I used a couple of books to guide my shopping:
The Girlfriends’ Guide to Baby Gear
Baby Bargains

The shopping list at Rookie Moms is helpful too.

Where we shopped in Germany:
We’re lucky that Nurnberg has a nice BabyWalz store, which carries just about everything.
There is a ToysRUs in town with a small baby section.
I also bought a couple of items online that I couldn’t find elsewhere through 4MyBaby, which I found through German Ebay.
I’ve found the best deals on durable and attractive baby clothes at H&M and Zara.
We live about a mile from IKEA, and you can’t beat their prices.

What I bought in the USA:
Baby Clothes
I bought/received plenty of this stuff during my visit to the States. American selection and prices can’t be beat. European stores like H&M and Zara have cute and practical baby clothes, and while you can find basics in a lot of places here, including baby specialty stores and even our grocery store, most of it costs twice as much as it would in the States. I was especially glad I got inexpensive onesies and cotton footed PJs in the U.S.

Maternity Clothes
I got this stuff in the U.S. mostly due to price, but also because I was just at the point of growing out of my regular wardrobe during my visit.

Swaddle Me blanket
We use this every night. The one time we didn’t use it, Theo woke up every hour. And we’re inept at swaddling him in a regular blanket; he always seems to break free.

Rearview mirror
This attaches to the headreast on the backseat of our car so that I can see what Theo is up to in his rear-facing carseat.

Diaper Bag
We have two – the funky Mom bag and the practical Dad bag. We use the Dad bag more – it has lots of good pockets and straps onto the stroller. We received it as a gift but it’s one piece of gear that I would highly recommend; I’d pay the price to buy it myself if I didn’t already have one.

Battery-operated Mobile/Crib Entertainer
I haven’t seen these here, but I’m glad to have this one. Theo likes to watch it and it buys me 15 or 20 minutes to eat lunch, wash my hands, etc. We also have this aquarium.

Medicine (Baby Tylenol, Mylicon, diaper rash ointment, nipple cream)
I’m sure versions of this stuff are available in Germany, but I wanted to be able to read the labels thoroughly. Over-the-counter medicine also tends to be very expensive here.

Pacifiers
Theo likes Soothie pacificiers so I’m glad I bought a couple of them. Other brands (Nuk, for example) are easily available here.

Cloth Diapers
We use a few of the old-fashioned kind to line the changing table

Baby washcloths and towels
Probably not exactly necessities but we got some nice ones as gifts. I have seen the hooded towels at IKEA.

Manicure/Health Care set (nail clippers, medicine dropper, digital thermometer)

Carseat
The major brands are different in the USA vs Germany, but the cars here have a version of the LATCH system, so American carseats work fine.

Baby Bjorn
Easily available in Germany but cheaper in the States.

Pregnancy and Child Care Books
Obviously, due to language issues

Books for Baby

Baby Scrapbook

Wha
t I bought here:

Maternity Clothes
H&M has a nice maternity line. I bought mainly sweats and clothes for the last couple of months, which saw me through til the end.

Crib and mattress
We ordered these at our local BabyWalz and have been happy with them so far. We seriously considered buying an inexpensive crib at IKEA but decided we wanted an adjustable one (IKEA cribs only had one mattress height). Here’s a photo of our crib.

Bedding
Crib and mattress dimensions here are different than their American counterparts (longer and narrower), so American sheets won’t fit. This goes for crib bumpers and ruffles too.

A lot of the stuff below is visible in this photo.

Wooden Mobile
We bought one of these, manufactured by Haba, a German toy company. They make all kinds of high-quality, brightly-colored wooden toys that are more difficult to find in the U.S.

Contoured changing pad
This wasn’t easy to locate, but I found it at a large department store. We put it on top of the dresser, but you can get a changing table at IKEA or elsewhere.

Rocking Chair
I had a really difficult time finding a rocker, but we ended up with one I love. It was on sale at IKEA. Apparently rocking chairs are not traditional baby furniture around here.

Dresser
IKEA strikes again. We bought an unfinished one and I painted it to go with Theo’s room.

Bottles
Avent, Nuk and Dr. Brown’s (under a different name) are available here.

Breast pump (manual and electric)
I started with a manual Avent pump and ended up buying a small electric Medela pump through my midwife. Working moms can get a prescription to pay for an electric pump through an OB/GYN.

