Pregnancy in Germany: Your First 9 Months Explained
This series has been a long time in the making…. 9 months in the making, in fact. When we first found out that we were expecting our little guy, there were a lot of questions mixed into the excitement of a new baby. Giving birth abroad and pregnancy in Germany can be a very different experience than giving birth in your home country. We didn’t have family members that we could call to ask questions about their experiences. And as first time parents, we had never been to a maternity ward before, let alone one in a foreign country. Understanding our birth options and healthcare coverage abroad was very new territory - pardon the pun.
So that’s why we’ve compiled a comprehensive overview of pregnancy in Germany, with details about what to expect in the first 9 months. Here we cover everything you need to know and what to expect in regards to your prenatal care.
Prenatal Care in Germany: The First Trimester
Whether your new baby is a surprise or was completely planned, pregnancy in Germany for foreigners can be daunting and you are likely to have quite a few questions. As an expat family and new parents, we can confidently assure you that the first trimester is a great time to lay a great foundational health care plan for you and your little one. While morning sickness may have you down, there is still so much to look forward to in your pregnancy. Let’s get started.
First Trimester Checklist
Confirmation of Pregnancy by Gynecologist (around week 8)
Receive your Mutterpass
First in-depth Ultrasound (between weeks 9-12)
Decide on Optional Prenatal Tests & Examinations
Find your Midwife (by week 12-14)
At Home Pregnancy Tests
Congratulations! You’re pregnant. Or well, at least you think you might be.
For most expectant mothers, the first “confirmation of pregnancy” will come from an at home pregnancy test kit (Schwangerschaftstest). In Germany, you can purchase these tests on Amazon.de, at your local drug store (such as DM.de) or at your local Pharmacy (Apotheka).
If you’re from the United States, you’ll recognize a lot of common brands, such as Clear Blue, and you can find both electronic/digital and manual dye tests.
Common Pregnancy Phrases in German:
Ovulation Test: Ovulationstest
Pregnancy Test: Schwangerschaftstest
Pregnant: Schwanger
Not Pregnant: Nicht Schwanger
Confirmation of Pregnancy by your Gynecologist
Once you see that second blue line (or a digital “Pregnant” result), your next step will be to call your Gynecologist (Frauenarzt) for a confirmation of pregnancy. Generally speaking, your Frauenarzt will schedule your in person exam around your 8th week of pregnancy (8 week since your last period).
During that exam, you will be asked to provide a urine sample (Urinprobe) and the doctor will perform an ultrasound/sonogram (Ultraschall) to confirm the pregnancy. You’ll even get to take the picture home of the tiny little peppercorn to hang on your refrigerator.
If you would like, you can also request an “official” statement from your doctor confirming your pregnancy to share with your employer. When should you inform your employer of your pregnancy in Germany? You can request this at any time during your pregnancy; however, if your work requires strenuous activity or you would like to inform them of future time off you will need this statement to apply for benefits.
Mutterpass
If you do not already have one from a previous pregnancy, your Frauenarzt will also issue you a Mutterpass during this appointment. Your Mutterpass is a small booklet where all of your exams and test results will be logged, along with information regarding the baby’s growth and anticipated due date.
This is an extremely important document that you should bring with you to every appointment moving forward and when it is time to give birth. It will give any new health provider all pertinent information about you and the baby during your pregnancy.
The person delivering your baby is not necessarily the same person who will perform your prenatal exams.
Prenatal Examinations & Schedule in Germany
If you have not yet been to a Frauenarzt in Germany, it may come as a surprise that it is not customary to receive a hospital gown to put on before your examination with your doctor. Rather, the experience is a bit more “up front”; you simply de-robe from the waist down and hop onto the exam table.
If this makes you uncomfortable, I suggest wearing a skirt, dress or long shirt that you can pull up when the time comes to perform the exam.
In addition, you may find that some doctor’s offices do not have a separate changing room/area to dress or undress. In fact, your doctor (like mine) may not leave the room at all after the initial consultation while you undress and just stay in the room with you.
While some expats may find this a bit unusual, you’re about to embark on a very personal and intimate journey with them anyway. So, ultimately, the modesty beforehand is best left in the waiting room.
In regards to the examination schedule, you should anticipate 12 examinations before your baby’s due date (Termin Datum). In the first trimester, these exams will occur once every 4 weeks.
After week 32, these will become more frequent at once every 2 weeks. If you do go past your due date, you may be required to go everyday or every other day, depending on the recommendation of your care provider.
What to Expect During your Prenatal Exams in the First Trimester
In the first trimester, in addition to an ultrasound, you can also expect a routine exam to include a check of your blood, blood pressure, urine and weight.
