus at least one other mother and that woman’s child.  And perhaps her friends.  Or her husband.  Or her uncle, grandfather, boyfriend, teenage son, etc.  Just who I want to see after giving birth.

In order to get a private room, one must let the staff know upon arrival at the hospital.  And pay a fee.  (There’s always a fee, right?).  The cost ranges from 40-135 euros per night, depending on the hospital and type of private room (family rooms – where the husband can sleep over – cost more).  I’d say that’s peanuts in exchange for not having to share a hospital bathroom or bunk with someone else’s screaming newborn.

In addition to all the physical characteristics, I have to take into account the general attitude of the hospital.  Are they c-section happy?  Do they get a kick out of using a vacuum extractor?  Will they make it hard for me to get an epidural if I want one?  Are they irritated or indifferent that I’m a foreigner?

Considering all the factors, I’ve only been able to make one decision so far: eliminate hospital C.  Truth be told, this elimination mostly has to do with the lead doctor being about as warm and friendly as my building superintendent than anything else.

I only have a few weeks left to decide between A & B.  But, then again, honestly I don’t actually have to choose.  As long as I am 36+ weeks along, I can just show up at either facility.  So, perhaps I won’t make a firm choice after all.  Or maybe I’ll just do eeny-meeny-miney-moe.

But you can bet wherever I go and whatever happens when I get there, I won’t be without a story to tell.

Insurance Makes the (German) World Go ‘Round

Thrifty Travel Mama | Expat Life - InsuranceGermans LOVE insurance.

It comes in all shapes and sizes and seems to make the world go ’round in the way that lawsuits do in America.  In contrast to the sue-happy American culture, the insurance-addicted German culture makes things possible here that aren’t there (say, sending your child to school with a peanut butter sandwich for lunch).

Of course, we have your garden-variety health and auto insurances here.  Both are required.  In fact, we cannot legally live in Germany without health insurance.  And auto insurance is a whole ‘nother ball game – a separate post for a rainy day.

But, the flavor of insurance I find most interesting – and applicable to families with children – is the personal liability insurance, or Haftpflichtversicherung.

We found out about this insurance several months after we moved here. The policy provides protection in the incidence of all kinds of personal accidents: throwing a ball through a neighbor’s window, tripping an old lady, bicycle collisions, and any other “oops” moments that involve damages.

I’d never heard of such thing before moving to Germany, and I assumed it had to be expensive.  Wrong.  It’s actually quite cheap.  We have a family plan that costs something like 7 euros per month for a gazillion euros of coverage.  It’s the one kind of policy us non-insurance crazed foreigners really should have.

When Doc Sci finally went to purchase a policy (after we lived an entire year here without it – eek!), the agent told him that one of her clients rode his bike in front of a tram and somehow got the bike stuck in the tram track.  The tram driver slammed on the brakes, and passengers went flying.  Some of the elderly ones sustained injuries requiring hospitalization.  The guy riding the bike was responsible for the whole thing – but lucky for him, his insurance paid for it all.  Had he been without a personal liability policy, he would’ve had to pay out of pocket for all injuries and damages.

(By the way, the story wasn’t a sales pitch; Doc Sci had already signed on the dotted line.)

I recently learned that some landlords will not rent to tenants without this personal liability insurance.  In the US, renter’s insurance will cover the tenants’ belongings as well as any accidental damage to the property.  In Germany, renter’s insurance only provides protection for the stuff.  We aren’t required to carry this kind of policy where we live, but most likely we’ll need it when/if we move.

Before we had this oh-so-German insurance, I was on the edge of a freakout whenever my kids got a stick or a rock anywhere near someone else’s car.  Or rode a bike too close to an elderly person in the park.  Or visited a new friend’s house (especially if said friend had no children).

Now that we have the policy, I still maintain a level of caution, but at least that caution is several steps down from the former paranoia.  I hope we never have to make a claim, but at least if we do, we’ll be covered.

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.

Pregnant in Germany: The Mutterpass

My Mutterpass.

Having a baby in Germany is such a trip you need a Mutterpass for the ride!

But, what exactly IS a Mutterpass?  It’s kind of a passport to motherhood, a document you are *supposed to* carry with you during your entire pregnancy.

Inside, you’ll find all kinds of details regarding your pregnancy: height, weight, age, blood type, family history, lab results, blood pressure, diseases, cravings, credit history, thoughts on the meaning of life, etc.  In essence, you’re in charge of keeping your own maternity medical records… and on you at all times, no less.

I’m finding that Germans aren’t so tight-fisted with medical records as we are in the US.  If I wanted a copy of the information in my chart at an American ob/gyn, I’d have to fill out a form, pay $236 per page for someone to stand at the copier and press the big green button, and then make an appointment to pick the sheets of gold up at a later date.  Patients just can’t be trusted with such things in the states.

But here, not only do I carry around my pregnancy medical records, I also keep both of my boys’ medical records and immunization records (Impfpass!) at home in a file cabinet.  Of course, this also means I am responsible to bring these records to every checkup.   And, therein lies the rub.

For some reason, I don’t think this system would work in the US.  I mean, it’s not like you can keep your Mutterpass on your iPhone.  It’s PAPER and you actually have to REMEMBER to bring it.

So, do I personally take this laminated booklet with me everywhere?  No yet.  From what I hear though, it’s wise to keep it at your side during the third trimester and always when traveling.  I guess my packing list just got a little bit longer.

