midwives and home births in germany, part the second

This post is part two of “midwives and home births in germany.” You can read part one here.

Midwives in Germany—home birth plans or not—come to your home for your appointments. I had read about the concept when doing research for a set of Young Germany articles about parenting in Germany, but remain astounded and jubilant at the luxury and convenience of it all to this day. While the first midwife we had met had had trouble finding our place, the second midwife showed up outside of my trailer door ten minutes before I had been expecting her. It wasn’t her first time at a Wagenplatz either—she’d come directly from an appointment with a pregnant woman at the Wagenplatz down the road. I figured that this could only work in my favor. I had telephoned with a handful of midwives before finding one who did home births and wasn’t already booked, and I didn’t want one of my few chances of having the baby at home shattered by misconceptions about and biases against Wagenplatz life.

This woman was older and not immediately overbearingly friendly. Her distanced behavior made me nervous: was she an unfriendly person or was this just Deutsche Distanz*? We sat at my table, and I poured her a mug of fresh peppermint tea while she flipped through my Mutterpass.** She asked me why I was interested in a home birth, and I explained my reasoning as best I could. (Reasoning that I explain here.)

She seemed satisfied with my answer and then looked around my trailer. “A home birth is one thing, but I don’t know.” She trailed off. “Is there running water here?” I pointed out the window at the house and told her we had running water inside. “And a bathroom?” Yes there is, I told her, and we’ve got a shower and a tub in the house as well. She considered this, still looking around. I didn’t know it at the time, but she had turned down another Wagenplatz mother the previous year because she hadn’t felt comfortable attempting a home birth in a Bauwagen. “Well, why not. It’s not like no one’s done it before.” YES! Yes yes yes!

Nervous about being able to find anyone at all willing to attempt a home birth, I forgot to ask her a lot of the questions that have since occurred to me. Specific questions about her philosophy and practice, about her history, about her experience. But reading between the lines, I thought we would be a good match, and a few weeks ago I talked to an aquaitance who had the same midwife attend her own recent birth. Now I know that we are a good match. Apparently she has a reputation as being a women who lets birth take its course without much intervention. Apparently she is the type of woman who, when she says it’s time for medical intervention, you can really believe. Perfect.

At the end of an hour, we wrapped up the conversation, and she asked for my insurance card and a signature. (Not only do midwives in Germany come to your home, but regular old state insurance pays for them to do so! Ba-da-bing! Though for the Beleghebamme/home birth servies we’ll need to pay an extra 250 euro.) “So why don’t you sleep on it, and then if you decide you want to work with me, give me a call and we’ll make an appointment for four weeks after your next ultrasound (my next ultra sound being the one that I mention here).” I walked her out of the trailer feeling relieved at having found a midwife willing to try delivering a baby in a Bauwagen with no running water and a wood stove for heat. When I called her to schedule our appointment the distance between us had dissolved and in a friendly tone we hashed out the date of our next meeting.

Do any of you have experience with midwives? How did the process of finding and working with one go for you?

*Deutsche Distanz is the term for the German habit of not “thawing” to new people until they have had time to establish an actual rapport.

**The Mutterpass (Mother pass) is a passport-sized book that your doctor issues you at your second prenatal appointment. In it all your pregnancy information, such as weight, fetal movement, and blood type, is recorded. This is meant to facilitate smooth transitions between doctors and midwives—as you are like to have at least one regular OB/GYN, a midwife, and whoever happens to be on duty when you go into labor—and to help any paramedics in case of an emergency while are you pregnant. For anyone in Germany looking to make sense of their Mutterpass, I recommend taking a look at this website (in German).

***Photo, as usual, copyright Click Clack Gorilla. That’s 23 weeks of Peanut in there, folks. And look, a little glimpse into what my wagon looks like when I’m not trying to take pretty pictures of it.

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Tuesday October 25th 2011, 9:00 am 15 Comments
Filed under: conspiracies,gorilla parent (pregnancy)

15 Comments so far. Please leave a comment.

Well done on finding the right midwife for you! It’s not easy and I know I was lucky to get any midwife at all after unknowingly waiting too long to find one here in Munich. Turns out she has been a very good match and I have been happy with her but I also did not elect to have a home birth, which elevates the midwife into a much more important role. I like the idea of home birth and we had considered it as well. I had researched enough to know about the downward spiral medical interventions in hospitals can trigger that ultimately take you away from the natural childbirth you might have envisioned. That being said, I decided to go the hospital route and I ended up having the exact hospital experience I was looking to avoid – 12 hours labor, several unplanned interventions, reaching full dilation and then suddenly an emergency c-section. While I was disappointed and wonder if we had made some different decisions would the outcome have been different, I will never know if the c-section was inevitable or preventable. I don’t dwell on it – it was the greatest day of my life and the outcome is no less significant.

