How do I find a midwife?
If you feel not only joy
What kinds of antenatel examinations are there?
Which antenatel examinations are useful?
What to do if an abnormality is detected?
A short overview on the most important antenatel examinations
Which care is offered by midwifes?
Which topics are covered during antenatal classes?
Where can I attend antenatal classes?
How do I find the hospital/place that is situable for me?
What does postnatal care mean?
Will I be able to breast feed my child?
How long before and after childbirth do I have to/ may I work?
Midwife Regina Müdsam offers courses before and after the childbirth that take place in the F(amily)P(lanning)C(entre).
She also does counselling personally. For further information contact her under: Telephone: 04165/ 222064
E-mail: regina.muedsam(at)web.de.
There is also the possibility to contact a midwife via the midwife organisation Hamburg: midwife
Maybe you did not plan to get pregnant and have difficulties to get used to the thought of being pregnant. Maybe you are on your own or your partner does not wish the pregnancy. Maybe you have conflicting feelings regarding pregnancy, delivery and being a mother or you are worried about the changes of your body.
As so much is changing during this time many pregnant women and their partners experience not only joy but also anxiety and uncertainty. If this makes you feel uncomfortable or affects your relationship, counselling could help you to regain your balance.
In some cases a depression, that should be treated, may develop during pregnancy and last even after childbirth. We will gladly help you to find help.
First of all there are regular antenatal examinations which are covered by your health insurance. In addition there are so-called examinations for prenatal diagnosis to detect possible foetal abnormalities. You may seek advice on the different available tests before you make a decision. It is important to know that these tests are not part of the routine antenatal care. You may have to pay for them yourself.
During the first 7 months you will have regular examinations once a month, and after the 7th month every two weeks. The doctors will take your blood pressure, take your weight, and urine samples to test for blood, sugar and protein. During the first examination you will also be tested for Chlamydia infection.
Most of the examinations can be done by a gynecologist or a midwife, others - such as ultrasound - only by a gynaecologist.
During routine antenatal health care there are three ultrasound examinations covered by the health insurance. For medical reasons additional examinations can be done. If you wish to have an ultrasound examination without medical reason or for a nuchal scan you will have to pay a fee.
A set of blood tests will be done at the beginning of pregnancy (examination of blood group, haemoglobin, rubella antibodies, testing for syphilis and HIV etc.) covered by your health insurance. Later you will be tested for Hepatitis B and blood-group antibodies will be checked. You may be offered further blood tests for which you will be charged.
Your gynaecologist may advise you on the possibility of additional antenatal examinations in the beginning of your pregnancy. You should decide yourself which examinations you want to have done. With these tests you can only detect certain abnormalities and diseases and you can’t be guaranteed to deliver a healthy child.
With some of the examinations you can only calculate probabilities for certain diseases and further examinations are necessary to get definitive results. Only a few of the diagnosed diseases may be treated during pregnancy or shortly after giving birth.
In most of the cases of abnormalities or diseases you may have to deal with the decision of having a late-term abortion. The decision whether to have antenatal examinations done involves many difficult questions: How much is appropriate for us to know or not to know? Can we imagine to have a disabled child? What would a late-term abortion mean for us?
Counselling may help you to reach a decision you can cope with.
Shock and grief are the predominant emotions in this situation. Nevertheless you have to make a decision whether you want to carry the child to term in this situation. Should you wish so, we are there to help you in reaching a decision, support you throughout the pregnancy, or help you cope with a possible abortion.
Nuchal Fold Scan
Ultrasound is used to measure the nuchal fold during the 11th-13th week of pregnancy. The thickness of the fold may be a sign for an abnormality. However further examinations are needed to determine whether there really is a foetal abnormality or disease. In most cases of an abnormal nuchal fold the child is healthy. A combination of special blood tests with a nuchal scan allow more accurate risk calculations, but cannot replace further examinations to provide a definitive diagnosis.
Amniocentesis
A sample of amniotic fluid is taken with a needle through the abdominal wall and the womb. The foetal cells in the amniotic fluid are tested for chromosomal abnormalities. This procedure can detect chromosomal abnormalities with high reliability. However, you will often not know exactly which disabilities the baby will have. An amniocentesis is usually performed during the 15th week of pregnancy, with the results being available two weeks later. In 0.5% of the cases the examination may lead to a miscarriage.
Chorionic Villus Sampling
A sample of tissue from the placenta is taken with a catheter through the vagina and cervix. The sample can be analyzed for chromosomal abnormalities. The procedure is somewhat less reliable than an amniocentesis, but may be performed earlier, during the 10th -12th week of pregnancy, and the results are available after a couple of days. Furthermore, the examination allows for the detection of hereditary metabolism disorders. The risk of miscarriage is similar to that of an amniocentesis.
Morphology Ultrasound Scan
During the 20th week of pregnancy ultrasound may be used to detect abnormalities in the development of foetal organs. The procedure is performed by specially trained gynecologists.
Doppler Ultrasound
During this procedure a special ultrasound technique is used to examine the blood flow in the child's blood vessels and the umbilical cord in order to determine whether the child gets enough oxygen and nutrients.
- Antenatal classes, exercise before and after birth, classes during 2nd and 3rd pregnancies - baby massage - antenatal health care (e.g. alternating with your gynaecologist) - assistance with a home birth - home visits for postnatal care - counselling on: diet, exercise, body changes during pregnancy, choosing a hospital, help and advice on pregnancy-related discomfort
prenatal classes, gymnastic classes before and after birth, classes during
2nd and 3rd pregnancy
babymassages
preventive examinations (e.g. alternating with your gynaecologist)
assisting with a home birth
supporting you with your puerperal at home
Counselling you on your diet, sports, your changing body during pregnancy, choosing a hospital, help and advise on pregnancy-related afflictions
how do I notice the beginning of labor and when do I have to go to the
hospital?
help and useful exercises for pregnancy-related afflictions
exercises easing pregnancy and preparing for giving birth
information on different positions during delivery and their respective
advantages
information on the health and Care of your child
share your experience with other pregnant women or couples ( not available
with all classes)
breathing and relaxation techniques previous to delivery
how to deal with pain during delivery
which hospital to choose
- The family planning centre offers a variety of classes - Through the list of midwives of Hamburg - on the internet at www.midwife.de
All maternity hospitals offer information meetings during which you can get a personal impression and ask questions. Your midwife can also give you individual information. Should you decide to give birth at home, you can find a midwife on the list of the midwives of Hamburg or on the internet at www.midwife.de . Usually one to three midwives will work as a team to support you during delivery. The Geburtshaus in Hamburg offers regular information meetings for women and couples who don’t feel comfortable with delivering at a hospital but are not able or do not want to plan a home birth.
Provided you arranged it in time, a midwife will visit you at home after childbirth and will care for you and your child. She will monitor wound healing, health and weight gain of your child, umbilical healing, and advises you on topics such as breast feeding, caring for your child, your diet while breast feeding etc. She also tells you if and when you need to consult a doctor.
Only on rare occasions a mother is not able to nurse her child. Should you be uncertain whether nursing is possible for you and your child you can consult your midwife.
The maternity leave is regulated by law, and every employer must adhere to it. You can get these maternity regulations at the family planning centre, from your employer, or the federal labour court. Basically, employed work is not allowed from 6 weeks before to 8 weeks after childbirth. The law contains many more regulations for your protection, so you might want to take a look.
