It’s a girl!

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

It's a girl!
Meet Miss Luisa! Photo: Josh Devins

It’s a girl! My husband and I are incredibly in love with our little Luisa Trudy, who decided to join us fashionably late on December 8, 2010, in the middle of a very snowy night in Berlin.

At the end of it all, or the beginning, depending on how you look at it, I can say I’m definitely glad we chose to have a baby here in Germany.

What I loved most about the experience were the midwife services. There are midwives back home in Canada, but their numbers are limited and it’s still seen as an alternative to the conventional approach. In Germany it’s the standard, and these amazing women offer a massive range of services. But you don’t have to choose one that offers it all: I ended up working with four different midwives.

The first was my main care provider, who came to my home for some of the check-ups towards the end of the pregnancy. Because Luisa was a week late, I was subject to one every second day and it was a luxury to stay home and have someone come to me, instead of waddling through Berlin’s snowy streets to the doctor’s office.

Other mothers had told me about the overwhelming “now what?” feeling that followed their return home from the hospital with their new little humans. But my husband and I left the delivery ward feeling confident that we were going to be just fine. We had the midwife coming every day for the foreseeable future. Luisa’s birth was uncomplicated and our midwife gave us everything from diaper changing tips, answers to numerous breast-feeding queries and reassurance that our baby was as perfect as we think she is.

But different midwives offer a different range of services, and my “main” midwife did not offer much outside of the before and after care. That brought us to another midwife to do our weekend birth preparation course, or Geburtsvorbereitungskurs. On the recommendation of fellow Mama-friends, I also did acupuncture that is said to shorten labour time. For this, I found another midwife who did a “group needling” session once a week at a midwife practice near my home. Yet another midwife attended Luisa’s birth.

No regrets about a hospital birth

I’ve written before about our choice to give birth at a hospital, and it wasn’t one that we regretted. I wanted a hospital that was close to home and we opted for university hospital Charité in central Berlin. The proximity of the hospital turned out to be ideal the weekend before Luisa arrived. Overdue by a week, I had to go to the hospital twice to check her heart rate.

But several people I encountered were critical of my choice of a hospital over a birthing house or home birth. One midwife I met berated me for choosing a hospital located in former East Berlin, saying that no one there would speak English for my Anglophone husband. She also said the hospital would hook me up to pitocin to hurry my labour, and that the staff would be heavy-handed with drugs.

Another mother said that I should definitely go to a hospital where I could have an attending midwife (a midwife who stays throughout the delivery and does the postnatal care) so I wouldn’t have to endure a shift change of midwives part way through. Another midwife told me that Charité was too big to provide a calm place to bring a baby into the world.

These people could not have been more wrong. It seemed strange to me that delivering in a hospital could be an intimate affair, but it was. For the most part, it was just my husband and I in the delivery room. One midwife was assigned to me and checked in every now and then. We did endure a shift change, but it was to our benefit – we really liked the next midwife and I was happy to have a fresh brain there with me, instead of someone dragging out the hours of her work day.

As my labour progressed, I wasn’t hooked up to any kind of IV drip. When I’d had enough of the pain and asked for some relief, they discouraged me from getting an epidural and offered a milder alternative. It wore off and I wanted more – but the midwife told me I wasn’t going to get it.

Almost everyone we encountered offered to speak English. Charité is a teaching hospital teeming with young doctors. The doctor who came in at the end of my labour to help the midwife deliver Luisa spoke English, which was very helpful for my husband. The paediatricians also offered to speak English, as did most of the doctors who made the rounds in the maternity ward.

Life goes on

It’s amazing how quickly things have gone back to “normal” post-pregnancy. While I was pregnant, it felt like a countdown to this momentous day when everything would change. Now that everything has changed, life still goes on. I’m grateful to be living in a city where many cafes have changing tables and parking spots for prams. And no one bats an eye at a woman breastfeeding in a restaurant, which has made the learning process so much easier.

Since I’m no longer pregnant, many Germans seem to be concerned about what kind of contraception I’ll be using. I was warned by two doctors at Charité that breastfeeding was not reliable contraception and that I should talk to my OB/GYN about getting on the pill when I went to see her six to eight weeks after Luisa’s birth. My midwife visited on our first day home and brought me a 91-page “pamphlet” on all the different contraception options. It’s almost as though they think it’s a miracle I didn’t get pregnant sooner.

At the age of seven weeks, Luisa has already had many visits to German bureaucratic offices. I heartily endorse using the Standesamt, or civil registry, outpost offered by hospital delivery wards – it made the paperwork much easier and we spent less time waiting around.

At the Bürgeramt we’ve also avoided long waits by making appointments ahead of time to get her baby passport. Showing up at the various government offices with a baby also seems to speed the bureaucratic process. Every official we’ve encountered has been delighted by Luisa’s chubby cheeks and take care of us right away.

Other than a few judgemental midwives and mothers, having Luisa in Germany made us want to stay in the country to bring her potential siblings into the world. Granted everything about my pregnancy, labour and delivery was uncomplicated, but our experience left us with confidence in the system should anything go wrong in the future (knock on wood).

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Immunisations and anal pharmacists

Motherhood in the Fatherland follows mum Sabine Devins as she navigates the cultural quirks of having a baby in Germany. In the latest instalment, she tackles immunisations and baby pharmaceuticals.

Immunisations and anal pharmacists
Photo: DPA

This month, my daughter reaches an important milestone: it’s her last round of immunizations until school age. It will be a relief for me to see her chubby little thighs bandage-free until she’s marching off to school with an overloaded Schultüte.