I think the best you can do is have a strong conviction of what you want beforehand (it gets much harder to make decisions once you are actually in labor – you are having contractions, you are new to the experience, have limited time for thinking things through, no time for researching options), find someone who has a matching philosophy and a track record to support that vision but who also has the experience to know when you can safely stay the course versus when you have to change plans. It’s also helpful to be as informed as possible ahead of delivery of all possible situations that could come up and options for handling them and to know that whatever you plan as your ideal delivery is only an ideal – flexibility will likely be required (that goes for after the baby is born too when you find out they have plenty of their own ideas on life ;-).

Good luck with the preparations!

Comment by Michelle 10.25.11 @ 10:56 am

Congratulations!

Comment by Ellen 10.25.11 @ 12:14 pm

I’m glad that you found a midwife that you are comfortable with. That being said I’m still a bit petrified for you. I had lofty ideas of home birth, water birth, mid wife, no drugs, etc. I won’t terrify you with scary birthing stories. I will say that I will be sending tons of good thoughts your way, for your youth and strength to carry you through to Peanuts arrival. Patty

Comment by Patty Squirell 10.25.11 @ 2:11 pm

I’m in the States, and midwifery in my part of the country was considered practicing medicine without a license until about a month after my little girl was born. Nevertheless, I decided I would have a home birth come heck or high water, and I had heard about an old family doc that still made housecalls and had delivered hundreds of babies over the last thirty or forty years. I went to his office, and the walls were plastered with photos of all the moms and babies he had helped, all snug in their beds at home, including some twins and a few with captions identifying them as breech births. I felt like we struck gold. He didn’t abandon me when I went past dates, and the labor went well. Compared to the first one – a 70 hour induction in the hospital, complete with unwanted interventions, bullying, lying, and failure to read important notes in my chart – 3 hours of labor and 3 more of pushing out a 9 pound baby with a nuchal hand felt like a walk in the bloomin’ park.

Comment by Rachele 10.26.11 @ 2:41 am

I have been pretty lucky with midwives for 5 of my 6 births. I had an OB-managed birth with the first that was traumatizing enough to send me screaming into the arms of midwives, and the experiences have been reasonably good, or at least as could be expected in a US state (Ohio) where midwifery is only quasi-legal.

We have a birthing center that exists within a hospital, and since our health insurance does not cover a homebirth midwife, we chosen to go with this option instead of birthing at home.

Most of my births after the first one have been unassisted, and the last three I pulled out myself. The second baby fell into the water of the birthing tub (creating years of hilariousness when we would tell the story, since I thought that my husband had caught her; he hadn’t). The third was discovered to have flipped from vertex to breech during labor, and the midwife did an external version, saving us from a c-section since the hospital did not allow them (!) at the time….the midwife handed her up to me from the water. Fourth babe I caught while laboring on my hands and knees, fifth I caught while standing, sixth I caught while kneeling in the water (#6 also had a nuchal cord, which was unwound by the midwife).

While there were doctors and midwives at the practice, I generally felt better with midwives. Not all of the midwives “clicked” with me, and I definitely had my preferences. Overall, when dealing with any health professional, I found that direct and vocal about my plans for birth, and by repeating these plans frequently, I was able to get what I wanted, which was:
-unassisted birth
-

Comment by jadebabylon 10.26.11 @ 4:41 am

Erg. I was trying to tab and make my comment neater, and instead I just posted it. Egads!

the list should read:

-unassisted birth, unless help was needed
-no cervix checks unless I asked
-baby on my chest right after birth
-no cutting of the cord until it was done pulsing
-no measuring, weighing, poking, prodding, whatever of the baby until they had nursed fully

Sounds like you found a great midwife, at least at first glance. Does she work with you to write a birth plan (providing birth plans are even needed in Germany…I am astounded that homebirth is covered by state insurance, wow!)?

Comment by jadebabylon 10.26.11 @ 4:47 am

Michelle: Awesome to hear some more about your birth! I figure the same: even if it turns out that my birth involves all the medical interventions I’m hoping to avoid, it’s still going to be a damn magical day. I’m going to have my midwife, the Beard, and another one of the people we live with along whether at home or in the hospital, so I think together they should be able to manage fighting off any too eager staff we might end up encountering. Fingers crossed.

