Reimagining postpartum care for expat mothers in Berlin
Interview with Katerina Koukaki
I chat with Newborn Mothers graduate Katerina Koukaki from Mothering Days. Together we discuss the realities of working as a postpartum doula in Berlin, why so many of her clients use health insurance to access her services, and how to support parents with realistic expectations around sleep and feeding. At the core of this conversation, we explore the cultural shift needed to move from crisis-based support to proactive, universal postpartum care.
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About Katerina
Her career shift from finance and administration began after having her first baby. With her second, she realized new mothers lacked support, understanding, and respect—so she started offering it to friends and relatives. She trained as a volunteer lactation consultant with La Leche League but wanted to do more. After discovering Newborn Mothers, she knew this was her path. For the past two years, she’s been supporting expat moms in Berlin, providing the help she once needed. Her services are covered by health insurance or can be paid privately.
Reach out to Katerina here: http://motheringdays.com/
We explore the following questions:
How did your journey from corporate finance to postpartum care begin, and what inspired you to make that shift?
What are the key lessons you've learned about balancing your personal life while running a postpartum support business?
How do you avoid burnout while still offering meaningful care to the families you support?
What advice would you give to doulas around valuing their work and setting healthy boundaries?
How does food and nourishment play a role in your approach to postpartum recovery?
How do you decide which services to offer while staying sustainable and avoiding overextension?
What has it been like working within the German health insurance system as a postpartum professional?
How has connecting with other doulas helped you grow your practice and reach more families?
What advice would you give to someone just starting out—especially if they don’t have a business or tech background?
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Transcript
Julia Jones:
Hello and welcome to the Newborn Mothers Podcast. Today I'm talking with Katerina from Berlin, and originally from Greece, but living in Berlin, supporting the expat community and other families. Katerina's background was in finance admin in a kind of corporate career. But when you had your babies, you found yourself really yearning to do some work, supporting families, and now you work as a postpartum doula, and lactation consultant. So, Katerina, thank you so much for coming on the podcast and sharing your story.
Katerina Koukaki:
Hello, Julia. Thank you for having me. I'm very happy to be here and share a little bit of my story and what I'm doing now. So, yeah, my background is completely different. And then I found myself when I moved to Berlin very quickly I got pregnant with my first baby, and then when I gave birth, I found a new reality, which I was not expecting, and I was not prepared about. So it was like, not really a shock, but I had to change many things. I had to change my schedule, you know, all these things that we have to change to adapt to the life with a newborn. And that's the point where I started being more active, reading, more actively, trying to find accurate information and not just opinions on mum's groups here and there. And then I had my second baby, and that's the point where I felt more confident.
And then there was no space for criticism or why you do it like this, you should be doing it like this, not like that. So everyone has an opinion. And then I found out that what new mums need is not opinions from different people, but rather, what is it that they need? Because for one mum, it's important to breastfeed her baby. For some other mum, this is not so important. So I thought that it's important to adjust your opinion according to what this mom needs.
And then I started, my training as a lactation consultant, as a volunteer lactation consultant. But I felt this was not enough. And then when my son grew up a little, I found an ad of your training, and I thought, wow, this is amazing. I didn't even know that it existed, but I really, I really like to support mums. And then the pandemic happened. So my kids were not going to school. The kindergarten was closed, everything was shut down, at least here in Germany. And in all that chaos, I found that, okay, I need to keep my sanity and do something else than cooking breakfast, dinner, lunch, you know, entertaining the kids, being the teacher, being everything. So I was doing a training at that time. I finished it during the pandemic, and then I found out—do we need to interrupt or should I continue?
Julia Jones:
Oh, you can continue. I have lots of questions, but I'm happy for you to just tell this story as it comes from your heart.
Katerina Koukaki:
Okay. So I had no idea about all how to set up the business because I was in corporate, so I was not a freelancer. I had to discover everything like from scratch. I watched your business modules on the training and I was like, wow, I didn't know this exists. And then I started helping people voluntarily and I said, okay, you know, I will find some clients and then I will just support them. They will pay me, all good, because I had all that pricing module and how to do it, and then all this—in theory! So in theory, I mastered everything.
