German And Irish Postpartum Care
Interview with Layla O’Mara
I chat with Newborn Mothers graduate Layla O'Mara from NuaNua. Together we discuss the system of ‘wochenbett’ in Germany - where you are cared for by a midwife in your home for 40 days, the difference this care makes in your long-term health and the contrast of its absence. At the core of this conversation, we explore how publicly funded or insurance provided postpartum care is the way of the future.
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About Layla
Layla O’Mara is a Five-Element Acupuncturist, writer, mum of three and Founder of Nua Nua. Layla has been passionate about women’s health for many years now, sparked almost always by experiences she has had herself, be it fertility or pregnancy challenges, premature babies, post-partum care or the seismic shift of motherhood. She has trained as both a postpartum doula and a matrescence activist and works supporting women to tap into their sovereignty and feel more assured in their own skin. Having lived in Berlin for 8 years, she now lives in her native Ireland with her family at the foot of the Wicklow mountains.
We explore the following questions:
What were your postpartum experiences like across Germany and Ireland?
Do you get to choose who your carer is?
Do you know at all what the political background to this is? Has it always existed or is it something that came about?
Did you really enjoy that experience as a first time mother? Did you find it at all invasive or interfering, or did you just really love it?
Did you have the same woman caring for you after your second baby was born? Do they come to the birth as well?
Was she doing this work before she was a mother herself?
How different was the care when you had your third baby outside of Germany in Ireland?
What was the difference between your experiences during that postpartum period and even afterwards in the longer term?
How are you feeling now at 10 months postpartum? Do you feel like you've managed to catch up or do you feel like that missing that first 40 days has had a longer-term impact?
Additional resources:
Layla’s website - https://nuanua.com/
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Transcript
Julia Jones:
Today we have Layla joining us. Layla is one of our students in Newborn Mothers Collective, and she is a five elements acupuncturist. What is really interesting about her story is, I'm actually hoping we can unpack really a more personal journey with her rather than her professional experience, because she's had babies in multiple countries. So it's really interesting to see the difference in postpartum care structures. We talk a lot around Newborn Mothers in terms of traditional cultural care. But another aspect that's really important is the actual systems, the government funding and the support that exists structurally in different countries, and it really does vary. So Layla, if you're happy to introduce yourself and tell us about ... You've had two babies in Germany and one in Australia, is that right?
Layla O'Mara:
One in Ireland.
Julia Jones:
One in Ireland.
Layla O'Mara:
I had two over the past ... My eldest is seven or just about to turn seven now. So I had two in Germany with no family around or any supports from that sense so I was really reliant on the system that was in place, I guess. Then my latest son was born in Ireland.
What were your postpartum experiences like across Germany and Ireland?
Julia Jones:
How was that experience? I'd love you to just step us through your postpartum journeys each time.
Layla O'Mara:
Well, it was my first baby, so it was my first experience of anything in Berlin in Germany. Being German, they have got a system for the whole thing, and they call it ‘wochenbett’ which means weeks in bed, literally. So there's a midwife. She's a birth midwife. She's medically trained from that perspective. So it's different to a doula in that sense. But she will be with you during your pregnancy and they'll visit you once a week in your home during pregnancy and do all those checkups. Then some of them will be there during the birth if you want them to be in the hospital. I didn't have that. I had to have C-sections for medical reasons, and I knew that in advance, so I didn't have a midwife with me. But then from literally the day you get home, that midwife comes to you every day for the first two weeks or so, and then sporadically it eases out. But every couple of days and then once a week for the first eight weeks after birth.
They call it 40 days, so they look at six to eight weeks, but they say it's 10 days in bed, 10 days around your bed not leaving your room, 10 days around your home, and then 10 days around your neighborhood before you start at all to go back to the world. It's really well-known. It's paid for by your health insurance, your public health insurance. I didn't have fancy health insurance. It's part of having a baby in Germany. It was quite wonderful from that perspective.
Julia Jones:
Yeah. I love it. I love that. It sounds like they're still in touch with some of their traditions in Germany that a lot of Western countries have really lost touch. But they even have the words. Can you say what that word was again?
Layla O'Mara:
Wochenbett. So ‘wochen’ is weeks and ‘bett’ is bad. So weeks in bed.
Julia Jones:
Yeah. I love it.
