A Pregnant American in Germany, part 2: The Doctor

Soon after getting over the initial shock and roller coaster of emotions connected with finding out we were in fact expecting we were faced with a new challenge: to find an OBGYN, or Frauenarzt as they are called in German.

There are plenty of doctor’s to choose from in Hannover- but how do you choose? We didn’t follow the advice of books like “What To Expect…” and interview doctors about their training, prenatal care routines, or delivery philosophies. We didn’t even think about personality compatibility. No sir. You see, when you are an expat living in a country where you have only basic language skills and practically no medical vocabulary knowledge, and then you find yourself pregnant, your desires in a doctor suddenly become much simpler than all of that. Your “wish list” of items gets tossed out the window and taken over by one sole goal: to find a doctor who speaks (and is willing to speak) English. Anything extra is icing on the cake.

We were super nervous when we started making phone calls, but praise God (!) for his provisions because Drew and I were extremely fortunate to be able to find a doctor relatively quickly and painlessly. Someone at Drew’s work gave us a recommendation for an English-speaking doctor, and she turned out to be just excellent. Her English is very good and she doesn’t seem to be bothered at all by the fact that we are foreigners or that it sometimes takes longer for us to figure things out due to cultural differences related to pregnancy. Fabulous.

After finding our doctor, my next job was to adjust to going to the doctor in Germany. And, there are some definite differences I have noticed regarding the doctor’s office / prenatal care in Germany as compared to the US. Let me share a few of those now:

-The privacy standards when you visit an OBGYN in Germany are not at all the same as when you go in the US. For example, instead of stepping out of the room, giving you a few minutes to undress and providing you with a gown, drape or blanket to cover up with, the doctor stays in the room with you as you undress and you aren’t given even the smallest scrap of fabric to cover yourself. Thus you sit, in “those everything-open-for-the-world-to-see” chairs, in your birthday suit, minus perhaps a pair of socks you just didn’t feel the necessity to remove. The first time I encountered this I was just about mortified, feeling robbed of my privacy, I remember thinking to myself- “I just can’t wait for this to be over- how embarrassing!”, but now, several appointments later I can say that I’ve gotten used to it and it’s no longer a concern.

-My clinic is all-in-one. By this I mean that the exams, ultrasounds and all of the necessary bloodwork are done right in the same office. I find this to be wonderful as it saves a lot of time I would have spent in the waiting rooms of blood drawing labs or ultrasound facilities in the US.

-Ultrasounds are done by the doctor herself and are given at EVERY appointment here! Yes, it’s true- Drew and I get to “see” our little girl each and every time we visit the doctor.

-Our Doctor may perform the ultrasounds but one thing she won’t do is deliver the baby. Yes, you read that correctly! Doctor’s in Germany do not deliver babies, they only do the prenatal care. Our baby will instead be delivered by whoever the midwife on duty is at our hospital when I go into labor. (More on midwifes and hospital practices in another post sometime).

-There seems to be a “don’t ask, don’t tell” policy here in Germany. Although our doctor is very happy to sit down and go over any questions we may have, she doesn’t offer up a lot of information without us asking for it. For example- I have never once been consulted on my diet in pregnancy, or the appropriate weight gain in pregnancy for someone my size (I wasn’t even weighed regularly until the 3rd appointment). No one has told me to “try to sleep on the right side” and we didn’t even discuss prenatal vitamins with our doctor until Drew and I directly asked about them. The mentality around here seems to be that if you must be responsible for yourself and if you don’t know something you have to ask.  The same goes with getting your results from blood work, urine tests, etc. Unless you specifically ask, the doctor won’t bring them up unless there is a concern. Being the uber-planner and researcher that I am, this do-it-yourself laid-back approach fits me just fine. In fact, I think I even prefer it as it has definitely helped to lessen my stress of doing everything “just right”.

-I’m almost 25 weeks along now and we have not once heard our baby’s heartbeat.  Oh she has one alright, we’ve seen it many times flashing on the ultrasound screen, but we’ve not yet experienced the joy of hearing it. When we asked the doctor about this she informed us that it wasn’t common practice in Germany to actually listen to the heartbeat, until much latter in the pregnancy. What is common is that sometime around the 30th week my doctor’s appointments will be getting much longer. This is because, in Germany, it is standard practice to listen to and monitor the baby’s heartbeat and movements for about 30-45 minutes at each appointment after the 30th week. So we will hear it eventually, and it’s something we are definitely looking forward to!

Ok, at just under 1000 words I think I’ve written enough for today. If you’re still here reading my ramblings about pregnancy and the German system- congratulations and thanks for staying with me. :)

Feel free to ask any questions you have if and when they come up.

More to come.

 

9 Responses to “A Pregnant American in Germany, part 2: The Doctor”

  1. Zoe writes:

    Really fascinating, Lisa! I wish you’d post more frequently–and write longer posts. I love reading cultural differences like these.