Travel bed with bassinet
Collapsible travel cribs are widely available here. I wanted one with a bassinet insert, which was hard to find. I ended up locating an online retailer, 4MyBaby, that sold some American brands, including Graco Pack-n-Play. I paid a premium, but I got what I wanted.

Diaper Pail
I’ve seen Diaper Genie-type contraptions here. For now, we’re just using a garbage can with a lid but I imagine we may need a different solution as things get more aromatic.

Nursing Pillow
I love my German nursing pillow. I bought it to use as a body pillow while I was pregnant and used it during nursing. Theo loved to sleep on it for the first couple of months and now we use it to prop him up. It’s bigger than Boppy and stuffed loosely, like a beanbag, so it’s more flexible. Here’s a photo.

Baby Bathtub
No fancy inserts or contraptions, but it works fine.

Swing
I also bought a Fisher Price swing through 4MyBaby. Other versions were available at ToysRUs.

Baby Monitor
I bought this used, from a fellow expat family moving back to the States. Moving sales are a great way to pick up some nice stuff, since most expats move after only a couple of years so their belongings are in good shape. And since electronics don’t tend to be portable due to voltage/plug differences, there are deals to be had.

Stroller
If you’re into strollers, Germany is a good place to live. We bought a PegPerego, which is a higher-end brand in the U.S. It was actually one of the cheaper options here. My theory is that families here do so much walking that they place a high priority on getting a stroller with special shock absorbers, big wheels, and sturdy tires. Most use a Bugaboo-type cradle stroller.

Infant Seat
We never found a “bouncy” seat, but we have a version that rocks, reclines, etc.

Other baby care items
Brand that I recognize are available here (Pampers, for example) along with Penaten which is the German brand name used by Johnson & Johnson (so the shampoo, lotion, etc that I recognize, just with a different name). Weleda, an all-natural German brand, is popular and very high quality.

What I wish I could find:
Exersaucer
For some reason, these have not caught on around here. I saw one for an exorbitant price at ToysRUs, but most place sell walkers instead, which have been practically banned from sale in the USA because they cause so many injuries. We haven’t decided whether to try a walker, pay for the exersaucer, or just keep Theo propped up on the couch while he watches his daily six hours of American Chopper reruns.

Part Three: Labor and Delivery
Part Two: Care Providers and Hospitals
Part One: The Nuts and Bolts of the First Half of Pregnancy
Introduction and Disclaimer

When Theo turned one month old, I posted the story of his birth. Here, I’ll attempt to answer some frequently asked questions about our hospital stay. I’ve focused on the unexpected experiences that seemed different than having a baby in an American hospital, so just imagine that between all the bewildering moments chronicled here, there were hours of normalcy and comfort. Overall, it was a joyful and memorable five days of our lives, and we’re grateful for the kind care of the hospital staff.

Please post additional questions in the comments if you have them, or e-mail me for more details if you want them.
Read the rest of the post here.

Part Two: Care Providers and Hospitals
Part One: The Nuts and Bolts of the First Half of Pregnancy
Introduction and Disclaimer

We are a family now. Theodore Joseph joined us on Wednesday, January 17th. We came home today and we’re all ready for a nap.

Thank you for your wonderful wishes and happy thoughts. More of our story to come.

Finding a Midwife and a Hospital
I started my midwife search by asking my doctor, who gave me one name, of a midwife who is very kind and competent but who said she didn’t feel comfortable working with me because of her limited English skills. I then asked another American woman who had recently given birth. She asked her midwife for referrals, and by making a bunch of phone calls and emails, I’m finally homing in on a final choice. My most important criteria include competence (duh), English skills, and willingness to listen to my preferences.

We’ve toured one hospital and will probably tour one more before we make our final decision. We’ve received very different responses as we’ve called around to try to arrange tours. The staff at the hospital we’ve already toured was extremely helpful, even arranging for a doctor to give us a private tour in English. At another hospital, I was met with a brick wall when I asked if I could call in advance to find out when the regularly-scheduled tour might be offered by a guide who spoke a little English. Of course, you can probably guess which hospital is ten minutes from our house and which is a 30-minute drive away. Fortunately, we’ve received good reviews of the medical care offered by all the facilities in the area. I am nervous about my ability communicate in either German or English with the hospital staff no matter where we go. I know from experience that most doctors speak near fluent English, but as you’ll read below, it’s the midwives that matter more.

