Did you know that you could get at-home support after your baby is born and that this can be paid for by your health insurance?
Postpartum doula Julie Meresse will tell us everything we need to know about this topic, tailored specifically to families living in Berlin. Initially a photographer from France, Julie has now been living in Berlin for 13 years, where she had her two children.
Just before the Covid crisis, she trained to be a doula to provide non-medical holistic support during pregnancy and birth. She started working as a Mütterpflegerin two years ago. She now shares her time between postpartum support, birth support and photography.
Postpartum doula Rebecca Ziehe also contributed to the article. Watch my Instagram LIVE with Rebecca about "How to receive free postpartum support", which explains the whole process.
In what types of situations can families get postpartum support?
Under certain circumstances, if you encounter difficulties after your baby is born, you may receive help at home, which can be paid for by your health insurance.
There are 3 important things to note:
This paid-for support is only available if the mother has public health insurance.
The health insurance will only provide paid support in cases of complications (during birth) or complicated situations (twin babies, difficulties with feeding /or breastfeeding, infant health condition, postpartum depression…).
Another requirement is that there’s no one else at home that can take over those chores.
This type of support can also be requested if you are having complications during pregnancy, it's the same process. But there will need to be two different requests, one for the pregnancy, one for the postpartum.
If you have private health insurance, you can ask if they would pay for it, at least partially, which sometimes they do, but it varies.
What do families need to do to receive postpartum support with their health insurance?
There are two steps in the process of applying for postpartum support (called Haushaltshilfe in German) with your health insurance:
Step 1: After the birth, you need to get a prescription from your doctor (OBGYN, GP or other), who will provide the following details for the health insurance:
the medical reason(s)
the number of hours per day and
the length of time
In some cases, the midwife can also fill in for the OBGYN, depending on the mother's health insurance.
Step 2: Then families will have to contact their Krankenkasse (health insurance company) to get the form to request a Haushalthilfe.
On this form, you will need to specify whether you need to be provided a list of Haushaltshilfe (some health insurance companies automatically refer to your their partner companies first).
Otherwise, you fill in with the name of the provider you found (with the provider’s data and their hourly rate). You can also “employ” a friend or relative, without invoice, for 11€/hour (families will then be reimbursed).
The postpartum doula can help you to fill out the form. They can even take over all communication with your health insurance on your behalf, if you grant them permission and submit it in writing to the insurance company.
Who will provide the support for the families?
The support can be provided by a Haushaltshilfe (household helper), a Mütterpfleger*in (trained professional specialized in the postpartum needs) or a postpartum doula.
By the way: This support is different from (and doesn’t substitute) the support of a Wochenbett Hebamme (postpartum midwife), who provides medical care, exams and follow ups, as well as baby and feeding-related advice.
A Haushaltshilfe, provided by the Krankenkasse, will most likely take care of the household, cleaning, laundry, shopping and cooking.
Mütterpflegerinnen and postpartum doulas will also take care of the mother and the baby and, depending on their individual specialities, have knowledge and tips around topics such as nutrition, massage, breastfeeding, belly binding, cloth diapers etc.
What can a Mütterpflegerin or doula help with and what will they not do?
There are three fields of support that Mütterpfleger*innen and postpartum doulas offer:
Help with the household: such as grocery shopping, postpartum meal suggestions, cooking, light cleaning, laundry etc.
Support for the mom’s body and mind: Helping to reflect your birth experience, talking about the transition into motherhood, emotional support. They can also offer tips about anything and everything related to body and baby, (breast)feeding and sleeping issues, childcare equipment; suggest and help with belly binding, yoni steam, pelvic floor exercises, and propose massages or ceremonies such as closing ceremony, or closing of the bones ceremony. This all depends on the family’s wishes and inclinations as well as the provider’s personal training and experience.
Help with the baby: help with the first baths, diapers, bottle feeding, carrying, and giving as much time as possible to the parent to rest, shower, organize papers etc.
Usually, Mütterpfleger*innen and doulas will not: babysit the siblings (although they can bring them to Kita/school), deep clean the house, stay alone with the baby for too long, drive members of the family to school or appointments (for insurance reasons).…
The exact tasks will vary from person to person and so it is important to be very clear about the expectations and limits before starting.
How long will the Mütterpflegerin support the family for?
Families may receive support for just a few days up to a few weeks. It depends on the medical reason, and whether the health insurance may agree to extend the contract.
The agreement (Bewilligung) is usually from 2 to 8 hours per day, 5 days a week, for 2 or more weeks. In some cases, agreements are extended for a month or two.
Keep in mind that sometimes, the health insurance may ask for a co-pay of 10% per day (up to €10 per day) from the families. This varies depending on the health insurance, the reasons, certain pre-existing conditions, etc.
What if a family can’t get a prescription or if the health insurance doesn’t approve the application?
If you can’t get a prescription but think you have legitimate reasons to get one, you could do one of the following:
You can ask your midwife to write a recommendation for the doctor, who could reconsider it.
Contact the Jugendamt, which also provides Haushaltshilfe under certain conditions.
If the health insurance doesn’t approve the application, you should try the following three tips:
You should get some help from the support provider you found.
Contact your health insurance company and discuss your case.
Contact a Mütterpflege expert like Elodie from Baby in Berlin or Franzi from Franzi für Mamas.
Thanks, Julie! Do you have any other thoughts around the topic of postpartum support for new families?
Yes! I personally think every family should receive support in the very often exhausting and emotionally overwhelming period of post-partum. Especially in big cities, where families often live far away from their relatives.
Weather you get a paid-for support or not, it’s always good to be well surrounded, know how to formulate your needs, have your midwife coming, have friends cook for you when they come to visit, and, why not, ask a few hours of post-partum care, wellness or even of a night doula as a birth present!
For other types of support for Berlin families with newborns, check out our tips for postpartum support for Berlin families.
