Schwangerschaft in Deutschland
Olivia Wilkins
As I am two days away from my baby’s Geburtstermin, I still cannot believe I have experienced German Kultur around Schwangerschaft und Geburt first-hand. One year ago, I still insisted I wouldn’t have any children until after grad school and probably not until I had a steady job. Yet here I am, Kulturbotschafter aus den USA, about to help boost Germany’s declining birthrate.
Being a first-time parent-to-be exclusively in Germany, I have no basis for attitudes and behaviors around Schwangerschaft in the United States. However, I have some basic idea of some of the differences between the two countries from my understanding of laws and services in the U.S. as well as from talking to another couple, Fulbright parents themselves to baby number two after having their first child in the States.
While initially Alex and I were ecstatically freaked out at the prospect of having a child in Deutschland away from our families and the comforts of Anglophone doctors, we have come to not only accept that having a baby in Germany is actually happening, but that here and now is perhaps the absolute best option for welcoming a new member of die Familie.
One reason for this is age. If we wait until we are settled and ready to have a baby, we’d never have one. Now, however, we are both young and full of energy, without significant obligations; we are more flexible now than we will be when I’m fighting for tenure or a research position and Alex is establishing a store-front Kaffeehaus. In Deutschland, my only obligations have been to learn and do research for the CDMS while applying to grad school—pretty low stress when compared to trying to establish a career with a husband trying to establish a small business.
Another big plus is the health insurance bit. It is no secret that Europeans have much better public health systems than Americans. About 90% of German residents have public health insurance. Fulbright pays for its American fellows in Germany to have private insurance, but they will drop the private insurance and give you the premiums toward public insurance should that be a better option. For families, public insurance is indeed the better deal because it covers pregnancy (whereas the private insurance offered through Fulbright does not). For Studenten under the age of 30, public health insurance is available for about 80 € (about $90) a month, with no additional cost for dependents. With the reimbursements from Fulbright, Alex and I pay about 20 € ($22) per month for both of us (and when he gets here, Baby, too).
At a woman's first OB appointment in Germany where pregnancy is confirmed, she receives a Mutterpass. The Mutterpass contains all of her medical records related to the pregnancy, putting the power and responsibility of caring for her records in the hands of the mother-to-be.
Not only are the public health insurance premiums extremely cheap for students and their families when compared to the government-subsidized insurance in the States, the additional expenses around pregnancy are virtually non-existent as well. There are no co-pays at die Praxis, and everything at the hospital is covered as well. The only money we’ve shelled out for anything medicine has been for pre-natal vitamins and some Manganese tablets, costing us a grand total of less than 20 € since I started taking them in Oktober. The fact that my pregnancy and birth is costing us 220 € (990 € without the reimbursement from Fulbright)—which we’d have to spend anyway to have health insurance—is pretty awesome. Unfortunately for the other Fulbright parents, they were not able to enroll in the public insurance; however, they reported that the out-of-pocket cost for the pregnancy and birth in Germany without insurance was about the same as what it was in the States with insurance.
Perhaps the discrepancy in cost between the U.S. and Germany for parents comes down to views of the family. While American politicians claim the backbone of America is the American family, their actual policies often don’t support this. When chatting with my research advisor, he was astonished that health insurance in the States wasn’t enough to have a baby, saying that “having children is a service to society; no one should have to pay to go to a hospital and have a baby.” Between healthcare costs and maternity leave practices, having an affordable and supported birth is a right in Germany, not a privilege. Birth here isn’t just about a baby physically entering the world; it is about nurturing and supporting a family.
I was surprised when my research group told me not to come in to die Universität four weeks before my due date. In Germany, it isn’t suggested or permitted for you to take off work during month nine, it is legally required for the safety of the mother as well as for liability purposes. Moreover, maternity leave is offered full-time for eight weeks and additional leave (full-or-part-time) is available after that. Who pays for this time? The government, arguing that parents spending time with their newborns is beneficial to society. Still wanting to be involved in the project, my research group is letting me work from home at my own convenience. But until the end of my grant, they want me to put my family and health first. This is much different from the policies at various research institutions in the U.S., which allow one month paid maternity leave (and that’s all the time off you can take). As eine Amerikanerin, the German approach stressed me out incredibly at first; I kept apologizing and expressing my guilt for leaving work at the beginning of April. My office-mates, however, looked at me like I was insane, because who in their right mind would put work over the health of their self and their baby?
This support doesn’t end after the baby arrives. Last week, Alex and I met our nach-Hebamme—the midwife who will come to our apartment every day for the first week after we leave the hospital (which is typically after three days in Germany) for a week and as needed (up to 16 times) in the following 12 weeks. The purpose of the visits by die Hebamme is to make sure the baby is nursing well, to help assess his sleeping, and to track his weight and size before we graduate to a pediatrician. Again, this is completely covered by our health insurance and is a right to all German residents.
When Alex and I first found out I was schwanger, I quickly became terrified. Birth in the United States is often described as a painful nightmare, where parents are left with little support from their doctors. Over the course of eight months, however, I slowly became more relaxed about my Schwangerschaft because it was clear that I had the support of the German system. Even the hospital told me to bring snacks, playing cards, music, or whatever else would make me feel at home with me for the birth. They asked me questions about how I wanted my birth to go, giving me both authority and confidence that within the next week, I can bring my child into this world in comfort and with joy, rather than as a patient at the mercy of a doctor.
Between the backing of Germany and the unwavering encouragement and support of Alex (who has gone above and beyond what I could ever hope for in a partner), our joke of bringing home a baby as a souvenir gone true statement is perhaps the best (and most-memorable) way to live in Deutschland.