  2. Rich writes:

    Hey, Lisa,

    Nice post, glad all this is working out. The part that jumped out at me about this was the heartbeat. There was no joy in my hearing it for the first time. Whereas you had your many emotions when you got the positive pregnancy test, I didn’t. Stuff didn’t seem real for several weeks, and I think I was still hoping we were having a puppy into the second trimester, when the ultrasound technician crushed that admittedly slim hope by showing us the limbs and feet and toes and whatnot. Hearing the heartbeat was one of the first times I was like, oh dear, we may actually have a little person to keep alive. Crap.

    360 days later (his birthday is Friday), though, I’ve rather gotten to like the boy. We had a delightful day today, playing in two parks and doing all sorts of fun stuff around the house. :)

  3. Stephanie writes:

    I am German living in the UK and I am constantly comparing health care between Germany and the UK. I had my son in December 2011. We got 2 ultrasounds in total. At 12 weeks and at 20 weeks and that’s it. I did not see a doctor at all during my preganancy, just a midwife who listened to babys heart beat for a minute on a doppler and measured my bump with a tape. Then, after delivery I had to share a room with 5 other women and their babies. As I did not have any complications during my pregnancy, I will see the midwife even less during my next pregnancy. So, this is really bad ante natal care imo.

  4. Blue Cakes Blogger writes:

    Stephanie- wow- I can’t imagine never seeing a doctor through out the entire pregnancy!

  5. Stephanie writes:

    I just realised that your baby was born in December as well. Yay for december babies. I can’t believe that Maxi (my son) is closer to being 1 year old than to being a newborn. Living abroad is an interesting experience, right? Because you do compare your country with the country you are currently living in all the time. I had a few (very expensive) private scans as 2 were just not enough for me and I did not trust a hand held doppler and a measure tape.

  6. Blue Cakes Blogger writes:

    Yes- Moriah will be 10 months already on Wednesday- time flies!
    And it certainly IS a trip having a baby abroad! As this is my first child, I don’t have experience having a baby in the US, but I still make comparisons to what I’m told by friends in the US- it’s crazy! :)

  7. Liv writes:

    Hey,

    I just came across this blog and I had a question for you, though I am not sure if you will be able to answer. I am now 23 weeks and have switched doctors due to personal reasons. At the first doctor I had a scan at every appointment as well but at the second doctor, though I still have the same insurance, I am now told there are only 3 scans covered in the pregnancy. I then also heard from another lady in the larger city next to mine that she not only has one at every appointment but that she has a 4d scan and its all covered by the insurance. I am completely confused at how there seems to be such an extreme discrepancy about this here and have no clue why that should be. Do you have any ideas or ever come across that yourself? (Also American in Germany btw :)

  8. Blue Cakes Blogger writes:

    Hi Liv,
    First of all- congrats on your pregnancy! :) Regarding your question, here’s my understanding of how it works- it is true that insurances in Germany (the public one and most private ones too) will only cover 3 ultrasounds per pregnancy. (This was the case with my -private- insurance too. I did have scans done at each appointment, although I paid out of pocket for the additional scans, which, for the record, were very inexpensive, something like 15-20 Euros each, which I felt was worth it). Now, that said, although the insurance will only cover 3 standard prenatal scans, a lot of doctors in Germany still make a habit of doing more. With the public insurance, as long as the doctor tells the insurance the scan is needed, the scan is paid for. It seems very easy to get more, as long as the doctor is comfortable telling the insurance it is needed. I had a friend here with public insurance whose doctor did a scan at every appointment (paid for by public insurance) because the doctor “felt more comfortable medically checking in on the baby that way”. My friend was thrilled. The same is true with the 4D scans- it’s up to the doctor. Private insurances aren’t as easy to convince that more than 3 scans are necessary. Mine did end up covering one or two additional scans, but only because I happened to go into very early pre-term labor and ended up in the hospital. (Also- I *believe*, and this is speculation so take it as you wish- I remember hearing from my doctor once that the public insurance in Germany has changed a lot over the last decade or so- they used to pay for many many more things, especially in the case of pregnancy. Many Germans and many German doctors are not thrilled about these changes. A lot of the doctors still do what they were used to before the changes (many more scans) and just write it off as “necessary / emergency” while others have accepted the new regulations… perhaps this also helps explain this a bit?). Anywho, that’s my understanding of it all. Hope this helps! Best wishes, ~Lisa

  9. Elaine writes:

    OH! How I wish to be back in Germany with my OB. I loved everything about the medical care there. Now I’m pregnant in the US. I do not understand ultrasound techs. It takes 5 minutes for the doc to perform the ultrasound and explain it as he/she goes. Here, the tech takes 15 minutes. Then you wait. Then the doc comes in (eventually). Then the doc looks at the images. Then the doc tells you what’s going on. Then, if there’s an issue, the doc does the ultrasound again. Pointless and inefficient with everyone’s time.

    I got an ultrasound on each visit in Germany as well. It was just part of the visit. My private insurance either always paid, or the doc didn’t charge every single one. I mean, after the machine is paid for, what is so expensive about ultrasounds, anyway?

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