Layla O'Mara:
They would be medically trained and everything, but they would also use quite a lot of traditional ... they would give you ... Which is actually Chinese herbs. They call it Kartoffelsuppe which is power strength soup, which is all these Chinese herbs that they would encourage your partner to make into a big stew with a whole chicken and vegetables or a vegetarian version. And they'd do massage. They'd do belly massage with you. A lot of them would do homeopathy or some of them would do a little bit of acupuncture. Then they also have things they're very into, it's called quark, which is a ricotta cheese that they might put on your breasts if they're engorged or old traditional stuff that they have brought into 21st century care as well.
Do you get to choose who your carer is?
Julia Jones:
Do you get to choose who your carer is?
Layla O'Mara:
Yeah. My carer,I looked for a while because I'd just moved to Berlin, so I chose somebody who could speak English and she was half Irish, half German. So you can choose completely who you want. People often will interview a few people before they ...
Julia Jones:
Do you have a name for these people?
Layla O'Mara:
They're called a ‘hebamme’, which translates as midwife.
Julia Jones:
Yeah. Lovely. Are they medically qualified midwives or is it a different role? They are as well?
Layla O'Mara:
Yes. This is what a midwife does in Germany. So some of them will work in hospitals and do births and are a part of that medical system, but a lot of them are self-employed or they might work out of centers where there's a few of them working together. But they're self-employed essentially. But they're medically trained.
You can also get, which I didn't get, but your health insurance may pay for it or your gynecologist can write you a prescription for house help after the birth. Which would be a little bit of that doula cooking and that type of care. The midwife wouldn't cook for you or clean or that side of it or care for your kids.
Do you know at all what the political background to this is? Has it always existed or is it something that came about?
Julia Jones:
That's just amazing. Do you know at all what the political background to this is? Has it always existed or is it something that came about?
Layla O'Mara:
I had planned to actually look up that just before our call because I didn't know and I didn't come across it yet. It comes out of a very German system of - if you look after yourself, you'll be well. So if I have a cold, I'm expected to rest and I'm expected to drink teas and I'm not taking an antibiotic and keep going. You're supposed to care for yourself and then you'll be better sooner and it's quite a logical approach to things.
So it's the same thing with this wochenbett. The idea is very logical and it's what you talk about as well in the course. It's the time you need to heal, and it's a time that you form a family. So the husband is given ‘elternzeit’ which is parental leave, so he'll be home as well. The idea is you're working out how to form a unit and you're also physically, everything is going back to where it should be in those eight weeks. So if you do that, then it's also a financial thing, in a way, because then you don't get sick later on. You don't get mastitis, you don't get all of this.
Julia Jones:
And you're stronger and ready to contribute back to your community.
Layla O'Mara:
A little bit of that. Yeah. Yeah.
Did you really enjoy that experience as a first time mother? Did you find it at all invasive or interfering, or did you just really love it?
Julia Jones:
It's really amazing. And did you really enjoy that experience as a first time mother? Did you find it at all invasive or interfering, or did you just really love it?
Layla O'Mara:
I loved it. I had a really hard time with my son. He was very colicky and screamed the whole time and all of that. I had a hard delivery, so it was just a lifesaver. To know that that person was coming to you every day. I formed a really close friendship with my midwife. Now I consider her a friend. So no, I didn't feel ... I know there's other people who have felt that, or other systems in Europe where it's more prescriptive and you can't choose who you have, but for me it was wonderful.
I didn't know how to bathe my baby or anything, but it was also about you. She would come and say, "Have you been out of bed today? We're still in the 10 days in bed. You shouldn't be doing all of those things. How do we work out? Get back into bed. How do we work out that you stay there?" And then she would say, "I think it's time maybe you walked around your room a little bit." And she takes you by the hand. Not literally, but slowly eases you back into the world. So for me it was, it was massively helpful. I'm not sure how well I would've done without it.
Did you have the same woman caring for you after your second baby was born? Do they come to the birth as well?
Julia Jones:
And did you have the same woman caring for you after your second baby was born?
Layla O'Mara:
I did up until a certain point in the pregnancy. So you have them from about six months of pregnancy, but she actually then had her baby. Her first baby. So I had a colleague of hers for the next part.
Julia Jones:
And do they come to the birth as well?
Layla O'Mara:
They can do. There's two types. The ones who come to the birth are harder to get hold of because they can take less people because they need to be available. But for me as well, all my births were C-sections because I couldn't give birth [vaginally], and I knew that in advance, so it wasn't such a big thing for me to have her there. But they can do. They can do.
