Darrick Robles From pregnancy and birth to the new everyday life as a family: having a baby is just as wonderful as it is exhausting. Anja Constance Gaca knows that too. She is the mother of four children, runs the blog “von good parents” with her husband and successfully writes advice on everything to do with babies. We spoke to Anja about the small and big challenges of having children – and about where young mothers and fathers can get advice .
1. Dear Anja, you work as a midwife and lactation consultant IBCLC. What is the nicest thing about your job?
Above all, I love the diversity of the profession, which arises from the fact that every care is different. Midwives accompany the growing family throughout the entire care arc from early pregnancy to the end of breastfeeding. I find it very valuable and important to support them in finding their individual path.
2. What should couples who are expecting a baby know during the pandemic?
Especially in the early days, various constantly changing regulations in practices or clinics, but also with regard to home visits and courses, made parents-to-be very insecure. Uncertainty is something that cannot be used at all in these already very exciting times. Parents should therefore find out about the current regulations in good time and also consider what options are available.
For example, many parents opted for an outpatient birth during phases in which visiting hours in the clinics were very strictly regulated. Many offers such as birth preparation courses or delivery room tours are now also available online. Presence offerings are certainly the better choice in most cases. But it is also possible online to gain more security and serenity for the birth and the time afterwards by increasing knowledge and exchanging information.
In times of a pandemic, I often find childcare to be even more necessary, especially when support from family and friends is very reduced. Otherwise, some questions would certainly be asked more in a family environment . We midwives were often the only visitors in the first few weeks after the birth .
Of course, the parents also lack social contacts. This includes baby courses and the like, where you can meet people in the same phase of life and exchange ideas. Conversely, the reduction in the number of appointments and many visits was often perceived as very positive. Things are also much more relaxed on the maternity wards if everyone doesn’t just drop by to see the baby.
3. How do you find a good maternity clinic?
The provision of maternity clinics, birth centers or midwives who look after in-hospital and out-of-hospital births varies greatly from region to region. While in some major cities you can choose from more than ten hospitals, in other regions it is several kilometers to get to the nearest maternity clinic. Or there is no longer any offer at all – as is now the case on many German islands. Reasons for the increasing closures of maternity clinics is always a lack of midwives and doctors.
Parents-to-be must therefore deal with the issue of choosing the place of birth at an early stage. In early pregnancy, one has not yet arrived at the subject of childbirth, but in many places it is now impossible to find a midwife after the 8th week of pregnancy. This also applies to registering at the birth center or looking for a home birth midwife. But even with popular clinics, you often have to take care of them early enough. At the very least, you should find out from which week of pregnancy you have to register for the birth there.
Apart from emergencies, clinics usually only accept a certain number of births per month. This is the only way to have enough delivery rooms and, above all, enough staff available. But since births cannot be planned, it can still happen that delivery rooms are closed “because of overcrowding” and expectant parents are referred on if the birth is not imminent.
The experiences of other parents are certainly helpful here and there – but births are too individual for direct comparisons. When choosing the place of birth, it is certainly more important to listen to your own needs than to your girlfriend’s “insider tip”. Ideally, the baby should be born in a place where you feel comfortable and where you can trust the midwives there.
4. What is your advice to moms-to-be who are afraid of giving birth?
It is important to recognize and face these fears. Where are you from? Some fears can be taken away with more or better-founded information. Building confidence in your own body and in your ability to have children is part of childbirth preparation. As midwives, we often have to compare the media image of birth with reality.
Most women who give birth today have never witnessed a birth themselves. Unfamiliar situations scare most people. The fear of the pain of childbirth can be countered by learning about ways to deal with it. From the body’s own possibilities of breathing, movement or self-hypnosis to drug pain relief, which also includes epidurals.
It is also important to keep conveying the message that childbirth is not a competition. A positive mindset is helpful, but too many fixed ideas can also be blocking. Sometimes the baby has a completely different plan for its birth than its parents. And just as you have to get involved with these new little people afterwards , pregnancy and birth are already phases of life in which many things are not under our control.
5. Up to 15% of all mothers suffer from postpartum depression. What feelings are normal and when should you seek help?
Postpartum depression, also known as postpartum depression, can occur throughout the first year after birth. The baby blues, also known as “howling days”, which occurs in the first few days after birth as a brief postpartum low mood, must be distinguished from this. This affects 25 to 50 percent of all women who have recently given birth.
However, the transition to postpartum depression can be fluid. The symptoms range from sadness, irritability, fear or even being overwhelmed to physical complaints such as headaches , dizziness, stomach pains , dizziness or even insomnia . A good screening tool is the Edinburgh Postnatal Depression Scale (EPDS) . This self-assessment questionnaire can be used to identify further needs for help. In general, the postpartum midwife is a suitable contact person, or the mother’s mental well-being is one of the aspects that are the focus of postpartum care.
Since the phase surrounding the birth is socially associated above all with great happiness and intimate positive feelings, those affected often do not dare to speak openly about their completely different feelings. They may even have doubts about their relationship with their child. Here it is important to recognize postpartum depression as a disease like a broken leg. Postpartum depression hits a mother just as involuntarily as one breaks a leg – and sometimes under seemingly ideal external conditions. A broken leg takes time to heal, and so does mental illness after childbirth.
Therapeutic and medical help as well as support for the entire family are important for the healing process.
6. What to do if breastfeeding doesn’t work right away?
It makes sense to prepare for breastfeeding before the baby is born. This does not mean physical preparation or the purchase of special pillows and other breastfeeding aids. Parents should be well informed about what is particularly important in the first few days of breastfeeding: the correct positioning, the stimulation of milk production and also what to do if breastfeeding problems arise.
Of course, there are specialist staff in the clinics and breastfeeding advice is an essential part of postpartum care. But on the maternity ward in the hospital there is often not enough staff for far too many women who need support. And in some regions, 50 percent of women can no longer find a postpartum midwife, even though they began their search in early pregnancy.
Especially in this scenario, it is good if parents have checked in advance what other support offers there are. These can be certified breastfeeding consultants, breastfeeding groups or outpatient breastfeeding clinics, such as those offered by some clinics. In addition, there are also offers for breastfeeding advice online if nobody can be found locally.
In the case of problems in the first few days and weeks, such as sore nipples, engorgement or the baby not gaining enough weight, you should act quickly. Prompt help is also important if there are problems later in the breastfeeding period, so that women do not inadvertently stop breastfeeding when they do not want to.
Support for breastfeeding problems from a midwife can be used beyond the postpartum period until the end of the breastfeeding period. Up to eight regular consultations are possible for this purpose. If there is an increased need for care, more appointments are possible with a doctor’s order. The costs are covered by the statutory (and many private) health insurance companies.
