Last Updated on July 28, 2022
In this part we talk about pregnancy check up in Germany and typical problems with health. We will take the classic version: a gynecologist is monitoring the pregnancy. In theory, you can get a midwife before giving birth (see about midwives in the next part), but now this is rather unrealistic.
There is also a non-standard option. The midwife works for the gynecologist and takes his patients alternately with him.
At the first visit, the Mutterpass is started (the old one continues) and a list of paid tests that can be done during pregnancy is given.
Mandatory part in pregnancy check up in Germany
- essential vitamin is folic acid, additional iodine is also recommended. Vitamin complexes are optional.
In a pharmacy (much cheaper and more choice in Internet pharmacies) you can buy various complexes at very different prices. The doctor usually does not recommend anything specific. But even if he advises, then following his recommendation is not necessary. All complexes are rather the same, and the alternative may be no worse than the well-promoted expensive complexes.
- examinations are held once a month, from the 32nd week – once every two weeks. At the end, maybe once a week, after the due date – every two days.
- each examination includes measurement of pressure, weight, urine test. From 30 weeks CTG (recording of a child’s cardiac activity) and determination of its position
- compulsory ultrasound three. If the pregnancy is risky (age, previous problems, non-standard sizes of the fetus on previous ultrasounds, etc.), then the doctor does as many ultrasounds as he considers necessary.
– blood for hemoglobin, erythrocytes, antibodies (conflict of Rh factors), rubella
– syphilis, HIV
– Hepatitis B
– “simple” analysis for sugar
If you have not received a booster vaccination against diphtheria, tetanus, polio, whooping cough (once every 10 years), then you may be offered to do it, just like the flu vaccination (“dead”).
and whether they make sense.
At the beginning, the doctor suggests a list of additional examination. It is better to study the question carefully at home. Some analyzes don’t make any sense, while others require you to think if you need it. Some of the tests are taken over by the Krankenkasse if there is a suspicion of an infection or a pregnant woman is working with children. Some Krankenkasse also voluntarily pay for part of the tests and have bonus programm for pregnant.
1. Ringelrötelnserologie, Windpockenserologie, Zytomegalie
They check if you have antibodies to erythema infectious disease, chickenpox, or cytomegaly.
Of course, these diseases are dangerous to the fetus. But the analyzes do not make deep sense. If you have antibodies, then you will not get sick anyway, and if there are no antibodies, then you cannot sit at home for the entire pregnancy, fearing these infections. They do not suggest any treatment. It turns out gettings on the nerves in its purest form.
It makes sense to check for chickenpox and rubella before pregnancy – if there are no antibodies, then get vaccinated.
Toxoplasmosis is caused by parasites and can be treated with antibiotics. However, if you still do not have antibodies, then you will have to do the analysis all the time. Otherwise, how will you know that you are ill. The symptoms are of a cold type, and the disease can go completely unnoticed.
In order not to catch parasites, there are a number of recommendations for nutrition and avoidance of places where it can meet (more details below).
3. Streptococcus (at the end of pregnancy)
The presence of streptococci does not necessarily lead to infection during childbirth. If the test is positive, antibiotics can be treated. That on the one hand will reduce the risk of infection for the child, but increase the risk of senseless antibiotic treatment. Which way to lean is up to you.
About 15 euros
4. Diagnosis of genetic abnormalities (Down syndrome and other trisomies)
The classic is a diagnostic ultrasound scan (about 160 euros) with a check for the number of fingers and the width of the neck. Number of fingers, by the way, does not mean anything – I know a person who had 1 more finger at birth, but everything is ok with intellect).
New is a genetic blood test, which allows you to determine not only Down’s syndrome, but also other trisomies in a child, as well as his gender. At the same time, a full ultrasound is performed with the same counting of fingers and measurement of other parts of the body. The cost includes, on the one hand, the test itself, on the other – the work of a gynecologist, which in total translates into 350-500 euros.
5. Additional ultrasounds
for your peace of mind at your request – about 30 euros.
“Baby TV” is now excluded from additional services. The state believes that this is pure entertainment and in the interests of the fetus, it allows 3D ultrasound to be done only for medical purposes.
6. Complete screening for diabetes
This test makes sense because diabetes in pregnancy often goes unnoticed. However, diabetes has a negative impact on the baby and childbirth. The Krankenkasse pays only for the “simple” analysis, which reveals only a part of the cases. “Big” analysis is paid only if the first one was unsuccessful.
Pregnancy is “not a disease”
1. Morning sickness
In addition to the classic advice – small portions and the first meal to eat in bed before getting up in the morning – there are a number of alternative and medicinal remedies for nausea. For example, figs, special vitamin preparations, and further on the list of medications from simpler to more serious – only as prescribed by a doctor.
2. Heartburn (Sodbrennen)
With heartburn, you need to give up juices, tea, coffee, nicotine, spices and eat in small portions. Helps not to eat or drink in the evening a couple of hours before bedtime.
It is advisable to double check your teeth during pregnancy. Tooth and gum problems can lead to premature birth.
4. Varicose veins and edema (Krampfadern, Ödeme)
Compression stockings are prescribed. Stockings are free, only a surcharge of about 8 euros. Made in a pharmacy on an individual basis. You can choose material, color, closed toe or not.
Edema requires increased attention, as it can indicate pressure problems that can be dangerous to the fetus.
Unfortunately, no special help is foreseen here. But a visit to the pool helps.
6. Leg cramps (Wadenkrämpfe)
Magnesium preparations help, alternating active movement with pauses when the legs are raised.
7. Vaginal fungus (Scheidenpilz)
Almost inevitable during pregnancy. Classic creams are also used during pregnancy.
8. Bladder weakness (Blasenschwäche / Unwillkürlicher Urinabgang)
Unfortunately, endure and treat vaginal fungus (it makes the situation worse), do muscle strengthening exercises.
9. Foodborne infections that can harm the fetus
Besides toxoplasmosis, it is also listeriosis and salmonellosis. You should refuse:
– raw milk and dairy products from it (Rohmilch),
– foods containing raw eggs (tiramisu, mayonnaise)
– ready-made salads, smoothies, ready-made antipasti, unprocessed grains and sprouts,
– crusts of any cheese, blue cheese, freshly made feta, mozzarella, sold grated cheese
– caviar, medium salted and slightly salted fish, cold and hot smoked fish, oysters, sushi
– salami, servlet, Lachsschinken, Teewurst, Serranoschinken, bacon, meat salad
– meat unprocessed thermally
– sandwiches prepared not by you
– communication with cats
And, of course, you can go on and on with “not decease”, and the main method of treatment will be patience: a constant runny nose, palpitations, lack of air, insomnia, increased salivation, hair loss …
Next – part 3 what do you find in Mutterpass, how to catch a midwife and of course part 4 about childbirth.