The Mutterpass: Motherhood, Healthcare, and Homeschooling in Germany

The Mutterpass: Motherhood, Healthcare, and Homeschooling in Germany, By Jennifer Stahl

HA note: The following is reprinted with permission from Jennifer Stahl’s blog Yeshua, Hineni. It was originally published on September 26, 2013 with the title, “German Homeschooling Cases – Things to consider.”

One of the arguments that I keep hearing from family, friends and acquaintances in North America and other English-speaking areas of the world about home-schooling in Germany is: “Homeschooling should not be regulated! Parents have the right to educate their children as they see fit! Should officials be doing welfare checks on babies and toddlers to make sure that they are well cared for?”

I usually stammer a bit and try to explain that things are just so different here with German culture vs. American or Canadian culture. With the healthcare system that we have, women who are prenatal and postnatal are well cared for and children are seen as an investment and something that the entire “village” should protect.

It all starts when you get your first positive pregnancy test.

No, really. It does.

First, you get your pregnancy test at the apothecary. It will not be available elsewhere, because that is strictly behind-the-counter stuff. You’ll be advised by the nice people at the apothecary that if it is positive, to contact your OB/GYN, and if you don’t have one, to contact your Hausarzt (The General Practitioner that you’re seeing), and get a referral to a good OB/GYN.

You pop out the pregnancy test and without a doubt, it’s positive. You might take another, but it too is positive. “Well, we’re having a baby!”  Or, whatever variation of that which was said in your home.

The next step is simple.

You contact your Hausarzt for the referral to an OB/GYN, or, you contact your friends really quickly and find out who is the best in the area. Then, you call and say “(Appropriate time of day greeting here)! My name is ________ from __________; and I just took a pregnancy test and it’s positive. Last missed period was on ________.” And before you can say “OK,” they’ve already hauled out the appointment book and are squeezing you in right away.

When the appointment date arrives, you will be given the almighty “Mutterpass“.

This is a mother’s passport and will remain with you your entire pregnancy and through to your postnatal checkups. This is your copy of your medical records. All appointments will be logged here, your test results on any blood tests or other tests that need to be done, how you’re measuring, and all ultrasounds.

 The Mutterpass has information that contains all relevant data on the health of the mother, such as blood group; iron content in the blood, test results for hereditary – and infectious diseases (hepatitis B , HIV , rubella); the condition of the child — such as position, weight, size, etc. up to the birth;  and the expected date of birth. Even after the child is born, some important facts about the child, and the postpartum follow-up of the mother, (6-8 weeks after birth), is recorded in the Mutterpass. In an emergency, Doctors have all this information and are able to respond faster.
Wikipedia

The mother passport has 16 pages. Each (double) page deals with various aspects of the health of mother and child.
Familienplannung.de [Tons of information here, including what is found in the Mutterpass] See also: Rund ums Baby and this PDF, which have example pages of what is in the Mutterpass.

Due to the length of my post today, I did want to share TheLocal.de‘s wonderful series “Motherhood in the Fatherland”. I know that sharing these posts seems like a lot of reading. I tend to over-share in this area, so I’d rather spare those details and let Sabine walk you through the process. Sabine has a tendency to walk one through all the fun steps of culture shock while maintaining an “Oh, right, this is how this works.”

• Baring all at the OB/GYN
• Morning Sickness? There’s a tea for that
• The Name Game
• Very superstitious: Evil eyes, birthmarks and blindness
• The midwife: Your best friend in natal care
• Hospital, Birthing house or at home? Delivery options in Germany
• Babyeaucracy – Paperwork for payouts
• It’s a girl!
• Mother’s milk: A secret weapon for everything [this does show a breastfeeding baby]
• Bare baby bums and flyswatters
• Kitting out babies the German way
• A very German shopping list
• Immunisations and anal pharmacists

Prior to choosing where you will give birth, your next choice is what midwife will be attending you for all your postnatal and breastfeeding needs.

Once you’ve secured her (usually a her, or so I’ve been told), you will have a visit or two to get to know each other, fill out medical information and share who your doctor is so that they can work together. You’ll also hand over your insurance card so that s/he can be paid on time for all the hard work that will be done.

Usually the midwife visits only a few times over the course of a couple of months to assess whether or not your child is growing adequately, you’re bonding well, or if you have PPD or other complications. She will also work with your OB/GYN on doing examinations at home, at a time that things are still very delicate, and you won’t be wanting to sit in the car or on waiting room chairs. She’ll ensure that your uterus is, indeed, going back to normal size, that it is functioning as it should, and that things are healing nicely.

After giving birth, you’ll spend some time recuperating. Birth is hard, messy business and it takes a while to bounce back. Most mothers will be off of work for at least a few months, but usually an entire year, or longer.

Mothers in Germany will receive “Elterngeld“, which will basically help with those extra needs that crop up when you have a little one join your life.

Parental leave is rather generous, allowing fathers to even take as many as fourteen weeks off from work to help his wife or partner out. There have been a few recent news articles discussing the generous leave and stipends to stay at home that are given to new mothers:

“We have this expression, ‘rabenmutter’, which doesn’t even exist in other languages. ‘Ravenmother’. It means a bad mother and a woman who works is often considered a ‘rabenmutter’ in Germany.”
Is the German insult ‘Raven mothers’ holding back women at work?

