After discovering I was pregnant, I started hearing the word Hebamme. I didn't really understand what they were for because we don't have them where I come from. If you are from a country where things work, like in Mexico, you have a gynecologist who will monitor your pregnancy. He and his team will do the monthly checkups where you see your little bundle of joy (monthly ultrasounds are routine and a lot of them 3D) and handle any possible complications. When the day comes, you call your doctor, and they meet you at the hospital you have chosen. They are there for most of the process, depending on how long it takes but definitely during birth. After birth, the doctor himself monitors you. When you go home, you usually have a grandma or two available to help you and a whole army of aunts, cousins, and friends at your disposal. Here it works a little bit differently.
In Germany, as in many countries, your gynecologist will be there just for pregnancy controls and will see you until about 6 weeks after birth. The gynecologist is in charge of the pregnancy but is not present for the birth. Labor and delivery are done by a Hebamme (midwife).
During pregnancy, Hebammes give birth preparation classes and guide you through the process. They can also perform specific checkups, monitor you and the baby, and help with pregnancy issues as they are often experts in homeopathy and acupuncture.
During birth, the Hebamme will be your guide. As long as everything is going well, the Hemmabe will care for you and receive the baby. If you decide you give birth in a birth house or at home, you might even have the same Hebamme as pre and postpartum. If you give birth in the hospital, one of the Hebammes on staff will be there for you; depending on the hospital, you will have approximately 1 for every 3 or 4 women working 8-hour shifts.
In my case, because my labor was so long, we had 4 hebammes. For me, this was the scariest part of giving birth in Germany, not knowing who would be with me at that CRUCIAL moment and if we would even be able to communicate. I kept reviewing "german vocabulary for birth." Still, it made me so anxious I couldn't even remember how to say "push."
It turned out I didn't have to worry. I was very lucky because all 4 spoke either a bit of English or Spanish and made me feel safe and cared for throughout the whole process. I felt and have also read that they are more prone to a natural birth process because of their training. I wanted this, but it also scared me because I had also read that they were very negative about interventions. This, for me, was not the case. They were very open about all my options, and I never felt an inclination towards one thing or another, we were in total control of our birth.
I am grateful that I gave birth here. Because of how the system works, I am 100% sure that in Mexico, I would have had a C-section instead of natural childbirth. My water broke at 9 am Thursday, and I gave birth at 15:42 on Friday, it was long and hard, and at all times, they were patient with my body and my process and guided me through the pain and exhaustion. And don't worry, there is also a doctor present when the baby is born just in case something is wrong, and there is a need for medical assistance.
During postpartum, you can also be accompanied by a Hebamme. This is where it gets tricky because, for the first two stages, you don't need to have your own Hebamme. If you don't have one, there are many preparation classes online or even at hospitals that you can take. For birth, you just need to check into the hospital, but for postpartum, you need to look for one on your own, and that search can be really hard.
Here is what happened to me, I found out I was pregnant in late November, and as soon as I found out, I told my husband and called my gynecologists. Her office said that it was too early for a consult, but I didn't care. I wanted her to confirm the pregnancy for me peeing on a stick. Although I had done it several times just to ensure I didn't have a false positive (the odds of that happening are tiny, but still, the control freak in me needed to make sure). So, I insisted and insisted until they gave me an appointment (one thing you need to know if you don't already is that for healthcare in Germany, it's better if you take control and that sometimes you need be a little pushy).
Anyways, we confirmed the pregnancy, and everything was perfect. After that, we went to Mexico to spend Christmas with my family and share the exciting news. We returned to Germany in January, by then, I was on week 13. I thought I was on time because, in the end, you are not supposed to make it official until the first trimester has passed, right? Also, to tell you the truth, it wasn't my priority to look for one. I wasn't sure I wanted one because I kept picturing a stereotypical German lady (you know, the Octoberfest type) yelling and me postpartum and trying to impose her way of doing things.
Everyone German insisted having a Hebamme was essential; everyone else had diverse comments. Everything from "my Hebamme was a lifesaver" to "you are better off without one." Still, so far, no one had explained exactly what they do. All I got is that they would take care of any postpartum issues and teach me how to take care of my baby.
It turns out that it wasn't even an option because no one had time for me. In the beginning, I was looking for someone that spoke English or Spanish. I thought that after birth, I would be at my most vulnerable moment and in need of someone who spoke my language. I also felt that if they did, they would maybe understand the cultural differences better. I didn't find many, so I broaden my search to basically anyone available. I called and emailed about 30, and they were fully booked already or were going on vacation around the time of my birth (my due date was August 3rd).
I kept looking for a while until I decided to give up. After all, my mom would be here for the birth and stay a month after, so she would help me take care of my baby. Little did I know a global pandemic was coming that would shut down the borders and wouldn't allow grandma to come for the birth.
As the due date closed in and we realized we would be alone, we started looking again, reached out to the people we knew, and got lucky. It turns out that the guy that cuts my husband's hair had a client who is a Hebamme and convinced her to help us. She didn't have the space for us, so the visits weren't as often, but she did manage to squeeze us in for a couple of appointments after birth. I won't talk about how often we met with her or for how long because, for us, that was a little different, but this is what she helped us with:
Every time she came, she weighed our baby and made sure he was gaining the right amount.
She cleaned his umbilical cord and taught us how to clean and care for it. When it wasn't healing correctly, she also used laser therapy to help him heal faster.
She gave us tips on how to change the diaper and tips about products we could use. This was great because all my friends kept recommending things that were not available here.
After about 3 weeks, when the cord was off, she helped us with the first bath. Yes, in Germany, babies don't get baths in the first weeks!!! When it was time, she taught us how to hold him and gave us tips on the skincare routine.
She checked the color of his skin to monitor Jaundice.
She gave us homeopathy for colic.
She checked his feet and gave us massage techniques for his feet that were a little crooked from being jammed in my belly.
She showed us different ways of swaddling, holding him, and feeding him.
She checked that my body was healing correctly, and when my stitches were not, she used laser therapy to help things move faster.
She provided help with all things related to breastfeeding. She is not a lactation consultant, and her support was limited but still better than being on your own.
She gave me homeopathy for the pain I was having.
She recommended great local products, everything from different breastfeeding pillows because mine was not working for me to lotions and homemade remedies to heal faster.
She showed me exercises I could do to start rebuilding my core and pelvic floor.
She gave him instructions on how to take care of me, everything from a list of products to my feeding schedule and nutritional requirements.
She taught him how to massage my breast to unclog my ducts (often, it helps when someone else does it for you and especially a man because their hands are bigger).
She gave him a lot of confidence by teaching him exactly how to hold him, pick him up, and generally care for him.
In general, it was reassuring for him to have her come and say everything was ok and we were being good parents.
You should know that insurance in Germany covers the Hebamme in general; certain things are not included, such as alternative medicine. Check with your health insurance what is covered, how many visits, and if you require more after that, you might be able to get it covered if your doctor recommends it.
Now that I have gone through the whole experience, I can recommend that if you can, you should definitely get a Hebamme. The search is complicated and stressful, but if you start as soon as you find out you are pregnant, I'm sure you will be successful.
Once you find one, take advantage of the resource. Understand that here, your doctor might not be as available as back home or that there is a lot of products and options that you might have never heard of. With a new baby, take all the help you can get, and in the end, if you find it's not working for you, you can always thank her for her services and explain you don't need it anymore.
As ex-pats, sometimes we don't want to let go of what we know from home and are scared of the imposition of a different way of doing things, but what I would recommend is to take what is useful and discard what is not, give the system a chance and it might surprise you.