And then magically, I found out that what I'm doing can be covered by the health insurance here. In Germany, I have to say, all the people have to have health insurance, have to be publicly insured. So that's mandatory. And then I connected with other doulas here in Berlin, most of them English speaking. And this is how I got my first client. So the client didn't pay me privately. And still, this is how I'm working, but it's under certain circumstances, these costs can be covered by health insurance. Unfortunately, not for all the mums, which I would wish. I wish this happens one day. There has to be some challenges—
Julia Jones:
So I just want to pause you there. So the funding is for, say, mums who have, I imagine a disability or some kind of disadvantage. Is that how, or is it if they just have the right health insurance or something?
Katerina Koukaki:
The health insurances are different. You know, there are many health insurances, but there has to be some challenge, which means that if a mom has a perfect pregnancy, perfect giving birth, and then there is no challenge, nothing, then probably she would not get it. So in order for the health insurance to approve that, there has to be like a doctor's…
Julia Jones:
A referral.
Katerina Koukaki:
A referral from a doctor saying, for example, there are breastfeeding challenges. There is traumatic birth, which of course that can be very, very general, or there can be postpartum depression. But it has to come from a doctor, and the doctor has to cooperate and has to be a little empathetic. Not like, “yeah, you're not the first one who has a child, so it's okay, you will manage, many women before you manage.” There has to be a nice, at least, relationship and understanding between the mom and the doctor.
Julia Jones:
And then as a professional, do you need any specific qualifications to be able to access that funding as well?
Katerina Koukaki:
I need to have a training.
Julia Jones:
Yes.
Katerina Koukaki:
It doesn't matter very much. What, because it's not really a profession that is registered or very well recognised. It's still a little abstract. It's a little, you know, they haven't said exactly what do you need.
Julia Jones:
Yeah. So the Newborn Mothers training that you did was enough?
Katerina Koukaki:
At this point, it's enough. I don't know if at some point the health insurances will say, no, we need it from the official German organisation who's training doulas. I don't know. But so far it's working. And what I need is some bureaucracy things. So it's like, I need an identification number, which I get from an organisation here. So they have me in their files and they know that I'm doing this officially.
Julia Jones:
Oh, this is so interesting to me. So you, now that you, you know, you realise this, you set up your business, you thought people were gonna pay you privately, but then there's actually this health insurance funding. Did that make it a lot easier for you to find work?
Katerina Koukaki:
Yes, definitely. I only had one private customer so far. And what I found interesting at the beginning, I thought I should connect more with mums, with mums in my area, with mums generally. But then what I found out is that it's equally important to connect with other doulas because for example, if a doula, I live, you know, in this district, and then there is a doula who lives, I don't know, five kilometres from here, but she might tell me, “I have a client who for me is very far to go every day. So can you go there for me?” So I'm getting the contract, the contract is between the health insurance and myself about this specific family. Usually the health insurance can be a little strict about how they approve specific time, like let's say from today for two weeks, every day for five hours, let's say. So we have to stick to that. So that—
Julia Jones:
And if one doula is already booked, she can't just say, I'll do it another day. But she might say, Katerina, can you take this client?
Katerina Koukaki:
Yes. Usually, that's what we do.
Julia Jones:
Mm.
Katerina Koukaki:
And yeah, that has the good side. And then it has the not-so-good side. Because sometimes I find if people pay privately, usually they are more, you know, they, you feel it in your pocket. If it's through the insurance, that's when, for me at least, the connection is different with a client because they're more relaxed. Because they don't feel that they have to pay directly out of the pocket. It's funny, they have paid—
Julia Jones:
Yes, but they don't feel so motivated to make changes or to do the things they want to do because the support is, you know, it feels free for them. It's not the same commitment.
