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MOTHERHOOD IN THE FATHERLAND

HEALTH

Morning sickness? There’s a tea for that

Giving birth while living abroad can be a daunting prospect. The second instalment of the Local's series Motherhood in the Fatherland follows expectant mum Sabine Devins as she negotiates the cultural quirks of having a baby in Germany.

Morning sickness? There's a tea for that
Photo: Josh Devins

At 18 weeks, I feel like I’ve already run the gamut of pregnancy side-effects. The queasy mornings and aching breasts of the first trimester have morphed into back aches and a host of digestive woes — and I haven’t even hit the halfway point.

If I were back home in Canada, I’d probably walk into a pharmacy and purchase a suitable medication thought safe for pregnant women. But in Germany doctors and chemists encourage a more natural remedy. Yes, to cure what ails during pregnancy, there’s a tea for that.

“It’s a tea-drinking culture here,” the pharmacist at my local Apotheke explained. “It’s very old, dating back to when monasteries were also healing places for the sick, and now it’s practically a tradition to turn to tea first.”

As someone used to finding a pill to cure my little complaints, I’ve actually been happy to dose myself with tea. Being pregnant means I’m extra careful about what I put into my body, and having natural alternatives that actually work is a great comfort.

“Every pill package here comes with a warning saying that the product is not tested on pregnant women. I would hate for someone to come into my pharmacy and say ‘you recommended that I take this to treat my cold and now my child has a birth defect’,” my pharmacist said.

In my first trimester, I was fortunate enough to have a fairly easy time with morning sickness – most of it went away when I ate breakfast – but peppermint tea also would have helped, I was told.

After discussing digestive issues with my obstetrician-gynaecologist, she wrote me a prescription, but told me to try fennel tea, or Fencheltee, first. I have yet to fill the prescription and will probably stick to the tea.

Against the leg cramps that I’m waiting to start any day now, I’m to drink chamomile tea, or Kamillentee. To combat the increased mucous my body produces (“A totally normal thing,” says my doctor), I drink the occasional cup of thyme tea, or Thymiantee.

There is even an herbal tea mixed specifically for pregnant women, appropriately called Schwangerschaftstee, or “pregnancy tea.” I got my leafy mixture at my local Apotheke, where the pharmacist explained that the particular brand, mixed by Bahnhof Apotheke, came highly recommended by Ingeborg Stadelmann, midwife and author of a well-known German guide to pregnancy. You can also find the tea at organic grocery shops and local drug stores.

The blend varies and most pharmacies work with midwives to make their mix, but almost all agree they should have Alchemella or Lady’s Mantle (Frauenmantel), lemon balm (Zitronen Melisse), nettle (Brennnesseln) and raspberry plant leaves (Himbeerblätter). The first two ingredients are meant to calm and relax while stabilising the influx of hormones in the body. Nettles help the body build up the extra 30 percent blood flow it needs to support the work of growing a baby. The raspberry leaves are the most important. They contain vitamin C, important for boosting my weakened immune system, and calcium and iron to boost the baby’s growing bones.

But as wholesome as it sounds, the tea isn’t the tastiest and I have a hard time swallowing the recommended two to three cups a day.

But progressing through my pregnancy and beyond, I can look forward to many other infusions. The pharmacist told me to stop by before my final month of pregnancy to get a blend with more raspberry plant leaves. This is meant to prepare me for birth by relaxing the cervix, which I learned from her has the cringe-worthy name of Muttermund, or “mother mouth.”

After Baby Devins makes its entry into the world, I’ll have to stop drinking peppermint tea, as midwives say it hinders milk production, and switch to a blend of breastfeeding tea (Stilltee), made of fennel, caraway, anise and fenugreek. According to my experienced mom friends, it’s delicious.

The same midwives who put together the Schwangerschaftstee also blend teas for the postnatal recovery time, called Wochenbett, which will help my body deal with another roller coaster of hormones as it goes back to its new normal.

If I were an expat in the North America, I wouldn’t have as many natural options. The US Food and Drug Administration says more than two-thirds of pregnant women there take some sort of prescription drug during their pregnancy. The same organization cautions against drinking too much herbal tea, claiming it is unknown how some herbs affect the foetus – not something German health experts seem too worried about.

In Canada I would also struggle to find German-style herbal tea blends to help calm my hormones or clear my sinuses. Former Berliner Susanne Wengenmeier told me that after moving to Vancouver she misses the tea remedies she found so readily available and effective during her time in the city.

“I was in the drug store and went to their ‘natural’ section to find the teas that cure everything and there was nothing! I was so disappointed,” she said. “I then felt really German.”