Julia Jones:
Yeah. Oh, this is really amazing. This is really what I think a lot of midwives in Australia and other parts of the world are really craving too. I know a lot of midwives, midwife means with woman, and we're finding that midwives are being so driven into only this clinical role and really not being allowed to be in this continuity of care and more holistic supportive role - that they're actually really struggling with their vocation because it's not really the job that they felt called to do, and they can't really do what they want to do in the system that we have. So I think it's really amazing, and I think it's something that Australia and probably the rest of the world could really learn from, particularly being able to choose your own care provider because by comparison in Australia, you just turn up at the hospital and you get who you get. And same with the child health nurse. Change of shift. Yeah. You just don't know who it's going to be.
Layla O'Mara:
It's a really personal relationship I think. For me, she's become a friend. You're sharing quite a huge time in your life, I guess.
Was she was doing this work before she was a mother herself?
Julia Jones:
And then was she was doing this work before she was a mother herself obviously?
Layla O'Mara:
She was doing it before she became ... In Germany you go into your career after school and that's your career. So she's been in that since her early 20s and she would say herself ... And she worked here because her father was Irish. She did spend some time working in Ireland as a midwife. And one of the reasons she moved back to Germany was that she said she didn't feel that she could give ... She wanted to work at a more holistic manner and with a bigger scope. It's a very similar system here to Australia, I guess. She didn't feel she could do what she had been trained to do here.
Julia Jones:
I actually had a German midwife for when my second baby was born, and she was the same. She was really struggling in the Australian system. I hired her as a private midwife so she could have much more freedom to offer that continuity of care and not just tick the boxes in the hospital. She's getting to the point where she was saying, "I'm actually considering moving back to Germany because I just don't feel like I can really do my work properly here."
Layla O'Mara:
That's what she felt. Then you were just asking about ... I think for Katrine, she felt ... and she writes a blog, so I've read her writing about it as well, that when she became a mother, her way of being a midwife also changed. Actually one of the things that she has written about is she used to just tick the boxes of advising about this ‘wochenbett’ and saying, "Yes, you should, but if the mother wanted to go to the shop, so she wanted to have a big party to welcome the baby, she would." But since having her own baby, she's become an awful lot more, not strict, but she's really advocated far more for it and seen what it really does do for you.
Julia Jones:
I think it's really dependent on the individual mother what kind of midwife role she wants to choose. But a lot of midwives do have that quite matronly, bossy manner about them. It can actually be really appealing at a time in your life when you feel it's so chaotic and out of control for someone to come in and just say, "Look, lie down. I'm going to bring you some food. I don't want you to have to worry about all of this. How are we going to make sure that it gets sorted out?" So for some women, that's actually really appealing.
Other women, they would feel really claustrophobic in that environment. Definitely a couple of my most favorite and respected midwives that I know have that manner about them. I admire it because I'm not like that myself, but sometimes I think, gosh, that's so cool that she just said that to someone. I would've been like, ‘oh, no, no, you do it your way’. But maybe it's that she would've been better to be told what to do.
Layla O'Mara:
Get back into bed.
Julia Jones:
Yeah. Oh, that's really interesting. It's good to hear it as well, because a lot of people listening to this podcast will be professionals and a lot of them don't have children themselves. Because it is something that people feel often is a calling and they want to do this work. But for some reason you're not allowed to be a doula if you haven't had children yourself, which is just one of those silly blocks, I think. But I think this shows that really although of course becoming a mother would change the way that you work and that you see birth and postpartum and motherhood, at the same time, that doesn't mean you can't be a really amazing postpartum professional before you've had children yourself. Or if you never have children yourself.
Layla O'Mara:
Katrine, she didn't have children when she was my midwife the first time at all, and she was still wonderful.
By comparison, when you went back to Ireland and you had your third baby, was that a real shock or did you know how different it was going to be? Did you realize how lucky you were?
Julia Jones:
So tell me by comparison, when you went back to Ireland and you had your third baby, was that a real shock or did you know how different it was going to be? Did you realize how lucky you were?
Layla O'Mara:
I did know how lucky I was. I did know that it didn't exist in Ireland at all. It was still a shock. Just the whole system is a lot more medicalized. So I came back pregnant and all of my prenatal care was you go into a huge hospital, whereas in Germany, the midwife would come to your home or you would go to a very nice warm yoga center feeling place rather than next door to the A&E, which is where it is in the hospital in Ireland. So it's a lot more medical feeling. So that was a bit of a shock.
So I did know. And I did hope that, I was going to try and get a postpartum doula and just do it myself. I also had two kids. I knew how to do it. A lot of those newborn questions, I guess I would have the answers tp from having the other two, but it just didn't work out for me. I ended up having a really tricky pregnancy. I ended up in hospital for three months, and then the baby came two months early. I was running into the hospital every day from the five days after I was released. So I didn't manage to do anything postpartum wise. I certainly didn't have my ‘wochenbett’ and I've really, really noticed the difference.