Katerina Koukaki:
No. But with most of them, I have such a good connection because they are more relaxed and they don't say, okay, it's three hours. In three hours, we have to do this, this, this, and this. So it's rather like, we have three hours. Let's talk a little. What I found out is that they want to talk to someone who will not tell them, “Ach, you did everything wrong. That's not how we do it. No, that's not the way to raise your baby.” They need someone to talk to and someone to understand and give them a hug. They want to cry sometimes. And I'm very, very grateful to say that with most of them, still they will send me photos of the babies as they grow up. You know, there is a very warm and nice connection. We're not friends, but there is that nice…like sending wishes for Christmas and for Easter…and all these very, very nice things. And I find that this is very important also.
Julia Jones:
Yes. To build that rapport. So I'm interested too, you were saying when you started, you'd never heard of a doula or a postpartum doula, but now you have a network of people in your area. So is that new? Were you just not aware of it? Is there really a lot of postpartum doulas where you live?
Katerina Koukaki:
I knew about birth doulas. I had a birth doula with my second, my second, baby. And of course, I asked her opinion when I started doing my postpartum training, postpartum doula training. I asked her opinion and I said, yeah, I found Newborn Mothers. And then I found some other trainings and she told me, no, no, no, that Newborn Mothers is very good. But I didn't really know that I could… I had the impression that I had to be a birth doula, and somehow on the side of that, I could do some postpartum.
Julia Jones:
Yes.
Katerina Koukaki:
But birth is not really my—I don't like hospitals, so birth is not really my thing. And I thought, how can I do it without the birth part? And then I found out that yes, this is possible. And yes, there are, I wouldn't say so many, but there are definitely some doulas here.
Julia Jones:
Mm-hmm.
Katerina Koukaki:
I'm most connected to the ones who are English speaking, so they're also expats.
Julia Jones:
Yeah, I think that's really interesting because I think a lot of people are under the impression that they have to be a birth doula, and that's what a doula means. But perhaps don't realise that Dana Raphael coined the word doula in the seventies to mean breastfeeding support, which is interestingly how you started, as well. And she had the idea that it was a companionship for after the baby was born. It was only later that the word became synonymous with birth support. But originally that wasn't her intention.
Katerina Koukaki:
Yeah. But somehow the birth things, they became more popular, birth doulas became more popular. And here most of my colleagues are also birth doulas, and they're also doing postpartum. The thing is that the birth doulas, if you're just a birth doula, it's not covered by insurance. Everything has to be covered. It's just that some of them who are birth doulas, they're combining the mom during pregnancy, then during birth, and then postpartum. But I really, really like the postpartum and especially the first-time mums, when they go home with the baby and they think, like I thought, that, okay, I'm pregnant. I will give birth and then it's over. And I didn't think that giving birth is the beginning, you know, of a new, of a new period in your life. I thought that, okay, I will have my baby and then I will continue my life as before, but I will have that baby.
You know, like we see in the commercials, you have the baby, you cuddle the baby, then you put the baby down. The baby’s sleeping, always clean. You always look fresh, your hair is washed. I had all these illusions, and I find that many mums have these illusions.
One thing I want to say that for me, the ideal is for the mom to approach me while she's still pregnant. And, so that we talk a little, we see if we're a good match, and then I know some things about her. So I'm there after she goes home with her baby. The thing is that—and I would like your opinion also, or what you heard from other doulas—the thing is that while they're pregnant, they are like I was, and they do not understand that things will change.
And with some babies, you know, some babies are like this, some babies are like that. They don't understand that if people tell them that your life will change, it's not some weird people who say these things. It's the reality that life is profoundly changing. When you come home with your baby, they don't understand that. No matter if you tell them as a professional, as a friend, as a relative, they don't. It's not easy because it's only theory.