But if there is one complaint I have about steeping away my ailments, there is one persistent pregnancy problem that the teas definitely do not help – my ever-shrinking bladder.

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HEALTH

What you should know about Germany’s plans to roll out e-prescriptions

Germany is taking a big step towards a more digital-friendly health system, with plans to roll out e-prescriptions nationwide. Here's what you should know.

A person holds the e-Rezept app in a pharmacy in Oldenburg, Lower Saxony.
A person holds the e-Rezept app in a pharmacy in Oldenburg, Lower Saxony. Photo: picture alliance/dpa | Mohssen Assanimoghaddam

What’s happening?

From January 1st 2022, people in Germany will receive their prescriptions digitally (known in Germany as an ‘e-Rezept’) from healthcare providers.

Patients should be able to get their prescription from their doctor via a QR code sent to an app, which can then be transmitted to a pharmacy. The pharmacy can then let the patient know whether their medicine is in stock (or if they want to order it), and when it is ready for collection. 

This model is to be mandatory for people with statutory health insurance from the start of 2022, replacing the good old paper prescription.

However, the QR code can also be given to the patient by the doctor on a piece of paper if a patient does not have access to or doesn’t want to use a smartphone. 

READ ALSO: The changes around doctors notes in Germany you should know 

How exactly will it work?

In theory this is the plan – you’ll visit the doctor or have a video consultation. After the examination, the doctor will issue you with an electronic prescription for the medication that has been prescribed to you. 

A prescription code is automatically created for each ‘e-Rezept’, which you will need so you can get the medicine at the pharmacy. As we mentioned above, patients in Germany can either open this QR code in the free e-prescription app developed by Gematik and the Health Ministry, or receive it as a printout from the doctor. 

Next, you can take the prescription QR code (either in the app or as a printout) to your pharmacy of choice to get the medication needed.

One of the major differences and timesavers under the new system is that you can also select the pharmacy you want to get the prescription from digitally, order the medication (if needed) and you’ll be alerted when the prescription is ready. You can also arrange to have it delivered if needed. 

A doctor’s signature is not required, as e-prescriptions are digitally signed. 

The aim is that it will save on paperwork, time at the medical office and trips to the pharmacy. 

Some patients have already been receiving digital prescriptions. The ‘e-Rezept’ was tested out successfully in selected practices and pharmacies with a focus on the Berlin-Brandenburg region of Germany. The test phase started on July 1st this year.

Pharmacies and doctors’ offices nationwide have also been given the opportunity to test the new system from the start of December. 

“This will enable practice providers and pharmacy management systems to better prepare for the mandatory launch on January 2022 1st,” said aponet.de, the official health portal site for German pharmacies

The new e-prescription app.
The new e-prescription app. Photo: picture alliance/dpa | Mohssen Assanimoghaddam

READ ALSO: 10 rules to know if you get sick in Germany

There is some leeway though – if there are technical difficulties, paper prescriptions can still be issued in individual cases until the end of June next year.

The National Association of Statutory Health Insurance Physicians estimates that it could take until mid-2022 until all users are equipped with e-prescription applications nationwide.

The obligation does not apply to privately insured people from January next year. Private insurance companies can decide voluntarily to make the preparations for their customers to use the e-prescription.

What’s this about an app?

To be able to receive and redeem prescriptions electronically, people with statutory health insurance need the Gematik ‘das e-Rezept’ app. 

One issue is that the app appears to only be available at the moment in German app stores. We’ll try and find out if there are plans to change this and widen out the access, but it seems likely for that to happen. 

Germany’s Covid-Warn app, for example, was initially only open to German app stores but was gradually widened out to many others. 

As mentioned above though, those who don’t have access to an app will be able to use the paper with the code on it to access their prescriptions. 

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

Has it all gone smoothly?

As you might expect, there have been a few hiccups. 

Originally, the introduction nationwide was planned for October but was postponed due to many providers not having all the tech requirements set up. 

Now though, more than 90 percent of the practice management systems have been certified by the Association of Statutory Health Insurance Physicians – a prerequisite to issue the e-prescriptions.

The e-prescription is part of Germany’s far-reaching plans to digitise and streamline the health care system.

The head of Gematik GmbH, Markus Leyck Dieken, recently spoke of a “new era” that is “finally starting for doctors and patients” in Germany. 

Useful vocabulary:

Prescription – (das) Rezept

Doctor’s office/practice – (die) Arztpraxis

To order – bestellen 

Pharmacy – (die) Apotheke

Video consultation – (die) Videosprechstunde

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