NOTE ABOUT LANGUAGE: I realize that it might seem like I’m obsessed with the English skills of my care providers, which I know is unfair. I am in Germany, after all, where the language is, um, German. Don’t imagine that I don’t realize how lucky I am that my native language is emphasized in the school system here, and that I have the option of being picky on this matter. In reality, though, communication is extremely important to me in this process, and the likelihood of my German improving enough in the next ten weeks to include any kind of medical terminology is zero. So I’m at the mercy of the kind English-speaking medical community in my area, and so far I’ve been very lucky.

Midwives – Prenatal Care
German midwives play a prominent role at almost every stage of the game. Some women see an OB/GYN for their prenatal care, but others do all prenatal care with a midwife unless complications arise. Others see them in tandem – doctor one month, midwife the next. Midwives have the equipment and training to do basic prenatal checks, including checking fetal heartbeat, position, lab work, etc. They do not offer ultrasounds. Some midwives work out of private practices, others are part of a Geburtshaus (Birth House – more on that later), and others work exclusively in hospitals. Prenatal classes are generally run by midwives. I chose to see an OB/GYN for the majority of my prenatal care simply because that’s what I was used to, and due to my age I probably would have been sent to one anyway for extra checks, ultrasounds, etc. It looks like we’ll work with a midwife to do some kind of private instruction along with one or two prenatal visits instead of attending a birthing class. This is a little disappointing for both of Jeff and me, since it would be nice to meet some other expectant couples, but all of the midwives we’ve met with told us that the courses are conducted completely in German, and we wouldn’t really get much out of them.

Midwives – During Birth
Midwives run the show during birth, unless serious complications arise. I have the option of giving birth at home (um, not for me), in a Geburtshaus, or at a hospital. Midwives are on hand in all these situations. About 5 percent of women in Germany have their babies outside a hospital. Home births have become less common over the years, though it is not uncommon for a midwife to assist a woman who prefers to labor at home, and then send her to the hospital as birth becomes imminent. Most towns have a Geburtshaus, which hosts a group of midwives and a “homier” but still medically-equipped (though not fully anesthesia-equipped) environment where women have their babies, then depart for home within hours. My choice, and the choice of 95% of women in this country, is to give birth at a hospital. Hospitals have staffs of numerous midwives and a handful of doctors on their labor and delivery wards. Midwives staff most aspects of L&D, delivering babies and handling patient care. Nurses take over after the baby is born.

Doctors – During Birth
One of the biggest surprises for me was learning that my regular doctor will definitely not deliver my baby. It is unlikely that I’ll see my regular midwife either, unless I choose a (rare) midwife that maintains a prenatal practice as well as a position at the hospital, and that she happens to be on duty at the crucial moment. The hospital staff of doctors and midwives is quite separate from the medical practice outside the hospital.

At the Hospital
Most of my friends in the US stayed in a combo delivery/patient room when they had their babies. The rooms were large and private, with a couch or recliner where Dad could sleep. German hospitals are set up more traditionally, with delivery rooms for women in active labor. Some are equipped with tubs for water birth, and all the pain relief options I’ve read about and heard about seem to be available. After the baby is born, Mom & baby move to a patient room. All patient rooms in the hospital we toured are doubles – two beds for two moms – with no sleeping facilities for Dad. If the ward is not crowded, however, Dad is allowed to stay in the room and sleep in the second bed. Most families stay at the hospital for 3 days so that the baby’s first pediatric check-up can be done before they go home. We will have the option of leaving earlier if all goes well. I’ve heard that the length of hospital stay is directly affected by the existence, volume, and family size of a roommate. Jeff is concerned mainly about the quality of the cafeteria food.

Midwives – Postnatal Care
Our midwife will visit us at home after the baby is born. She (I’ve never heard of a male midwife here) will come to the house regularly (daily for the first week if I choose) to help with nursing, check my physical and mental state (yikes) and to check on the baby. The frequency and duration of her visits is up for negotiation, so if I need more or less help, I can ask for it. This seems like a wonderful idea, especially since I’m planning to attempt to nurse, and I know I’ll probably use all the help I can get. I imagine these visits will also ease the panicked feeling I inevitably will have when I am sent home with a tiny baby, no close friends or family nearby, and no clue how to take care of him.