Julia Jones:
It really shows how much the support really needs to be systemic and a social responsibility because it's a really big ask. If you're pregnant and you already have two children and you're sick in hospital and you're scared about your baby and your health and what's going to happen, you really don't have the capacity then to do research and reach out and find the people who are going to support you. It really just needs to be built in. It needs to just be automatic that it happens for everyone.
Layla O'Mara:
I think if I had been in Germany ...and it did happen to me with my second daughter. I had some issues and I had to be on bedrest for the last 10 weeks of the pregnancy. So you get a prescription written by the hospital and you hand that to your health insurance and they send you help for five or six hours every day, and that's paid for by your health insurance because you're supposed to be resting in bed. So if the same thing had happened to me in Germany, the same thing would've happened. My hospital would've written a prescription, and you can go off and hire your own person. You don't have to have the person they prescribe. But there would've been that support system in place.
Julia Jones:
I have looked after mothers in that situation before when they've been on extended bed rest. It is really a difficult time, emotionally, physically. You just can't do anything. Fortunately, these people had enough money that they could privately pay me, but not everyone is that fortunate. It's really, I think, very unfair if a doctor tells you for the safety of your baby, you need to be on bedrest, but offers absolutely no practical support, particularly if you've already got children, of how you're going to actually keep your baby safe. How can you actually rest in bed when you've got kids to feed and school drop off. You've got to eat and shop and all that stuff. So yeah, it really should just be automatic that if you need to do that for the safety of your baby, then you should be able to access the resources and the support that you need to be able to actually do that.
Layla O'Mara:
As you say, being systemic rather than you having to. Sometimes it's not even a matter of affordability, you might be able to afford it, but just finding that person.
What was the difference between your experiences during that postpartum period and even afterwards in the longer term?
Julia Jones:
Finding it. Absolutely. So tell me the difference. Because you obviously had a different physical experience because you were more sick and the baby, so there was a lot of factors. But tell me how you did feel during that postpartum period and even afterwards in the longer term.
Layla O'Mara:
I think it isn't comparable in one way, but I had a really hard time at my first son who was born. I had a hard C-section and hard recovery, and he was really colicky. But mentally I managed it. I was very tired, but I felt pretty able to cope with it with that midwife support. This time I was obviously ... We'd just moved country as well, so there was an awful lot more going on in one way, but just far more emotional. I went into overdrive and didn't rest at all, and I got mastitis. I just drained myself, I guess. Emotionally it was a lot more up and down and a lot more. I just found it a lot harder. Also really, really wanted somebody to look after me. That makes you grumpy or something. You want to be looked after and that wasn't there.
Julia Jones:
Yeah. Because you knew that you deserved that by then. I guess having had that experience before you knew what that felt like to be looked after.
Layla O'Mara:
Yeah. You mourn that period. Having that. It's such a beautiful time that just being in bed with a newborn. It's so special. So going in reverse and not having that then, I appreciate the time that I had so much now with the other two, and I can see you're ready to go out into the world then rather than it being a challenge.
Julia Jones:
You're, what, 10 months in now? Did you say your youngest is 10 months old?
Layla O'Mara:
He's just turned 10 months. Yeah.
How are you feeling now at 10 months postpartum? Do you feel like you've managed to catch up or do you feel like that missing that first 40 days has had a longer-term impact?
Julia Jones:
Yeah. And how are you feeling now? Do you feel like you've managed to catch up or do you feel like that missing that first 40 days has had a longer-term impact?
Layla O'Mara:
I think I'm managing. If I wasn't more aware of what I should have done, if you know what I mean, or what I wasn't able to do and trying to ... You can never get it back. But just trying to be slow and trying to look after yourself a little bit. Even just emotionally processing it all. Even doing this course has been really super for that. I feel I'm catching up, but it's taken the 10 months. I think there's not many people would be as aware of it as I was. Without that awareness and without really doing some work and giving some time to it, I think I'd be still really struggling.
Julia Jones:
I think that's a big difference, isn't it? If you didn't understand that getting that support is actually normal because you'd had that experience in Germany, a lot of people then feel like, I am not coping. I'm a failure. There's something wrong with me that I'm so exhausted, overwhelmed. So they turn that all on themselves and they think there's something wrong with them, rather than going, "Hey, this system sucks and I deserve better than this." Because then you can actually start healing from it when you have that awareness.
