A guest post by Rachel Beyerlein
Pic (c) JMG PIXELIO
As I am writing this, I’m now 37 weeks pregnant and enjoying my Mutterschutz (maternity time) from the sofa at 6am. I keep thinking, how on earth would I have been able to manage this pregnancy in the US – if I’m lucky I sleep around 6 hours a night, sitting for too long is uncomfortable (as is standing, laying or walking), and I have so much stuff to do! If I were at home in the US, I’d still be expected to work 8 hours a day up until my water broke at my desk. Not in Germany…it’s very different here. So much so, that I’ve needed to educate myself on the system so as not to miss out on some of the offered (and free) perks.
As a result, I thought it might be a good idea to write a “reference” post outlining what my experience has been thusfar, what I’ve discovered about the system, and advice I’d have for other women who are pregnant in Hamburg, Germany.
1. We’re Pregnant!
My husband and I were lucky enough to be able to get pregnant naturally, but as most newly pregnant ladies, I had no idea I was pregnant until I realized that the taste of wine made me want to puke and then I was late. At about 7 weeks pregnant, with my positive pregnancy test, I made an emergency last-minute appointment with my Frauenarzt (Gynecologist) to see what was going on.
The Gynecologist’s office in Germany is very different from the US. There are no gowns, no separate consultation rooms, no need for modesty. Usually you remove your bottoms for the vaginal exam, so wear a long shirt if you feel uncomfortable with your hoohaa hanging out in the breeze. And then for the breast exam, you can put your bottoms back on only to remove your top and bra and have your tatas hanging out. So remember, leave your body image anxiety at the door because you’re exposed in Germany – and frankly….it’s ok!
So, I arrive at the doctor and immediately I’m given a sonogram. My office has a machine in the room, and my doctor LOVES to use that thing. Actually, throughout my pregnancy, I’ve gotten an ultrasound at almost every visit. I know that there is conflicting information regarding whether or not that is safe for the fetus, and I don’t think every office checks that often, but it is available and a possibility when visiting the dr. He’s even done ultrasound on my breasts before when they were aching in my 4th month of pregnancy.
Ultrasound is subsidied by the public insurance coverage for up to three times - and when there is reason to do so, ie. something worries the gyn. You can still buy ultrasound and the normal one comes for around 25-30 EUR. If you are privately insured the number of ultrasounds differ and you should inquire with your insurer about the rules.
So after we saw our baby bean on the 7 week ultrasound, it was on. I was making appointments every 3-4 weeks with the Frauenarzt up until the third trimester and the beginning of all the bloodwork, tests, and what have you began.
The doctor gave me my very very important Mutterpass also. The Mutterpass is basically your passport through pregnancy. You need to carry it on you at all times throughout the pregnancy, and it has all your information within – bloodwork, tests, ultrasounds.
At this point, everything was still very secretive, but I did leak to a few friends here in Hamburg who told me that by 12-15 weeks pregnant, I needed to start looking for a Hebamme (a midwife) especially if I wanted to find someone who spoke English.
2. Find a Hebamme/Midwife
First off, what is the role of a Hebamme in Germany? The answer is, there are a few different types of Hebammen. The one you need to find is a Hebamme who will come to your home after the baby is born to assist with the transition into motherhood. My Hebamme has already met with us 3 times at this point and we’ve talked about breathing exercised during labor, massage techniques for Ken to help me with labor, baby products, baby essentials in Germany, pain management, sleep management. Basically, the Hebamme is there for you after the birth to assist with all questions, fears, concerns once you bring baby home.
After finding our Hebamme she explained to us that we can meet however many times we need before the birth (uusually between 1 – 4 times) and then after the birth she will come every day for the first two weeks and then as often as we need her for up to a year. I do think that there is a limit, like 30 visits or something, but that number isn’t clear to me yet. Either way, having a Hebamme is essential, especially at the very beginning, and in Hamburg they’re in HIGH DEMAND. Plus, it’s covered in your insurance – therefore it is your RIGHT as a tax-payer to have a Hebamme.
So by week 12-15, find yourself a Hebamme. If you don’t have someone to recommend a Hebamme, the internets can help: http://hebammen.info/
Again the number of visits differs between public insurance coverage and private insurance coverage. The first 10 days it is one visit per day, even 2 visits can be argued. In total 16 visits are granted within the first 8 weeks after your baby was brought into the world. And another 4 visits are granted to help with breastfeeding issues. If you are privately insured you may have differing services covered, hence, it makes sense to read the conditions of your police.
Apart from the mentioned visits a midwife is also allowed to undertake some of the medical examinations you gyn would otherwise do. It is your free decision who shall undertake them. The examinations include controlling your weight and blood pressure, analyse your urine for proteins and sugar, analyse your blood, control the heartbeat of your baby as well as determine the size and position of the baby.
3. Tell your office you’re pregnant
Somewhere between week 12-20, it would be good to get a Schwangerschaftsbestätigung from your Frauenarzt to officially inform your office you are pregnant. If you are working with infants, and are changing diapers, you should tell your employer sooner because you’re not legally allowed to work in that environment when pregnant and will be removed on medical leave for the remainder of your pregnancy, while being paid 100% (sweet.) This official document stating your pregnancy legally protects you from being fired for the duration of your pregnancy, and at this point you’re safe in your job until you return from maternity leave however many years later!
Mutterschutz is a fixed time period starting with the day you are pregnant - not when you tell your employer. It extends until 4 months after the birth of the child. The employer is then free to release you based on the normal stipulations of Work Law. There is a whole law called Mutterschutzgesetz which also deals with the nature of tasks you are allowed to perform during pregnancy. You may however apply for Elternzeit, which cannot be denied and is likewise means that your employer cannot cancel your employment contract. There are some rare exeptions, though. Elternzeit can be taken for maximum 3 years and only until the child is 3 years old. should your employer agree you can extend 12 month of the Elternzeit to a period after the second birthday up to the 8th birthday of your child. The Elternzeit Law is rather complex and we would recommend to get some advice before making an uninformed decision.