Here is a brief overview of routine care during your first trimester:
Gynecological examination and advice (Frauenärztliche untersuchung und beratung)
Blood Pressure Measurement (Blutdruckmessung)
Urinalysis (Urinuntersuchung)
Exclusion of chlamydia infection (once) (Ausschluss Chlamydieninfektion (einmalig))
Exclusion of urinary tract infections, pregnancy diseases (regular) (Ausschluss Harnwegsinfekt, Schwangerschaftserkrankungen (regelmäßig))
Weight Monitoring & Control (Gewichtskontrolle)
Blood tests to determine:
Blood Hemoglobin Protein (Hb- Wert)
Blood Group and Antibody Test (Antikörpertest)
Rubella Immune Status (Rötelinimmunstatus)
Other Infectious Diseases: Syphilis, Hepatitis, and HIV (voluntary) (Lues, Hepatitis, HIV (freiwillig))
First In-Depth Ultrasound Screening (between weeks 9-12 gestation)
Speaking of insurance coverage, you will also need to make a decision early on with which prenatal exams and scans you would like that go above and beyond what is covered by statutory health insurance. This includes, but is not limited to, genetic sequencing for disorders and disabilities, 3D ultrasounds, and further blood analysis for familial disorders.
While we found that the costs of giving birth and pregnancy in Germany were very, very low in comparison to the United States - there are noted inclusions and exclusions in statutory healthcare that may affect how much you end up paying.
Please note, some of these tests and exams may be time or gestation sensitive, and your doctor should provide you with a list of tests and the out of pocket costs associated with them during your first appointment.
Finding a Midwife
I distinctly remember going into my 12 week appointment with my Frauenarzt and having the following conversation:
Doctor: “So, who is your midwife?”
Me, staring back at her like a deer in headlights: “Um… am I supposed to have a midwife?”
One contrast in healthcare I have noticed during my pregnancy in Germany is that there is a very significant difference in the ways in which I interact with my doctor. In the United States, my doctor would always offer up information and care options automatically in order to ensure that I was well informed. In Germany, there seems to be a greater emphasis on self-led learning.
Just like our friends at How to Germany, I am not sure if this is a cultural difference (i.e., perhaps Americans expect to participate in medical care decisions more than their German counterparts), a language difference (i.e., since it is awkward communicating in a language other than our mother tongue, we tend to communicate less), a procedural difference (i.e., dosage information in the U.S. is provided by the doctor and in Germany it is provided at the Pharmacy or Apotheke) or a combination of all three.
Resultantly, one of the first trimester checklist items that I wish I had known sooner, was how important it is to find the right midwife (Hebamme) EARLY if you want to have one as part of your pre- and post-natal care. I waited until week 14 to find mine, and was disheartened that so many of those that I called were already booked.
Additionally, the role of a midwife (Hebamme) in Germany is very different from what I had previously presumed from the United States. In Germany, a Hebamme is a trained medical professional who is licensed to perform physical examinations of mom and baby and is the primary person for delivering the baby.
They are on call 24 hours a day and will help with absolutely any questions that you may have (including breast-feeding, formula-feeding, diapering and bathing) before, during and after delivery.
Due to my own medical history, I remained with my Frauenarzt for the entirety of my prenatal care, opting instead to have a midwife provide follow-up care at home afterwards for 8 weeks. However, you do have the option to see your midwife instead for many of your appointments privately at your home and to hire a midwife that can perform at-home births.
One of the best things about German healthcare is the emphasis on quality, comprehensive care that suits your individual needs. Whether you would like a Hebamme or not, you are encouraged to pursue your own needs and desires during your pregnancy.
Prenatal Care in Germany: The Second Trimester
Ah yes, the second trimester. If your pregnancy was anything like mine, the second trimester was considerably more “smooth sailing”. The first trimester morning sickness had largely faded away. I began looking pregnant (rather than just coronavirus snacking). And we officially found out that we were expecting our little boy. My pregnancy was now well underway, and with big milestones came a few significant changes in my prenatal care.
Second Trimester Checklist
Second in-depth Ultrasound (between weeks 19-22)
Complete your Gestational Diabetes Glucose Test (between weeks 24-28) Screening auf Gestationsdiabetes “Schwangerschaftszucker”
Start Planning for your Maternity Leave “Mutterschutz” and Parental Leave with “Elterngeld”
Second in-depth Ultrasound
The second ultrasound, which occurs between weeks 19 and 22 and is covered by statutory health insurance, is where many expecting parents find out whether they are having a little boy “Junge” or little girl “Mädchen”.
However, as I mention in above in the First Trimester, if you would like to find out sooner, you can opt for either a blood test or an early ultrasound. Keep in mind, you will need to pay for this out of pocket, typically around 130EUR.
At most gynecologist offices your “Frauenarzt” will complete an anatomy scan “Organscreening”. During this exam, your doctor will be able to rule out any fetal abnormalities and some genetic conditions (such as spina bifida “ and trisomy 18 or Down Syndrome “Down-Syndrom”) if you did not opt for the early blood test.
Because this ultrasound is such a major milestone in your journey for pregnancy, it is highly encouraged that your significant other or close family member attend the scan with you.