Cost
All of the above is covered by the public health insurance system, including prenatal instruction and postnatal home visits.

Odds and Ends
If I had it to do over, I would have gotten serious about searching for a midwife much earlier in my pregnancy, mainly due to my (probably excessive) desire for advance information. It’s been such a relief to sit down with
a midwife and have time to get the answers we’ve wanted for so many weeks (like all the info above). I am much less nervous now that I know vaguely who is responsible for what, I’m familiar with my pain relief options, and it’s likely that some kind midwife or doctor will be able to communicate with me in English during all stages of this process.

My concerns about bedside manner have been somewhat alleviated, mainly because the midwives I’ve met aren’t nearly as rushed as my doctor is. Occasionally I still come up against what has become my least favorite phrase in any language – “That is not possible,” followed by a blank stare – but I’m learning to navigate around it, and find people to help me who are willing to think about possibilities instead of impossibilities.

Next Time
If I’m lucky, and no complications arise, my next installment will be a recap of what actually happened at the hospital and the aftermath. How terrifying. If anything interesting happens before then, I’ll post in the interim.

Part One: The Nuts and Bolts of the First Half of Pregnancy
Introduction and Disclaimer

Choosing my Doctor
I chose my OB/GYN based on a recommendation from our relocation consultant. I was looking for someone who a)accepted the public health insurance (see “Insurance” below), b) speaks English, and c) had an office that was accessible to me without a car, if possible. I wanted to keep my pregnancy private for a while, so I was hesitant to ask other English-speaking acquaintances that I’d met through Jeff’s work or my German courses, but this might have been a good avenue as well.

Appointments
I see the doctor every four weeks until I near the end of my pregnancy, when I will see her more frequently. This is about what I expected. My doctor’s office has been very efficient – I’ve never had to wait more than 30 minutes to see my doctor. This seems to be unusual; even with an appointment, it seems that the system here requires most patients to expect a long wait before seeing a physician.

Insurance
I use the German public health insurance (both private and public insurance are available here, and the number of people eschewing the public system for private providers is increasing). At my first appointment, I handed over my insurance card, expecting to be met with a handful of forms. Magically, when my card was swiped through a magnetic reader, my identifying information and the medical history I’d provided when I registered with the insurance company appeared on the receptionist’s computer screen. I’ve had good luck with the public system, though I know there are some providers who accept only private insurance. Public insurance will not cover a private room when I deliver. Coming from the USA and the mess that is the health care system there, it’s hard to complain (though I’m sure I may utter a few unkind words if I end up with multiple roommates in various stages of labor). The system here isn’t perfect (My dental exam was covered, for example, but I had to pay out of pocket to have my teeth cleaned) but at least every person who lives in Germany is required by law to have coverage.

Mutterpass
I received a Mutterpass (“Mother Passport”) at my first prenatal appointment. It’s a standard form used, as far as I can tell, by all doctors throughout Germany. My doctor fills out a section of it at each of my appointments, including vital stats, blood and urine test results, and the results of any other testing or recommendations that I’ve received. A short version of my medical history is in there too. I was advised to keep the Mutterpass with me at all times, so that if I have a medical emergency or need to see a physician when I am away from home, I’ll have this information handy.

Prenatal Testing
I have received most of the prenatal testing I expected based on friends’ anecdotes and on my own research. My doctor doesn’t seem to be an advocate of extra tests – in the USA, for example, I may have been more strongly encouraged toward an amniocentesis due to my age, but she steered me toward the more thorough ultrasound along with blood tests to check for indicators, then allowed us to make the call on the amnio once the results came back with low odds for Down Syndrome, Trisomy 30 and Trisomy 80.

Ultrasounds
I’ve had five prenatal appointments, and an ultrasound has been performed at four of them. This was a pleasant surprise, since I know that many American moms must wait until the twenty week mark to see an ultrasound, and must do so at a time and location outside their normal prenatal appointments. My OB/GYN has performed all my ultrasounds in her office; in fact, both exam rooms I’ve seen there are equipped with their own ultrasound machines. The purpose each ultrasound:
-1st one (6 weeks) – confirm pregnancy
-2nd one (10 weeks) – set due date
-3rd one (14 weeks) – optional test for indicators that an amniocentesis may be necessary (We chose to do this because I am of “advanced maternal age.”)
-4th one (22 weeks) – 20-week ultrasound to take measurements and confirm that all is progressing as it should be
I will have one more ultrasound as part of the normal prenatal series, at 30 weeks. Three of the four ultrasounds I’ve had so far, along with the 30-week ultrasound, are included in my health care plan, and if my doctor decides she needs to do more based on symptomataic or test indicators, those will be covered too. The third ultrasound was optional, and cost us 50 euros. If I want more (for, as my doctor calls it, “baby viewing”), I can pay extra – 25 euros per extra ultrasound or a flat fee of 90 euros if I want one at every appointment.

