Upon first arrival, many expat women must navigate a foreign medical system that may be remarkably different from the healthcare system back “home.” Germany has a reputation for having one of the best healthcare systems in the world, providing its residents with comprehensive health insurance coverage.
Approximately 85% of the population is part of the public health insurance while the rest have private health insurance. In 2007, health insurance reform required everyone to have coverage for at least hospital and outpatient medical treatment. This mandatory insurance also includes coverage for pregnancy and certain medical check-ups.
Pregnant women in Germany receive three mandatory ultrasounds: One scan weeks 9-12, another during weeks 19-22, and a final scan during weeks 29-32. All scan results are entered into your Mutterpass, a booklet documenting your health statistics. But aside from the typical Google search results, what else does a pregnant expat in Germany need to know?
I asked two American women currently living in Germany, Michele Landreman-Löschner, and Maureen Kösters, to provide some insider tips for navigating the German health system while pregnant.
Michele: I wish I would’ve known about all of the programs that are offered and covered by our health insurance. Prenatal classes and yoga classes are provided to pregnant women in Germany. I also wish I would have known the difference between public and private health insurance.
We have public insurance, so after childbirth, I shared a room with another mom (which I really enjoyed) while my daughter was in the NICU. It was nice to have someone to talk with during this time. Some things you need to provide yourself, like your own towels for the showers.
Maureen: The Germans use midwives, and they seem to be very important to pregnant women in Germany, both during and after pregnancy. I have been advised my OB/GYN to contact and find one right away because there is a shortage right now, and if I wait too long to find one, I might end up not having one.
Michele: Yes! Bring your medical records with you if you can. It doesn’t hurt to have them, and they will appreciate that you come prepared. They may or may not start from scratch. They will start a booklet for you called a Mutterpass. In this booklet, they will put all the information from each medical visit. It’s good to carry it with you at all times as it has your blood type, for emergencies. If the patient switches doctors, the new doctor will reference this booklet, and you won’t need to start all over again taking new blood samples or laboratory tests.
Maureen: I’ve had the same OBGYN since 2006. When I first saw her in 2006, I showed her my past records, so she knew when my last Pap smear etc. was, but I don’t think it was necessary to do this.
Michele: I asked neighbors and friends for referrals. Before doing any research, it is best first to call, or to visit in-person to see if they are accepting new patients. Where I live, it was very hard to fun a doctor who was accepting new patients. Unfortunately, I settled for a doctor who was located just down the street. I chose her based on her close location, rather than quality patient reviews—now I know why her reviews weren’t very favorable.
Long story short, she sent me home with antibiotics rather than sending me to the hospital where I was diagnosed with HELLP Syndrome (liver failure). My advice is to be insistent. If you know something isn’t right, skip your general practitioner and go straight to the hospital. The hospitals are better equipped, and your health insurance will cover it.
When you are selecting a hospital for your birth, go on hospital tours and read reviews. We chose one that had great reviews, wasn’t too far away, and had a NICU. Our daughter stayed in the hospital for six weeks and was very well taken care of. I was able to sleep over at the hospital during the last week before bringing her home.
Maureen: I didn’t really research my OB/GYN in 2006. I just looked on the Internet for someone who spoke English, was close to my home, and was accessible via public transportation.
Michele: Overall, I would say that moms living in Germany should find a hebame (midwife) as soon as they know they are pregnant. They are a great source of information. After the baby is born, they come over to your house at least once a week to check on mommy and baby. My midwife weighed my baby and answered lots of questions about breastfeeding, helped me find where I could sign up for Rückbildungsgymnasic—a class for moms to workout while the baby lounges on the mat and plays. I met other moms there with whom I am still in contact.
Maureen: The Germans are very open about their bodies in comparison to Americans. German women have no problem getting naked in front of doctors. So for example, when you are getting a Pap smear/examination, you won’t get a sheet or anything to put over your lap. I’ve never seen a gown either during a checkup. I think if you wanted to bring your own gown or towel to cover up with, this would not be a problem at all.
There are a lot of programs for pregnant women in Germany like pregnancy swimming and pregnancy yoga. These types of activities are a great chance to meet other pregnant women. After pregnancy, they have great exercise classes where you have your baby in a baby carrier, and you do postpartum exercises like squats.
Overall, it helps to know a friend or two to help you navigate the foreign medical health system. Don’t be afraid to ask questions, seek advice, and enjoy your pregnancy and birthing experience.