Most pregnant people in Germany decide to give birth in hospitals. However, you are essentially free to choose whether you want to give birth in a clinic, a birth centre, or at home. Which birthplace is right for you depends mainly on where you feel safest and most comfortable. A delivery in a birth centre or at home is mainly an option if you have an uncomplicated pregnancy with low risks. You should also think about how much support you want in the days after the birth. Depending on the type of care, you may incur additional costs. An outpatient birth is possible with hospitals as well as with the birth centres. In this case, you can go home a few hours after the delivery. Ask your gynaecologist or midwife what they would recommend.
Information About Medical Interventions During Birth
Doctors and other people who provide you with medical care may only perform a medical procedure on you or your child if you have given your written consent. This also applies to childbirth and the period shortly afterwards. The exception to this is emergencies and situations where a decision must be made very quickly to save your life and that of your child. In all other cases, your doctor or midwife must have informed you about the reason, the aim and the possible risks of the treatment before the procedure. They should also give you information on other possible treatments. They also have to tell you what the consequences will be if you don't have the particular procedure done. This must also be put in writing and signed. Before the birth, you can use the appointments with your doctor or midwife to discuss what is important to you during the birth. Your doctor and midwife can then tell you what advantages or disadvantages certain measures have for you. If an intervention becomes necessary during birth but was not foreseeable beforehand, you’ll get information during the preparations for the intervention.
Birth is an exceptional physical and emotional situation. Many people find it to be one of their happiest moments. However, there are also a lot of cases where a traumatic birth leaves deep scars. These can be physical, but also emotional injuries. In order to counteract as many negative experiences as possible, it makes sense to think about how you would like your child to be born while you are still pregnant. The more you know about the process, the more likely you are to have a self-determined birth. You can then better decide what is important to you during the course of your delivery. This includes learning about your rights in this particular situation.
Partners and family at the birth
Birth is a very personal event. That's why it matters a lot who accompanies you. There should not be more than one or two people. It is important that you can trust your escort. If you are in a relationship, then of course your partner is a good choice. However, you can also be assisted during the birth by a person from your family or your closest circle of friends. If you don't have a confidant who can accompany you to the birth, usually the midwives in the hospital, birth centre or in a home birth will simply take care of you a little more.
There are four stages of childbirth. In Germany, these phases may be named and measured differently than what you are familiar with: here, labour begins with the ‘opening phase’, followed by the ‘transition phase’, the ‘expulsion phase’ and the ‘postpartum phase’. Before the first contractions begin, the birth may already be announced by a slightly bloody discharge. Another sure sign that it's about to begin is the rupture of the membranes, otherwise known as your water breaking. During rupture of the membranes, the amniotic sac that surrounds your baby during pregnancy empties. Every birth is different. However, the sequence of birth stages is usually the same.
Induction of Labour
Almost all babies are born within two weeks before or after their due date. If you and the baby are doing well, there is no particular risk to either of you in the first week after your due date. After that, however, the risk increases that you or the baby will develop health problems. Then the birth can be induced. Doctors and midwives have various options at their disposal. They can administer medication as well as mechanically assist. However, not all procedures are suitable for every pregnancy. Also, there is no guarantee that birth induction will always work. It is best to talk to your midwife and doctors about what induction of labour procedures are offered by the hospital or birth centre where you will be giving birth. Have the pros and cons explained to you. Induction of labour is not an emergency. Whether and when to induce labour is a personal decision. You can make the decision together with the doctors who look after you.
Birth Positions and Water Births
There are several positions in which you can deliver your baby. Many pregnant people feel more comfortable standing than lying down at the beginning of labour. As things progress, however, they automatically adopt different positions because different postures are comfortable in the different stages of labour or because they help the birth along better than other positions. Childbirth preparation courses will teach you which birthing positions there are and which advantages and disadvantages they have. In most hospitals and birth centres you can switch between different positions and try out which one you are most comfortable with. Ask your midwife or doctor for advice and ask the obstetric team for suggestions.
