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Thanks to you all.
I'm going to use 'Has it started' and 'what must be, must be' as the translations; they seem to fit the context best.
Ingeborg is English, and has not been welcomed as the wife of her husband who is the local Lutheran pastor. Ilse is her maid, and is rather more sympathetic than the rest. Frau Dosch, the midwife, and Pastor Dremmel are not sympathetic, and are more focused on Ingeborg's duty to provide a male heir than her well-being.
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