The Catholic Church of the Beatitudes, a congregation representing a “new way to be Roman Catholic,” is composed mostly of women (mostly of mothers, in fact, as was apparent last Mother’s Day when 90 percent of those in attendance came forward for our blessing of mothers).
The Beatitudes community seeks not only to be prophetic within the church, by calling women to priestly ministry, but also within civil society, by shining a light in the dark corners of American life. A previous article by one of our members, Lynn Kienzel, drew attention to “Cruel But Not Unusual Punishment for Juveniles.” Today the topic is life itself — maternal and child care.
We invite our readers to consider an article that recently appeared in the “Common Good Forum,” an outreach of Catholics in Alliance for the Common Good. Its original title was “Happy Mothers’ Day.” Comparing America’s maternal and child care today to that of Germany reminds us that we can and should be doing much better. Here (with due permission to reproduce) is the story, as narrated by Ben Palumbo:
On Feb. 12 of this year, my wife and I had the enormous pleasure of being presented with our first granddaughter. Her parents are our youngest son, Guy, and his wonderful wife, Gabi, both of whom helped write this piece. They live in Fürth, Germany, a town adjacent to the city of Nürnberg. The little girl is named for her beautiful and loving grandmother, my wife Magdalene.
After three sons and two grandsons, we were ecstatic at having a little girl to love, care for, spoil and adore. We will do so by exercising our absolute grandparental rights!
However, one of the most interesting things about this new arrival was the peek it provided into the German health care and family support systems, at least as they deal with the care received by mothers and infants during pregnancy, following birth, through childhood and into young adulthood. It is so comprehensive that it prompted me to compare the German mortality rates for both expectant mothers and infants with rates in the United States. Our rates reflect a significantly greater lethality in both categories.
The numbers I used were compiled by the CIA. For expectant mother mortality, the last compilation was 2010; for infant mortality, 2011. Those are pretty current. Here are the figures:
» A. Expectant mother mortality rates: In the U.S. it is 21 per 100,000; in Germany it is 7. Some other comparisons may be of interest: France 8 per 100,000; UK and Canada 12; Sweden 4; Spain 6; Poland 5. In fact, most of Europe and many other countries are safer for expectant mothers than ours;
» B. Infant mortality rates: In the U.S. it is 6 per 1,000; In Germany it is 3.51. Again, some other rates may be of interest: France 3.40 per 1,000; Canada 4.85; UK 4.56; Sweden 2.74; Japan 2.21; for the entire EU it is 4.49.
As you see, the Germans have a safer environment in both categories. In fact, most of Europe does.
Why doesn’t the so-called “American exceptionalism” provide an exceptionally safer environment for expectant mothers and infants? Why isn’t “the richest country in the world” the best in both these categories? I am not a doctor so I cannot say for sure, but perhaps the comprehensiveness of the care is the reason. Here is how it is done in Germany:
When our daughter-in-law had her pregnancy confirmed by a doctor’s examination, all of her tests were recorded in what is called a “maternal passport” or “Mutterpass“ in German. The pregnant mother carries it with her everywhere. At the time of the confirmation, a doctor’s appointment is made for the following month and recorded in the passport. If the mother fails to show, she is contacted to determine the reason and an alternative date is set. In between appointments, she has access to midwives and, if need be, the doctor. At every appointment her latest results are recorded in the maternal passport; this continues through the entire pregnancy.
Before the delivery, Gabi was able to research and choose the hospital at which she would like to give birth (unless she went into labor too far away to get to her hospital of choice). At Gabi's chosen hospital, St. Theresien Krankenhaus in Nürnberg, beginning a month before the due date she had access to free acupuncture once a week as it is believed that acupuncture helps the body prepare for an easier delivery. Also, before the birth, expectant mothers have access to pre-natal, yoga, fitness and various other courses that are inexpensive, or free, depending on which hospital is chosen. It should be noted that if the partner would like to attend, then most courses will include costs, but are in most cases partially covered by insurance.
When the date of delivery arrives, it will be handled by either the doctor or a midwife in a hospital. In our case, it was the midwife for the first several hours of the delivery, and then the doctor (7,000 previous deliveries) who was assisted by the midwife for the last hour. After being weighed by the midwife, the child was immediately brought back to the mother and given the opportunity to suckle. The hospital stay for Gabi and Magdalene lasted four days, which compares favorably with the U.S. (the German standard is three days for the new mother and child, but Magdalene was born in the middle of the night, so they stayed an extra day).