Luisa and her counterparts in North America and the UK are lucky to count going to the doctor as a fact of life. When a baby is born in Germany, he gets presented with a Babypass. Like my Mutterpass, the little book is a transportable medical file that mothers can take from doctor to doctor with her medical history. It also tracks baby’s development.

All of the check-ups, or Untersuchungen, are abbreviated to U1, U2, U3, etc. Luisa’s appointments are labelled on the front of her Kinderpass with what dates they should fall between, going all the way to April 2016. Each Untersuchung has a page for the doctor to fill out. It also leaves me with a handy little guide to how much Luisa has grown over the last year (it’s a lot!).

Most of the exams so far have been simple physicals. Making sure Luisa is growing properly and all her little parts with it. At the U3, there is an ultrasound to look for hip dysplasia — something that I find Germans to be disproportionately concerned with. As there is some hip joint issues in Luisa’s family medical history, she received an ultrasound at her U2, then again three weeks later, then with a specialist, and then again at the U3. The conclusion: “Her hips are just fine, we just like to be very careful when it comes to hip dysplasia,” said our doctor.

According to the International Hip Dysplasia Institute, hips that require treatment only occur in two to three children per 1,000.

What I do like about Germany’s scheduled medical care for babies is that they do immunizations a little later than in the English-speaking world. While Luisa’s friends in the US, the UK, and Canada all had their first round of shots at two months, Luisa didn’t get her first Impfungen until she was nearly four months. The first round is done in conjunction with the U4 check up, when Luisa is between two and four months old. Since her appointment was booked closer to the end of the fourth, that was simply when she got her first round.

As for the immunizations themselves, they are very much the same as what children in North America and the UK are given. Right now, Luisa has fighting power against tetanus, diphtheria, pertussis or whooping cough, polio, pneumococcus and hepatitis B. On the advice of my paediatrician, I skipped the Rotavirus immunisation and many German parents also leave out the Hepatitis B. After her last round, Luisa will also be armed against measles, mumps, and rubella.

Overall, there isn’t much difference between the care Luisa would get here versus there. But what is different in Germany is the at-home care and what Mamas keep in their at-home medical kit.

I’ve written before on the various uses of breast milk to cure these things, but that does come to an end and now those ailments lead me to the medicine cabinet.

For stuffed noses, we have saline solution. It’s hated by our little one and therefore seldom used. As Germany is the birthplace of homoeopathy, I can find all sorts of natural remedies. My favourite is called Osanit and they’re little pearls I use for teething pain. It’s main medicinal ingredient is chamomile. Whenever those gums start causing problems, babes are dosed with a few little pearls that they can roll around in their mouth and it seems to work. Life goes on. American mom Laurie has a similar product in her cabinet called Dentinox-Gel N, which also contains chamomile but in a gel format.

For those fevers, we use paracetamol, but its application is what makes our stash “very German”. The favoured method of dosing your child by the Mamas is Zäpfchen, or suppositories.

I wasn’t sure what to make the first time I realised what my doctor had prescribed after Luisa’s first round of immunizations in case of fever. But she was hot and miserable and so it happened and it was awful for everyone, but it did make her feel better. The next day I went to the pharmacy and asked for liquid paracetamol to give her instead.

The pharmacist was confused by my request. “But with the suppositories, you know she’s getting the right amount. You don’t have to worry about getting her to swallow it and once it’s done, it’s done,” she said, very pragmatically.

With the next fever, I took out a spoon and tried to get Luisa to swallow her medicine. It didn’t work. Her mouth clamped shut, she shook her head and sticky, orange-flavoured syrup got all over the floor. The practical German in me took over and we went back to the Zäpfchen. I’m now a convert.

I’m not the only one. British mum Tori told me she thinks they’re brilliant. “I would have never used them if I were raising Max [in England], but my husband, who is a doctor, was the one who stocked up the medicine shelf and at first I wasn’t so sure, but now they’re all I use.”

But others aren’t convinced.

When Laurie’s son has a fever, she uses liquid ibuprofen, which her pharmacist told her not to use until he was six months old. Before that, she had infant’s Advil and Triminic sent from the US. She also keeps American-bought Neosporin on hand. She also wishes that children’s acetaminophen were more available in the Fatherland.

English mum Susannah won’t touch the Zäpfchen. “Sticking things up a baby’s bum is not an idea I’d ever considered until I became a parent here. I would have no idea how to go about it, and would worry I was hurting her.”

Instead, she stocked up on the beloved English cure-all Calpol on her last trip home. “It’s poured liberally down English children’s throats from a very young age, whereas Germany seems less into plying babies with drugs,” she explained. “By extension, the German equivalents seemed less trustworthy in my mind: Irrational but true.”

She also has Calpol saline nose spray, as an assistant at her local pharmacy “raised her voice and eyebrows at my request for — what she called — a brutal product. She pretty much accused me of wanting to shoot drugs into my innocent child’s brain tissue.” But Susannah felt the German saline drops weren’t working and was delighted when she read “Suitable from birth” emblazoned on the English saline spray.

These days, we more readily turn to Google than our mothers to answer the million times we need to know: “Is this normal?” However, when it comes to comforts and cures, we turn back to what we know from childhood, whether it’s Laurie who goes for Neosporin to treat her son’s scrapes or Susannah who trusts one name to cure it all. Even if similar products are available in the German Apotheke, it’s just not the same as what we know.

And just because I use the Zäpfchen, doesn’t mean I wouldn’t be grateful for your tips on getting your babes to swallow their medicine.