The federal government passed a law late last year introducing a monthly childcare supplement of €100 to €150… which translates roughly to “money with which to care for someone.” It’s expected to cost the government €1.2 billion each year.
As of August, this supplement will be paid to parents of children aged three and under who are not in a state-subsidized daycare.
German childcare allowance raises questions about working moms

…women who are both underemployed and underpaid. German women work fewer hours than women in most other OECD countries (see chart). The gap in median pay is the third-widest in the club, after South Korea’s and Japan’s. That is partly because mothers stay at home. In 2008 just 18% of children under the age of three were in formal child care, against an OECD average of 30%.
German family policy – Pay to stay at home

…On average, a mother of one takes three years off, a mother of two up to seven years off and even then only goes back to work part-time…
With child care this good and affordable, what is it that’s keeping German mothers out of the workplace? …School often finishes at midday, it’s hard to find any job that fits this schedule.” … “There’s also a culture of mothers not working,” another mother added, “and those who do might get called a Rabenmutter.” That’s a raven mother – one who doesn’t care about her children.
The reluctant hausfrau: being a German mother

After having our first check-up with the pediatrician at the hospital of our choice, we learned rather quickly, that your children also get a copy of their medical records in an “U-heft” (Untersuchungsheft: children’s examination folder) which is also known as a “Gelbes Heft” (Yellow folder). This will house all copies of medical data from the child’s birth, through their eighteenth year. Like the Mutterpass, it is advised you take it and the Impfpass  [vaccination passport] along if you go on a trip anywhere, especially out of the country.

Prior to moving to Germany, in 2005, a law was passed in several Länder (German states) that made these check-ups legally binding, and prosecutable if you miss them.

Originally, there were ten checkups mandated, but this has changed in the last year or so with several additional check-ups added to the folder and us being told we will have additional appointments.

Children’s preventative checkups are to ensure that defects and diseases… especially those which endanger the normal physical and mental development of the child … are recognized quickly by a pediatrician, early enough to initiate appropriate therapy. At the same time studies are carried out to document cases of neglect , abandonment , child abuse or sexual abuse…
Wikipedia

Since the early seventies there were, in the Federal Republic of Germany, ten statutory checkups for children and adolescents, but not all parents were taking their children to these voluntary health checks.
Due to the appalling cases of child neglect – and child abuse…  Experts in child and youth services, child protection, physicians, doctors and many politicians began demanding federally regulated, legally mandatory, screenings for all German children.
Vorsorgeuntersuchungen

  “We have revised all mandatory checkups from the U1 to J2,” Hartmann said. The questionnaires that doctors will fill out with feedback from the parents, will in future, explore various risk factors [for example in the areas of exercise, nutrition, media consumption and parent-child interaction.]
Barmer und Kinderärzte starten neue Kindervorsorge­untersuchungen

We received the following letter in 2008:

Ladies and gentlemen, dear parents,
On the 1st of January 2008, the Hessian Child Health Protection Act came into force in Hessen. The pediatric check-ups (U1, U2, U3, U4, U5, U6, U7, U7a, U8, U9) have become mandatory by this law. To ensure that all check-ups, beginning with U4 have been conducted to U9, the …Hessian children’s care center based at the University Hospital of Frankfurt is responsible. . .
Hessisches Kindervorsorgezentrum

We ended up with three or four additional check-ups, leaving us with about fifteen or so before our children will be 18. So, double that, and we’ll be in the doctor’s office at least thirty-odd times in twenty years of being parents, barring illnesses that have us in more frequently.

One of the more frequent arguments I hear from my friends and acquaintances in the US are summed up very well by Hermana Linda at Why Not Train a Child?

My opinion is that parents are responsible for their children, the state is not. I do not believe that the state should take charge of children unless there is a dire circumstance such as obvious abuse. I do not believe that the state should be checking on children in order to make sure that they are not being abused. . .
It is just as easy, if not easier, to abuse a child before they reach school age. So, if we’re going to worry about school aged children being abused, why not worry about pre-school aged children being abused..?
Why Not Regulate Homeschoolers?

Well, as you can see, Germany doesn’t work like the United States or Canada. Nope, not at all.

Children are not only part of their family, but part of a wider, well-networked village.

Also unlike the United States, Germany has outlawed punitive discipline — you get the picture. Some areas are more granola than others, but, for the most part, Germany is very protective of mothers and children. It is also very proactive with health issues, and looking to stamp out and educate parents on how to prevent child abuse.

Germany has no separation of church and state like the United States, so it is expected that you will likely be religious, and additionally have the support network of your local church, synagogue or mosque.

If you do not, groups like Caritas, Diakonie, and such are available to you, and you will be informed by your midwife about something like MOPS that is available from your local church, as well as about 100 different types of “Mommy and me” activities.

With the check-ups in place, there has been a decrease in reported abuse cases. Sadly, I cannot find these numbers at the moment, but I trust one of my German readers will know where I can find that again. I’d lost my laptop at the beginning of the year, which means I lost a vast mess of data from my old favorites, which included all of this.

I’ve had friends who argue, “With all these precautions, how could anyone educate at home?” — People do it all the time. Generally speaking, those people are either celebrities, government officials, parents who move frequently or parents of children with illnesses that necessitate schooling at home or in a hospital. It’s done every day.

I believe, if we could take care of the issue of curriculum and ensuring that parents are well supported, that education at home could be possible. My line of thinking is quite similar to what was blogged at Homeschooling’s Invisible Children today:

We do not want to do away with homeschooling… We would simply like to see convicted child abusers or sex offenders barred from homeschooling, light monitoring when families with a previous history of neglect or abuse begin homeschooling, and yearly academic assessments (via standardized test or portfolio review) to ensure that families who claim to be homeschooling are not doing so to hide abuse rather than to educate their children.

I believe that if the government could work with the families who are already schooling at home, they could come to some sort of agreement.

Well, that is my hope. We’ll see what is decided as more proceedings go through the court system, what is decided for the future of the German educational system.