So usually what happens is they contact me when they go home and after they've been overwhelmed. It can be some days, not very late. And so I go there and it's like, oh, she came to save us. But you don't have to, you don't—it would be fantastic if somehow the pregnant mums, especially first-time mums would somehow listen that yes, it can be great. You don't have to get to that point where you say, okay, I need help. Do your research before, and then have it even if you don't need it that much. Because if you have help from the beginning and support, probably you would not get to the point where you say, okay, I cannot do this on my own. Now I need someone to come and help me.
Julia Jones:
Yeah. I think it's so interesting what you're saying, and I've definitely had a lot of experiences like that. I think probably the main difference is because you are saying you get mostly clients through health insurance, who have to be referred through a doctor. So they have to experience some kind of crisis to even be told that you exist and to have the funding for that.
In Australia, very few people would have any sort of access to funding for postnatal care. I found a lot of my clients were already in some kind of challenging situation. Sometimes it was because they'd lost their own mother. Sometimes it was because they'd already had some quite serious mental health challenges that they were worried were gonna recur. Sometimes it was because they were pregnant with twins. Sometimes it was because they'd experienced loss, but there had to be something already there when they were pregnant that had made them have that little bit of concern and want to plan and have that security blanket during their postpartum.
So it's interesting because I agree, I think definitely the feeling is that you need to be in crisis before you get that support. Whereas it would be great if we could move that cultural perception to say that every woman deserves to be held and seen and, you know, and cared for and respected and revered during her postpartum. You don't have to have a crisis before someone can come and cook you a meal. It's, you know, it should just be automatic.
And I know in a lot of traditional cultures, it is in a lot of traditional cultures, they tell me we would never dream of having a baby alone. That's just the most crazy thing you've ever said. Like, how could you even think that that would be possible? Yet for us, it's the opposite. You assume you're gonna do it alone, and then you only ask for help when you're really pushed to breaking point, which is very sad.
Katerina Koukaki:
It's interesting because when I was starting, I decided to do a free workshop for new mums, and then we discussed about everything. It was really very, very nice. I wanted to do a series of workshops, but I only did once. And it's like you say, they had that thing that no, I can do it on my own. And even single mums, they say, no, I'll do it on my own. By the way, single mums are the only ones who for sure will get the approval from the health insurance.
Julia Jones:
Hmm, interesting. Yeah.
Katerina Koukaki:
Yes, because okay, they say you are alone. There is no partner usually. But of course the health insurance will only approve if you don't have anyone around. So even if it's a mom that let's say, has a postpartum depression, if her mums come here, her mom comes here from, I don't know, from abroad, and the health insurance knows that, then they will not approve because they will say, okay, you have your partner, you have your mom or your sister or your mother, the mother-in-law, or someone. And then probably they will not approve. And generally, it's not that the health insurance is really advertising it very much. It's a little…we don't talk about it. Yes, we do it, but it's not yet. You will find it on the website. Sometimes the doctors don't even know. So it's a little like, not secret, but it's like, yeah, if you find out good, otherwise good luck. I mean, I didn't know. I didn't know when I had my babies here and I could have had the support, but I didn't know such a thing existed.
Julia Jones:
Yeah, it's so interesting, isn't it, that even when—and we have the same with funding pathways here, that there is sort of some extra funding for things like, you know, mental health and things like that, that people don't know about. And often that's really the value of having a doula, is for someone to actually help you to go, oh, you need this referral, then you can get some rebates at the physio. Or, you know, you need to see this person, and then you can get help with that thing. But it's not easy for a mum, particularly when she's already overwhelmed and sleep deprived and figuring so many things out for her to know what to ask and what's available.
I want to hear a little bit about your job now. Tell me kind of what a day in your life looks like when you're caring for a mum and are you happy with your role in the work that you're doing now?
Katerina Koukaki:
Generally, yes. I'm happy. At the moment, you know, there are those ups and downs, but now for some months I'm constantly booked until the summer, until the holidays, I mean. It's not that it's always perfect. Like I said, with most families, the connection is really good and there is mutual appreciation and respect. And I find that I have to adjust a little in the sense of, not just going when a client needs me, but rather than having a phone call or an in-person meeting with a family, I would say that maybe it would be even useful that I visit them before we start, before we commit to each other to see if it's a good match. Because I find that for me, if it's a family that is, okay, I don't really feel very good here, or we're not a good match, as personalities we're not a good match, then it's not so easy.
