What does hospital birth mean?
In Germany, about 98% of all children are born in the hospital (GBE 2006). The other children are born in the birthing center, at home, or in a doctor's office (very few are litter-born in an unplanned place).
You can give birth in any hospital that has an obstetric department. Large hospitals and university hospitals are usually connected to a children's clinic, which also has a neonatal and premature intensive care unit (so-called perinatal centers). They are a good choice for women with high-risk pregnancies. Some hospitals also work with documentary midwives. Then you can be cared for by the midwife, who took care of you during the pregnancy.
You can also give birth in a hospital if your gynecologist offers it. He / she then looks after the birth. This option is only offered by a few gynecologists.
What does a maternity hospital offer?
Maternity hospitals offer great medical safety for both mother and child - in an emergency, both can be helped quickly, either with an emergency C-section, suction cup or forceps, and some maternity hospitals also have a connected premature baby unit in case it should start too early.
A delivery in the clinic is always accompanied by a midwife - if not by the one who has taken care of you during pregnancy, unless you have a documentary midwife. In the delivery rooms in the hospital, however, there is almost always a doctor present who looks after the birth.
Few hospitals offer "midwifery halls" where gynecologists are only called to help with complications. Instead, you are usually cared for by two midwives.
The image of the sterile, cold delivery room with a clinical atmosphere is gradually changing. More and more clinics are working to create a more pleasant ambience for the woman and to meet the wishes of the expectant mother. For example, the woman giving birth may choose her own birth position, refrain from painkillers or have a water birth. A Gebärwanne is now no longer rare. Pezziball, rope or wall bars and wide birth beds are also to be found.
What a clinic can not offer you
You may not be looked after by the same midwife all the time, and maybe not all the time a midwife is by your side. Midwives in hospitals work in a shift system - so it may be that the midwife changes on-the-spot during labor or childbirth. Also, hospitals do not provide 1: 1 care, which would mean that the on-duty midwife will take care of you and your baby, unless you have a documentary midwife. It is much more likely that the midwife cares for several women giving birth at the same time.
What are "baby-friendly hospitals"?
It is an initiative of the World Health Organization WHO and UNICEF. In the past, the initiative was called the Still-friendly Hospital in Germany, because successful full-breastfeeding is the main goal of the campaign - because breastfeeding has many advantages for both mother and child.
UNICEF formulates the following 10 points for a Baby Friendly Hospital (UNICEF):
- There must be breastfeeding guidelines that are routinely brought to the attention of health professionals.
- The staff is trained to implement the breastfeeding guidelines.
- Every pregnant woman is informed about the benefits of breastfeeding.
- The mother is helped at least half an hour after the birth, to put on the baby for the first time.
- The mother is shown how she can breastfeed and how she can sustain the flow of milk, even if she is separated from her baby.
- The newborn only gets to eat and drink breastmilk, unless it is medically necessary.
- Rooming-in is practiced - meaning that mother and child can be together 24 hours a day.
- Breastfeeding as needed is encouraged.
- Pacifiers or suckers are not given to the baby.
- Supporting breastfeeding groups, notes for the mother on these groups after discharge from the clinic.
The clinics that have joined this initiative are accordingly identified by a badge, in Germany there are 88. More can be found at www.babyfreundlich.org
where can I inform myself?
Most clinics provide informational events for expectant parents. There you can ask midwives, birth attendants and doctors all the questions that are important to you. Also, a visit to the maternity ward and the delivery rooms is possible. Take a look at all the clinics in the area and compare.
Here are some questions you can ask:
- How many women give birth in the clinic every year?
- How many of the births are normal vaginal births?
- How often is a cesarean section made?
- How often are suction cups or forceps used?
- How many breech births (pelvic endings) are performed annually?
- What are the neonatal APGAR scores?
- How long do women spend on average in the clinic?
- Is an outpatient birth possible?
- Is there a family room in which the partner can be accommodated?
- Can I stay with my baby 24 hours a day (rooming in) or do I have to go to the baby station?
- Is breastfeeding promoted and if so, how?
- Is there also a senior doctor or obstetrician present at night?
- Can I check in to the clinic around the clock?
- Is there a pediatrician or an infants emergency unit?
- Is there a premature baby station?
Labor and birth
- Can my family be present at birth?
- How many staff (doctors, midwives, medical students, interns) will be in the delivery room?
- Can my documentary midwife be present at birth?
- Is the birth routinely initiated and the amniotic sac open?
- Can I choose my birth position freely?
- Can I get up and walk around in labor or do I have to stay in bed?
- How is my baby monitored during birth?
- Which analgesic remedies are available?
- Is there a limit to how long I can press (2nd birth phase)?
- With which methods is the birth accelerated, for example with the egg-bubble solution?
- How often are episiotomies made?
- Which alternative therapies are offered and how trained is the staff?
- Can I eat and drink during labor?
- What kind of childbearing aids (stool, birthing basin, ball, rope) are available?
- Can I have a water birth?
- Are alternative treatments such as acupuncture, homeopathy, etc. available?
The information evenings in the clinics are, of course, also "advertising events". Ask therefore also your friends, where they made good experiences.
What is different in Switzerland in a hospital birth?
You can read more about this in our article "Birth in the hospital in Switzerland".
GBE 2006. Federal Health Reporting: "Health in Germany". Published by the Federal Statistical Office and the Robert-Institut, Berlin, July 2006
Health in Germany [pdf-file 6016 kb, as of May 2009]
UNICEF: The Baby-Friendly Hospital Initiative [as of May 2009]