During this stay, Gabi had full access to the care of the doctors, nurses and midwives and was instructed on breastfeeding, child care as well as how to care for her own recuperation. The child's weight gain, pH levels (to monitor for jaundice), sight and hearing test results and health were also regularly monitored and recorded in the "Yellow book" or "Gelbe Heft," which is the book used to keep a record of the child's health for the first 64 (1!) months of life. There are a total of nine benchmark doctor's visitations at varying intervals over the first 64 months, and during these visits various tests are thoroughly outlined in the booklet, and performed and recorded by the doctor. There is a second, smaller, yellow book which is approved by the World Health Organization, called the International Certificate of Vaccination, dedicated to keeping records of immunizations.
For eight weeks following discharge from the hospital, a midwife will visit at least once, or even several times a week if either necessary or so desired by the family, to check up on both her and the baby. Gabi was able to research and call several midwives before she chose one whom she was both comfortable with and was available (sometimes the midwives' schedules can be too full to take on a new client). In Gabi's case, the midwife generally came for about one hour, she examined and weighed the child and talked with Gabi and answered any questions she may have had. Before the birth, the midwife even gives foot massages to the expectant mother!
After the birth, the mother has the opportunity to take advantage of many different classes for both her and her baby, such as child care courses, rehabilitation courses (there are courses that can be done with and without the child), baby development courses, "play group" socializing courses, fitness courses and many more. Sometimes these courses are free, sometimes they involve partial costs, but all are affordable. The rehabilitation course offered in Nürnberg is an example: After six weeks, the mother can take a physical rehabilitation course consisting of eight 90-minute sessions. The total cost is €94.20, €30 of which the mother is responsible for with the balance covered by insurance (if she is publicly insured, which Gabi is).
This clearly reveals a very comprehensive approach to the process of pregnancy, delivery and follow-up care. And interestingly, our son and his family paid nothing out of their pocket for this. Of course, Gabi’s health care was covered by her employer, for which the cost was €26.92 per month. Her employer is a small business. If she were employed full time under contract, her health-care costs would be 15.5 percent of her monthly salary, 7.3 percent of which is covered by the employer (for public insurance). If she earns more than €51,000.00 per year, she would be able to choose private insurance, which is calculated based on age as well as the results of a full physical from the doctor, and is paid for by the employee, not the employer. If she is unemployed, her health care would be provided by the government.
But the story of Germany’s support for pregnant women and children does not end there. My son’s family will receive a monthly stipend of €184.00, called "Kindergeld" (received within a month after the application is made), to help with raising Magdalene until she is 18, if she does not go on to college, or until she is 27 if she is a college student. (The parents will receive, monthly, €184.00 per child for the first two children, €190 per child if there are three children in the household, and caps out at €214.00 per child after four children or more are in the household). Moreover, Gabi will also receive "Parent's money," or "Elterngeld," in German. Elterngeld is calculated based on 67 percent of the previous 12 months wages of the person who is making the application (the mother or the father) with a cap on how little and how much can be received. The mother or father can receive a minimum of €300.00 and a maximum of €1,800.00 each month for a maximum of 12 months if she is raising the child with the father (living together) or 14 months if she (or he) are not living together.
Judge for yourselves whether Germany’s expectant mothers and their children are better cared for than their American counterparts, and reflect on the consequences. For me, there is no doubt: We ought to strive to equal or exceed the countries with records better than ours. That is what it should mean to be the “greatest country in the world.”
And yes, this comprehensive and caring approach involves tax money. But if that results in greatly enhanced chances for mothers and infants to survive and thrive through pregnancy, delivery, childhood and young adulthood; if that means that the family unit’s ability to withstand the inevitable shocks that life brings, then surely it is worth it. Maybe one day we will stack up favorably with Germany’s record in maternal and infant health. Let’s pray that we reach that day.
[Note: This article first appeared as a Common Good Forum in the Catholics in Alliance for the Common Good website. Distribution and reproduction of this article is permitted where the source is credited.]
— Thomas Heck is a member of and music minister for the Catholic Church of the Beatitudes, which celebrates Mass at 5:30 p.m. Saturdays at First Congregational Church of Santa Barbara, 2101 State St. Click here for more information, or call 805.252.4105. Click here for previous columns.