Julia Jones:
Yeah. So it sounds like you even need a bigger network of postpartum doulas so that you can sort of say, look, I don't think I'm the right person for you, but I know someone else who might be a better match.
Katerina Koukaki:
Yeah. This is happening. But I'm quite happy. And also here, the insurance is covered not only for the mums with newborns, but sometimes even, I mean, at the moment I'm working with a mom who has an older child, but she needed to have the surgery. So her one arm, she cannot use her arm. So I'm there for her. These are also some cases that the health insurances will cover. It's not the best, you know, it's not exactly what I dreamed of, but it's nice in a different way because the mom is more relaxed and then the connection comes in a different level. But it's definitely important that, for me at least, that I feel well, and the family feels well with me being there, because I'm going there every day for, I don't know, three or five hours, even six hours sometimes. And it's a lot of time. And there, there needs to be mutual understanding and respect and a good connection. A good connection, I would say.
Julia Jones:
Yeah, that makes a lot of sense. What do you see in the future for Mothering Days? Are you happy just continuing what you're doing? Do you have any other kind of dreams or ideas for the future?
Katerina Koukaki:
I'm happy to continue what I'm doing, and also I want to expand my knowledge with breastfeeding. So, because now I'm a volunteer and I would like to make that more official, so have even more knowledge.
And then the other path I want to follow is that whole sleeping, I will call it training, but not in the sense of sleep train your baby, but rather having the knowledge to give to new mums of what is realistic, what is normal, that not all the babies are difficult, that the baby who will sleep on the mom or the dad or the partner is not some difficult and bad baby who's manipulating the parents, but it's a baby that needs contact. So I want to explore that path.
Also a little from the, not only the practical, but also the more scientific thing, like what's happening with the baby's brains, what's happening with the parent's brains. I want to go through these two paths, but I will not do that before the summer. So that's a plan for next year and then ahead of that.
Julia Jones:
I love it. When you started, did you have, I mean, you told me you had that sort of doubt that you were worried you would have to do births, but once that was cleared up and you knew you only had to do postpartum you were happy. But did you have any other fears or concerns, you know, when you were deciding to do this career?
Katerina Koukaki:
No, actually, no. I was very excited. The only fear I had was with all these amazing bureaucracy that Germany has with all the tax office and the tax statement, and I have to have my own company, and I'm a freelancer, which indeed was a mess. But the postpartum part that, like my training, okay, I had to learn things from scratch. Like I tried for one year to build my own website. I failed miserably, then I thought, okay, now it's time to give it to some professional. But it was exciting for me. I learned so many things. Only the bureaucracy. Other than that, I'm still very excited when I start working with a new family. No, I enjoy it very much. I really, especially if it's a good match with the family, I enjoy it very much. And since I'm Greek, I had my first Greek client this year, and I found that how nice it is because I worked in my mother language and I enjoyed it, particularly. The connection is different.
Julia Jones:
That's beautiful. I have one more question for you because I'm always curious to learn more about the word doula, because obviously in English we have a particular meaning for it. But originally it was a Greek word, and had you come across, you know, that sort of meaning, and was that difficult for you to sort of change to what the English meaning is?
Katerina Koukaki:
Yes, because the word in Greek it's like a slave. It's like a servant. But really these things don't exist anymore. At least not, not in the western civilization, the western world, but it's like someone you have and you just throw them one piece of bread and say, yeah, now you clean the floor. It's like Cinderella, a little, you know, that kind of person. Not appreciated, not respected, from a lower class and all these things. So yeah, my Greek friends, sometimes they make fun of me. But okay, since I'm so familiar now English is anyway in my everyday life. But yeah, if you think about it and I say, okay, this is what I am, but then I'm not this, so it's just, it's just mostly for fun at the moment.