4. Enjoy for a few months
At this point, you have your Hebamme, your office is notified…you can just enjoy your pregnancy for a while. Maybe you want to take a birthing class/Geburtsvorbereitungskurs, which, if taught by a Hebamme are often also covered by insurance. We took an English speaking class as a couple (Ken had to pay his portion,) but as a result we got a chance to meet other pregnant couples and learn more about the German birthing system.
5. Register at a Hospital/Birthing Center (Geburtsanmeldung)
In Germany, your Frauenarzt doesn’t assist in the birth of your child, rather hospital midwives do. These midwives are not necessarily the same as the one you will have after the birth – these are strictly there to birth your baby. You could find a midwife who is affiliated with a hospital and will also be your midwife, but then you should be looking for her already at 9-12 weeks pregnant because there aren’t many who are available.
Since your doctor isn’t going to the hospital, you have a choice of where you can have your baby – do you want to go to a clinical hospital, do you want to go to a birthing house, do you know? I didn’t – which is why it’s so great that each facility has an Infoabend. Usually on Mondays or Wednesdays twice a month, the Infoabend is an overview of the birthing facilities, you meet the Hebammen, get to see the Kreissaal (the birthing room) and get to ask all your questions about stillen (breast feeding), Kaiserschnitt (c-sections), enspannung baden (birthing tubs), PDAs (Epidurals), Famillienzimmer (Family lodging rooms) and the sort. These sessions are all in German, but after the 30-45min talking session, you can always approach the drs and midwives afterwards to ask questions in English.
They recommend you attend the Infoabend around 20-25 weeks because you need to register at your desired birthing facility around week 30 of pregnancy.
For registry you will need:
2. Insurance Card
4. Registration form from your Frauenarzt (Überweisung)
You do NOT need to register anywhere – most hospitals will take you last minute, especially for pre-term labor, complications or if you just plum forgot. But by registering, they already know your desires and birth plan. Worst case scenario and you don’t register, they still have all your info in your Mutterpass.
The benefit of registering is that you get the brown packet for registering your baby’s birth with the city and getting the Geburtsurkunde (the birth certificate). For this you need to have your original birth certificates, your original marriage license (if married) and a few other forms. But if you want to have a baby in Germany, you need to have your own birth certificate with you!
6. 34 weeks pregnant – you are officially on Maternity/Mutterschutz
Your Frauenarzt will give you a form that you need to send to both your insurance company and your employers to inform them that you are on Maternity. Maternity is usually 6 weeks before the due date of your baby, and two months after the birth. If you have a premie, multiples or there are other complications, Mutterschutz might be longer. During this time you will be paid 100% of your salary.
If you did everything correctly, you should receive a confirmation from your insurance company outlining how much they will be contributing to the Mutterschutzgeld (Maternity pay).
Additionally you should write a letter to your company outlining your intentions for Elternzeit – this is the time after Mutterschutz when you will be home with the baby. I believe the law is you can stay up to 3 years at home with your baby while your office holds your position for your return. I used this form as a guideline for the letter: https://www.kanzlei-hasselbach.de/2012/antrag-auf-elternzeit-musterschreiben-arbeitgeber/01/
OMG – so much paperwork. I’m overwhelmed, so I actually made an appointment at the Family Planning Center/Familienplannungszentrum here in Hamburg to assist with everything.
I brought with me paperwork for the following:
1. Baby Registration
2. Elterngeld paperwork
3. Kindergeld paperwork
They not only assisted with my paperwork, but also made sure that I had the current forms. When my husband is ready to take his Elternzeit, he will probably also need to make an appointment to go through the Elterngeld paperwork. For Elterngeld, you will also need to send a lot of additional information, such as proof of 14 months salary before taking Elternzeit, your city registration (Meldebescheinigung), copies of your passport and Aufenthaltstitel (visa). You will also need to send an original birth certificate with the paperwork. For this reason, I think my husband and I are planning on ordering duplicates!
you’ve filled out all the paperwork, you’ve prepared the baby room, you’ve figured out the Hebamme and the hospital and now you’re ready to….
The Elterngeld is a very generous allowance which start with a base allowance of 300 EUR for every family. Maximum pay is 1.800 and the actual pay depends on your net income earned in the last 12 months - even if the income is from outside Germany - as long as within an EU country. The application is no easy thing the moment you have had income that should be considered and it is recommended to seek support. Read more on family allowances granted.
8. Have your Baby
I haven’t gotten this far yet. I’m still sitting on the sofa and waiting for her to arrive. She should be here in the next 3-4 weeks. If not, then I will be bouncing on the bed and eating spicy food so as to not get induced. I think you’re allowed to be 10 days overdue here in Hamburg before you are induced. But before that, feel free to make an appointment for Acupuncture/Acupressure which could be performed by your Hebamme to help induce birth. Germans prefer to try to get things started naturally, so you may also be told to drink Himbeerblätter-Tee (raspberry leaf tea) or consume Castor oil to help move things along.
9. More Paperwork
Once baby has arrived, we will need to get the little one a US passport, a stay visa and Social Security Card. We will also finally need to send in all the paperwork once we get the Birth Certificates in the mail. But, I’m hoping that at that point I’m more able to focus on our little bean and less on the German system.
I hope that this will act as a good introduction to all those who were feeling as lost as I was when I first got pregnant. I’m sure I forgot some steps or things within the post. Feel free to mention them in the comments.
Have a healthy pregnancy ladies!
Read more from Rachel: kenandrachel.com