Breathing During Birth
Even before the birth, you can learn about how certain breathing techniques can help make the delivery easier for you during childbirth preparation courses . You will also learn about the stages of labour and how to tense and relax different muscles that are important for childbirth. This can give you some influence over the pain. This knowledge is very useful and gives you more confidence during childbirth. The best thing to do is to register early for a childbirth course. Most health insurances cover the costs up to a certain number of hours. Many insurances even pay the course fee for a companion who will support you later during the birth.
Breech Presentation and Turning
Starting in the second trimester, you can usually feel the first movements of pregnancy in your belly. Until about the 36th week of pregnancy, the baby still has enough room to change positions again and again. After that, it gets harder and harder as the baby grows and it gets tighter in your belly. If your baby is not yet head down by this time and has therefore not yet assumed the correct position for birth, this is known as a breech presentation. Your baby's head is on top and their bottom, legs or knees are pointing down towards the cervix. But that's nothing to worry about. On the one hand, sometimes the baby can still be turned with the help of special techniques. On the other hand, a baby can still be born without a c-section, even in this situation.
A caesarean section or c-section is an operation in which doctors remove the baby from the womb through an abdominal incision. The baby is therefore not born through the cervix and vagina as in a spontaneous vaginal delivery, but is delivered through the abdominal wall. Most people who deliver their babies by c-section have a planned caesarean section. Often there are medical reasons for this already apparent during pregnancy. Sometimes it is not until you are in the hospital that it is determined that it is better to have an unplanned, cesarean section, which is then performed similarly to a planned procedure. In some cases, however, doctors have to perform a caesarean section very spontaneously and quickly because complications suddenly arise during the birth process. This is called an emergency caesarean section. However, this rarely occurs.
In Germany, one in ten children is born prematurely. This means that the baby is born in the 37th week of pregnancy or before the 260th day of pregnancy. There are three categories into which premature babies are divided. Extremely premature babies are those born up to the 27th week of pregnancy. Very premature babies are born between the 28th and 31st week. Late premature babies are born at 32 to 37 weeks.
Pain Management During Childbirth
Many people surprise themselves by going above and beyond when they give birth. Childbirth is an exceptional, energy-sapping situation in which you also have to overcome severe pain until your baby sees the light of day. Anxiety and cramping can exacerbate this pain. People who are giving birth for the first time are often especially insecure. Childbirth preparation courses can help you reduce anxiety and learn relaxation exercises. In the group and guided by a midwife, you can talk openly about your fears, how to deal with pain and how to manage it. You may still feel like you can't take it anymore during the birth. This is normal. But in those moments, you don't have to lose hope. If you think it's getting to be too much, there are several options open to you to relieve the pain with medication as well.
Vomiting and Diarrhoea During Childbirth
You've probably already gotten used to strong reactions from your body during your pregnancy. For many pregnant people, this starts in the first trimester with the familiar morning sickness. As your pregnancy develops in the months that follow, it will put more pressure on your bowels, causing you to have to go to the bathroom more often. For many pregnant people, labour also begins with diarrhoea or vomiting. In a way, the body is making room for birth. It sounds more embarrassing than it is. Midwives and obstetricians know this reaction of the body. They can also help you to specifically empty your bowels beforehand, so that you can devote yourself entirely to pushing during the birth.
Injuries to the Perineum: Perineal laceration and episiotomy
Various injuries can occur during childbirth. In particular, the perineum - i.e. the area between the vaginal opening and the anus - is often affected. This area between the anus and the vagina consists of skin, muscle, fat and connective tissue. As your baby is pushed into the world, this area is strained and stretched. Often the perineum tears. In rare cases, the medical professionals attending the birth decide to make and incision in the perineum as a precaution. Injuries to the perineum are usually easy to treat and heal. Complications only arise occasionally. Perineal laceration and episiotomy are among the most common birth injuries.
Birth Injuries During Vaginal Delivery
In the case of a vaginal birth, the mother may suffer birth injuries. Most of the time they are small and heal quickly. The most common birth injuries include perineal laceration and episiotomy. But the vagina, labia, clitoris and pelvic floor can also be affected by injuries. Small lesions, tears in the tissue and bruising cause pain, especially in the first few days after delivery. You can alleviate most discomfort with simple measures. Even cooling a swollen area with a cold cloth or compress made of quark may help. Most injuries heal without problems during the postpartum period. Complicated birth injuries occur less frequently.