Julia Jones:
Yes. And then obviously in Berlin, that is a common word too. People know the word doula because that's, you know, then you kind of have to use that word because otherwise people won't know what you do.
Katerina Koukaki:
Yes. But in Greek we have a different word for saying. We don't say doula. It's a word which means like a supporter, a helper of motherhood.
Julia Jones:
And what's the word?
Katerina Koukaki:
Should I say it in Greek?
Julia Jones:
Yes, please.
Katerina Koukaki:
Ah, okay. It's voithos, which is—
Julia Jones:
How do you spell that?
Katerina Koukaki:
I spell it with…ah, in Greek we have a different alphabet!
Julia Jones:
Yes, I know. Because even doula you say almost like TH, it sounds like to me.
Katerina Koukaki:
So the D is TH in Greek. But yeah, Voss, if I have to say it in Latin, is V-O-I-T-H-O-S.
Julia Jones:
Yes.
Katerina Koukaki:
That's the one word. And the other word is mitrotitas, which means motherhood. And I would spell it like M-I-T-R-O-T-I-T-A-S-T-I-T-A-S.
Julia Jones:
Okay. I have another little rabbit hole to go down. Now, I love learning about traditional cultural care, and Greek is such an interesting one because of that word doula and how we've sort of co-opted it in English.
Katerina Koukaki:
Why someone thought of using this word, there must be some reason?
Julia Jones:
So it was Dana Raphael, who was an anthropologist. And she said, she was talking about it in the supermarket, saying, oh, I'm studying, you know, supporting breastfeeding women. And she said that there was an older Greek woman just in the queue at the checkout, and she said, oh, we have this word doula, but this must have been misunderstood. This was in America in the 1970s. So it's possible it was not correct.
Katerina Koukaki:
I don't know. It could be if it was some immigrant from Greece who went to the US, and then some people use a little, I find myself now using outdated words. I live abroad it's ten years. So that can be something, that's something I could imagine that.
Julia Jones:
So if this Greek grandmother had already lived in America, she might have been using Greek language from 50 years ago.
Katerina Koukaki:
Yes. Yes.
Julia Jones:
So you said that second word…?
Katerina Koukaki:
Mitro.
Julia Jones:
And that means motherhood?
Katerina Koukaki:
Motherhood, the first one.
Julia Jones:
And what does the other word mean?
Katerina Koukaki:
It means helper.
Julia Jones:
Oh, perfect. That's beautiful.
Katerina Koukaki:
It's like motherhood helper.
Julia Jones:
Yeah.
Katerina Koukaki:
Assistant helper. Something like that.
Julia Jones:
Thank you so much for sharing that. I think that people will find really, really interesting.
I think that's all my questions. Do you have anything else you want to share about your work or with people who are thinking about doing this as a career?
Katerina Koukaki:
About my work, it's very rewarding, it's very giving, for me at least. It's work that you need to give a lot, but it's very rewarding on the other hand. I'm always excited. I still enjoy it very much.
And for the people who feel like they want to do it and they have all these doubts, “will I manage? I don't know enough. I don't have 100 trainings.” I think that if I managed that—I was clueless about everything, I started being completely naive and innocent—so if I managed it, anyone who has a passion about it can manage. I think even if you have no idea about promoting, business, website, I don't know. The first time I wanted to upload a story on Instagram, I had no clue how you do that. So if I learned it, I think anyone can do it.
Julia Jones:
Thank you, Katerina. That's really beautiful and inspiring. And if people want to learn more about you, they can visit motheringdays.com. We'll pop the link in the show notes over at newbornmothers.com. Thank you so much for sharing.
Katerina Koukaki:
Thank you very much for having me, Julia. Have a nice day. And, yeah, I'm very happy. I'm very happy for the change of career that I did. Thank you.
Julia Jones:
And we are very happy you did this too, because now there are so many more mums in Berlin with support, so thank you for that.