Now, if I could only read what’s in it…

Pregnant in Germany

I’m excited to announce some very special news!   Here at Thrifty Travel Mama, we’re expanding by one seat!  As someone pointed out, we’ll soon be able to fully book the middle, five-across section of a 747 jet.  Awesome.  I wonder if we could get a group discount?

I’ll be posting about once a month on the topic of having a baby in Germany.  The system is certainly different, though the care seems to be equally as good as the US (or so my uninitiated self thinks at this point!).

For those having (or thinking of having) a baby in Deutschland, I hope you find these posts informative.  For everyone else, hold on to your hats.  There’s bound to be a barrel of laughs involved.

As is the case in the US, a mama’s got to visit an obstetrician throughout her pregnancy.  Well, generally.  You could go to a midwife instead.  But, I’ll write more about that later.  For now, let’s talk ob/gyn.

Ladies, listen up.  If you’re going to the ob/gyn in Germany, there are two very important things you should know.

  • NO nurses
  • NO gowns or drapes

First, no nurses means you’ll be alone in the examination room with your doctor.  Choose wisely.  Most of the interaction you’ll have with this person will be sans pants.

Second, no gowns or drapes means you should wear a dress with leggings or a long shirt.  Again with the interaction sans pants.

And, the doctor does not leave the room.  If you’re lucky, you’ll have a small screen to hide behind to wiggle in and out of your skivvies.  But what does it matter anyway?  You’ll still have to skedaddle across the room to the table, you guessed it, sans pants.

I am NOT a fan of this system.

Just sayin’..

If you happen to be visiting the ob/gyn because you’re pregnant, expect to have an ultrasound (of the uncomfortable variety) to confirm you are, indeed, knocked up.

And, if you don’t have anything in German stating your blood type (and whether or not you’re Rh negative), you will have to have blood drawn.

The ob/gyn is the only doctor’s office in Germany where I’ve had a nurse draw my blood.  All other doctors I have visited have done it themselves.

And, that ultrasound I mentioned?  It will also be performed by the doctor, not a tech.

Speaking of ultrasounds, Germans consider them quite safe.  I’m just beginning my second trimester, and I’ve already had three.  In the US, my insurance only covered one per pregnancy.

Since I’m no longer a newb at being pregnant, I discussed with my doctor right off the bat that I’d be refusing most tests (glucose, quad-screen, etc).  I gave my reasons, and she heard me out.  If you’re like me, find out what you’re doctor thinks of your opinions.  Luckily, my doctor said to me, “I don’t have a problem with problem patients.”

Thanks, Doc.  I think we’ll get along just fine.

Travel Insurance – Do You Need It?

Thrifty Travel Mama - Do You Need Travel Insurance?Have I told you yet about our latest and greatest upcoming itinerary?  No?  Really?  Well, now would be a good time.

We’re going to South Korea!!

I’m ridiculously excited.  This will be our first trip to Asia, and all four of us will be going (would you expect anything less?).  This trip also marks a huge transition for our family as this will be the first time we have to pay for four plane tickets.  And my-oh-my those pups were NOT cheap.

I’ll tell you about buying my tickets to South Korea in another post.  Today, I want to focus on travel insurance.

The first question to ask of course is, do I need travel insurance?  For the most part, my answer is almost always no.  In fact, this is only the third time in my life I have purchased it.

Ten years ago, I went out of the country for the first time.. to Russia.  Talk about an eye opener.  I had no idea what to expect other than the chitter chatter of other travelers.  I knew that baggage was frequently delayed or lost and that medical care up to western standards can be hard to find.  I wanted peace of mind that I wouldn’t have to wear the same shirt for two weeks and that I could be airlifted out to Western Europe had I been run down by a crazy driver while wearing said shirt.  Definitely worth it.

However, most of my trips after that have been fairly inexpensive and the amount of luggage I carried decreased dramatically.  I didn’t give a thought to overseas health coverage since I traveled mostly to countries with western medicine standards and, let’s face it, hospitals are the last thing on a twenty-something’s mind.

But now I’ve paid the most I ever have just for plane tickets.  And, I have two unknown variables: Screech and T-Rex.  Should either one of them decide that the night before departure would be a great time to contract a nasty case of the norwalk virus or pneumonia or break their first limb, we’d be out more euros than I want to stress about.

And, that is exactly the point.  With travel insurance, you don’t have to worry about it.  Well, provided you did your homework and are familiar with the policy’s coverage that is.  Put on your worst-case-scenario thinking cap, make a list of questions, dial up a company, and grill the agent.  Nicely.  Please.

Reasons why I would buy travel insurance:

  • My trip is very expensive and nonrefundable.
  • My existing health insurance does not cover treatment at my destination.
  • I’m concerned about a natural disaster or potential terrorist act at my destination.
  • It would ruin my trip if my luggage was lost or delayed.
  • There’s a strong chance my trip could be canceled or delayed due to illness in the traveling party or immediate family.

If you’re still on the fence, calculate about 5% of your trip costs (nonrefundable items such as plane tickets and prepaid hotel reservations or tour costs).  Ask yourself if this number is a fair price to pay for peace of mind in the event that one of the above scenarios occurs.

Most of the time (especially if travel is only within the US), I find it personally unnecessary.  I’m thrifty and determined, and I’d rather take the chance on not coughing up the extra cash for a potentially unused service.

But if you’re a newbie (new to traveling outside the US), spent a month’s salary (or more) on your airline tickets, or have two accident-prone boys, I’d highly recommend it.

If you’re interested, the company I use is Travelex.  I do not work for Travelex and receive no compensation for referring you to their services.  I also take no responsibility should you not be satisfied with their coverage. Signature-Marigold