Bedside Manner
This is, of course, a highly subjective topic and varies greatly from doctor to doctor. Since Jeff and I have both had several different experiences with healthcare providers in the past year (different kinds of physicians, dentists, etc), we did draw a few conclusions about cultural differences between the bedside manners of German doctors versus what we’re used to in the USA. As Americans, we are used to being treated as consumers in the medical world, due to a customer-service oriented culture and the competitiveness the currently exists in the American health care industry. My American practitioners sat down after my annual exams and gave me carte blanche to ask about any ache, pain, or weird bump on the top of my head that might be bothering me. I had always imagined the first doctor’s appointment of my pregnancy to be an opportunity for information-gathering. I’d heard about the questionnaires, the photocopied lists of recommended dietary precautions, and the urgency with which I would be encouraged to sign up for a prenatal instruction course.

My German OB/GYN has been friendly, helpful, and more than willing to speak English with me. She seems competent and knowledgeable, and I trust the care I have received so far. I was surprised, however, when she seemed brusque and breezed quickly in and out of my appointments. She usually stands up after she finishes my exam, shakes my hand, and starts to leave the room before I stop her with my list of questions. Sometimes she answers my questions – other times she tells me to refer to my Mutterpass (see above), or (very occasionally) tells me that I really don’t need to know that information yet. I have never been given advice about diet, exercise, or health habits. I’ve never been asked if I am a smoker, or told not to empty the cat’s litter box. I imagine there are several reasons for this, and the language barrier is probably a big one. Her English is good, but not fluent, and my German is elementary at best; if she routinely provides questionnaires or handouts to her patients, they are probably printed in German. I would bet, however, that it is more attributable to a cultural difference. I am expected to take responsibility for my own health, and to read and learn about what is best for me. There is something empowering about this philosophy that I like, though it requires more effort and different expectations from me. I’ve also found that, when dealing with a professional in any field (real estate agent, carpenter, insurance broker), we have been required to ask very specifically for the information we wanted – there are no long explanations or words of advice followed by, “any questions?”

Next time
The final explanation for my doctor’s brusque manner is, I think, due to the pivotal role that the midwife usually plays in prenatal care and childbirth here. Midwives and physicians work together with expectant mothers – most women here use both. Jeff and I have scheduled meeti
ngs with prospective midwives in the coming weeks, so next time I’ll write more about the role of my midwife.

Introduction and Disclaimer

And all that information became basically worthless to me when we moved from the USA to Germany last year. I knew that choosing to have a baby overseas would be a challenge; it would mean confronting the language barrier and the cultural differences from a whole new direction. Living in a new country means one surprise after another, from what arrives on the table at a restaurant to what’s expected of me by my neighbors. But I was hoping to minimize a few surprises during this whole pregnancy/childbirth odyssey. I hoped that some other expatriate hausfrau might have written (in English) an account of her experience having a baby in Deutschland. But I’ve done a bunch of searching around bookstores and the internet and, so far, no dice. The English-language books and websites I’ve been devouring are helpful, but when they start referring to the best carseat brands, or how things work at the hospital, I have to read with the awareness that procedures and traditions in my current life could be very, very different than what happens in the typical American doctor’s office or baby supply store. Or they could be the same – how am I to know?

So, to fill that void (someday, someone else is going to wonder about this stuff, I just know it), I plan to write a series of posts about my journey through pregnancy as an American woman in Germany. By series, I mean I may end up writing a couple of posts, or I may write eight or ten. It’s probably obvious that I am not a medical professional, nor am I a cultural expert, so let this serve as a disclaimer that this will be my story, from my perspective, colored by my biased opinions and expectations.

If this stuff bores you, don’t worry, I’ll still post my regular pop culture commentaries and food photos and daily drivel. And I promise not to post any photos that might gross you out. Stay tuned for the first installment.