Patty: Don’t worry, you can’t terrify me with birth stories! The gorier the better, I say when I’m reading, because I like to prepare myself for everything, and I don’t like it when people gloss over the details of the pain and the gore. I am totally intrigued to find out exactly what kind of pain birthing pain is because there are some kinds of pain that I find easier to handle then others. Cramping pain I find easier to deal with then upset-stomach pain, for example. And very few people seem able to really concretely describe the feeling.

Rachele: Glad you finally got to have the birth experience you want! 70 hours? Damn.

Jadebabylon: Damn, girl, six kids! Nice one. And thanks so much for sharing. I love hearing about this stuff. I haven’t had any further meetings with the midwife yet (three more weeks I believe) so I don’t know if she urges folks to write birthing plans or not yet. But I’m planning on writing one all the same, if only so that the Beard and co. know exactly what they are supposed to be advocating for when/if the time comes.

Comment by clickclackgorilla 10.26.11 @ 7:33 pm

[...] (or at least finish El Gato’s), but I am only sort of together with that.  While reading click clack gorilla recently, it struck me that I never shared our birth plan, which seems a shame since we put so much [...]

Pingback by Our Last (and Best!) Birth Plan « twilight monkey 10.26.11 @ 10:15 pm

[...] midwives and home births in germany, part the second [...]

Pingback by midwives and home births in germany, part the first | click clack gorilla 10.27.11 @ 2:25 pm

[...] This post was originally two posts that can be read here and here. [...]

Pingback by The Expecting Expat: Midwives and Home Births in Germany | Young Germany 10.27.11 @ 2:50 pm

I must have fallen ridiculously behind in my blog reading to have missed this news. Congratulations! If you want any tips, email me. I didn’t have a home birth (wanted the hospital in case of complications) but very well could’ve had one and found the midwife aspect awesome (never even saw a doctor until I had to sign paperwork for my hospital release). Mine never mentioned anything about a birth plan but the hospital where we registered in advance (your midwife will likely encourage this — or a Geburtshaus — just so you don’t have to go through “admissions” if you do end up at a hospital) asked me if I had any requests and I said, yes, water, no drugs… When I walked in at 9 cm dilated, they immediately drew a bath (without me mentioning it) and essentially followed whatever birth plan I might’ve written down if I’d bothered. I’d say find your back-up hospital, just in case, and make that part of your birth plan (that meant we took a cab ride 20 minutes away to get away from the hospital notorious for vacuum births here, and that info was def. worth having).

Comment by C 10.27.11 @ 11:25 pm

You’re so lucky. My two deliveries in Germany were both problem cases… I was in hospital for 4 months leading up to my son’s birth and for 4 weeks before my youngest daughter’s (oh and I was also involved in a car crash during that pregnancy where I damaged my spine… which I don’t recommend when you’re pregnant and your spine is under weird pressures anyway).

I’d have loved to give birth at home… but the most important thing was that I had lovely healthy babies (OK – the boy was premature and had to be incubated for a while, but he was fine once he’d put on a bit of weight).

Finding a good midwife is fantastic. The one good thing about being in hospital for so long before giving birth was that I knew all the midwives very well indeed… so it didn’t really matter which one was on shift when the babies actually showed up.

Comment by Cathy 10.30.11 @ 7:09 pm

[...] midwives and home births in germany, part the second [...]

Pingback by my cloth diaper fairy godmother delivers | click clack gorilla 11.11.11 @ 8:53 am

I have to admit that I’ve become at least mildly obsessed with your blog. You have such a fascinating lifestyle and a great talent for sharing it. I felt compelled to share a link with you when you asked how contractions feel. I don’t have children, but my friend explains it so well in her blog post about the birth of her daughter and I wanted to recommend it. This post was the first to ever really convince me to someday consider a non-hospital birth; it’s really lovely. http://ruthiepearl.com/the-birth-of-harper

Comment by Maegan 01.06.12 @ 12:21 am

C: Yeah, the potential hospital aspects of it are all part of the planning going on in my head. My midwife does the registering for us. We’ve visited already, but I still need to find out a number of things about their policies. My midwife works there though, which makes me feel pretty good about her being able to advocate for me with her colleagues should they try to push something on me that I don’t want. Also curious what they would do if they try to force something on me and I just got up and left…

Cathy: Every time I think of how long you were in the hospital before those two births I am like, wow, tough lady. Hospitals make me nuts. Kudos to you for being able to stand it.

Maegan: Why thanks, blush blush. And thanks for the link. That’s a really interesting description of a contraction, and the most descriptive I may have seen in writing yet.

Comment by clickclackgorilla 01.06.12 @ 8:52 pm




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