Layla O'Mara:
Yeah. I have friends who've had first babies recently, and just watching her breaks my heart. Just seeing hard birth or whatever, and really reaching out and trying to find those systems, which as you say, you're building the system for yourself each time. You're reinventing the wheel each time because it's not structurally or systemically in place. So really hard time and emotionally, really hard journey and breastfeeding and all of that is such an uphill struggle because it's all new for them, who haven't had a baby before and who don't know that they should be pampered and looked after for that time.
Julia Jones:
Yeah. I love that. I think that idea of being pampered and cared for, it's still even a longing that I have and my youngest is two. But I still often feel like you spend as a mother so much time caring for other people, don't you? I sometimes are just like, oh, I just wish someone ... If I've got a cold, I wish someone else would bring me the herbs and I wish someone else would cook me the soup. I do actually have great support compared to a lot of parents because my mum's nearby, I have a nanny and I have a cleaner, and I've got great neighbours. We all support each other. My husband's awesome. All of that stuff. But yeah, I can really, really relate to that urge. I think when you know that you are worth it and that you deserve it, and then actually that care makes you stronger, then it's a very different perspective, isn't it? That feeling like, no, I deserve better than this. I need more support and more care and more love than this, and that's why I'm feeling bad.
Layla O’Mara:
And it's not a luxury. I think that's the one thing I took from it in Germany is that it's just part of the system. It's what happens and what should happen. It's what's medically important as well. It should be pampering, but it's pampering for ... It's not an indulgence I suppose. It's really important like that quote you have of the 40 days for 40 years or 42 days for 42 years.
Julia Jones:
Yeah. Which I learned from Ysha Oakes but which is common in so many different cultures. Like you said, they have a similar belief in Germany, but all over the world this idea that you invest that time and that care in that adjustment period and that transition. It really does set you up to be a really strong mum. As you've said, it doesn't mean if you miss that, you can never get it back. You can still do it. It just takes a bit longer and a lot more effort if it's not just already automatically provided for everyone.
Layla O'Mara:
Yeah, Exactly.
Do you have any last things to share with people?
Julia Jones:
Amazing Layla. I really appreciate your thoughts. Do you have any last things to share with people?
Layla O'Mara:
I think we've covered most things. Just as an experience that time was just so wonderful. It sets you up for what's to come. Just talking about whether you need to have had kids to be a doula or to be a midwife, it's not about that. It's about just holding space for somebody while they work out how they're going to be a parent and be a mother and anyone can do that. I was talking to a friend of mine and she was just saying her mother did it just because her mother is Iranian, and that's what they did. So she was there for five or six hours every day for the first three months. It's possible, whoever you are, wherever you are to do it, I think. It's about integrating it into normality and it's just what happens rather than it being something unusual.
Julia Jones:
I think taking it from you, having had three children and me also having three children, but I think sometimes for a lot of first time mothers, if they're not in a culture that does support this, if you're in a culture that you should just get up and on with it, then that first baby can be a real shock and you can feel like a real failure for needing support and asking for help. But in actual fact, I think from our combined experience of having had six babies between us, it's really essential that you get that help. So if anyone at home is thinking, I'm really struggling, then go out and find that support network. It sucks that you have to do that yourself, but it's still important that you do whatever you can, whatever's available to you. Whether it's friends, family, professionals.
Layla O'Mara:
Yeah.
Julia Jones:
Awesome. Thank you so much, Layla. I have learned a lot. I'm really, really interested and fascinated to learn more. And also really passionate about trying to figure out how we can get these kinds of structural changes in Australia and other parts of the world as well. So it's really cool to see what's working in other countries so we've got something to model it on. Thank you so much, Layla. Tell us briefly as well where people can find you and learn more about your work.
Layla O'Mara:
Yeah. Well, my website is my name, so it's L-A-Y-L-A-O-M-A-R-A, laylaomara.com. [Updated to: https://nuanua.com/ ]And so that's my website about my work as an acupuncturist, and I work with fertility and living seasonally and all that kind of thing.
Julia Jones:
Great. Whereabouts in Ireland are you?
Layla O'Mara:
I'm in the countryside in Wexford, so the south of the country, right down the south by the sea.
Julia Jones:
Beautiful. So if anyone's listening from there, go and see Layla. Awesome. Thank you so much.
Layla O'Mara:
Okay. Thanks a million. Enjoyed that. Thanks.
Julia Jones:
See you. Bye.
Layla O'Mara:
Bye-bye.