Even though I was pregnant during the height of the Coronavirus pandemic, where Jonathan was prohibited from attending any of the prenatal exams with me, he was still allowed to attend this exam.
Additionally, as your Frauenarzt will take the time to examine all of the major bones and organs, anticipate this exam taking a bit longer than usual (around 45 minutes). We were fascinated to see all of the intricacies of our little guy, from the individual chambers of his heart to the spinal cord and brain development.
Changes in Your Examination Routine
You may also notice that there are a few changes in your standard examinations during your second trimester. While you will still be seeing your Frauenarzt or midwife “Hebamme” every 4 weeks, because of the size of your baby’s development your ultrasounds will now be conducted transabdominal, rather than transvaginal.
Also, you should also anticipate your healthcare provider to begin checking your cervix or “Gebärmutterhals” at each examination. He or she will be looking to make sure that you do not have any abnormalities and infections. Additionally, a pelvic exam can help your Frauenarzt to evaluate the size of the pelvis and cervix. This will help them to evaluate whether cervical weakness could lead to miscarriage or preterm labor.
As with all of your examinations, your healthcare provider will still be taking regular urine samples “Urinprobe”, checking your blood pressure “Blutdruck”, and weight “Gewicht”.
Complete your Gestational Diabetes Glucose Test
The second major milestone for pregnancy during your second trimester, is to complete your gestational diabetes glucose test Screening auf Gestationsdiabetes ‘Schwangerschaftszucker’ order ‘Glukosetoleranztest’”.
Technically speaking, only the 1 hour test is considered “routine” for having a baby in Germany and therefore covered by statutory health insurance. However, my Frauenarzt advised me that this test is not as comprehensive and misses about a third of cases of Gestational Diabetes. As such, she encouraged me to take the 2 hour test which cost me 30 euros out of pocket. Again, this is not a high price, but does contribute to the overall cost of pregnancy.
Regardless of which exam you take, you should anticipate an overnight fast (8-14 hours without eating) with an initial fasting blood draw “Nüchternblutzucker” before drinking a sugary orange drink and testing your blood sugar levels in regular 1 or 2 hour intervals.
Most Frauenarzt do not have the ability to tell you your blood sugar results in real time, so you should anticipate having a nurse call you to provide you with your results within a couple of days once the labs are finished.
If you are diagnosed with gestational diabetes or “Gestationsdiabetes”, your Frauenarzt will send you to your local diabetes clinic for follow up with a referral note “Überweisung”. Because this is a confirmed diagnosis, any follow up medication, testing strips, monitors, and diet classes will be covered by statutory health insurance.
Start Planning for your Maternity Leave “Mutterschutz” and Parental Leave with “Elterngeld”
Although you will not be able to sign-up for or qualify for any of these paid times off just yet, it is a good idea to begin planning for any work leave.
Why is considering parental leave important?
Contrary to the norm in the United States, most daycare centers “Kitas” in Germany do not accept children under 1 year old. In special cases you can find openings at a “krippe”, which are special daycare centers equipped to take children from the newborn stage. However, these spots will likely go quickly so make sure to sign up for a spot with your city’s Office for Children, Youth and Families “Amt für Kinder, Jugend und Familie”, or AKi for short, as soon as your little one is born.
In order to understand parental leave and subsidies from the German government, I will begin by briefly explaining the difference between Maternity leave “Mutterschutz” and parental leave with “Elterngeld”, and how expecting parents are supported during and after pregnancy in Germany.
Maternity Leave in Germany“Mutterschutz”
Legally, all new mothers are entitled to time off just before and immediately after giving birth. This is true whether you are a student or an employed person, expat, foreigner, or native citizen, in Germany. Although there are many features to this program, it is generally composed of 2 features: job protection during leave and paid time off.
The Mutterschutzgesetz, Maternity Protection Act of 1968 was instituted to ensure that expecting mothers are not discriminated against when applying for jobs and to provide them with added protection from being dismissed from work as a result of their pregnancy or arrival of their newborn child.
According to the Maternity Protection Act / Mutterschutzgesetz, job protection during leave includes:
Expecting mothers do not have to work during the last 6 weeks of their projected pregnancy in Germany, but may do so as long as they formally state their intention to work during this period (paragraph 3).
New mothers are not allowed to return to work until 8 weeks have passed since the date of their child's birth (paragraph 5).
Importantly - This is still protected even if your baby makes a late entrance into the world. You are not penalized with less time to recover and bond with your baby.
For premature, multiple and cesarean births, the return date to work is extended automatically to 12 weeks after birth (paragraph 5.1).
How much money you receive during these time periods depends largely on the the of employment you had leading up to birth and the type of health insurance that you have.
Maternity benefit from statutory health insurance
If you are covered by statutory health insurance you will receive maternity benefit based on your average earnings from employment in the last three months that you received full pay. The maximum amount you can receive is 13 euros per day. This is then “topped up” by your employer (see below).
Maternity benefit from Federal Insurance Office
If you are an employee but not a member of a statutory health insurance scheme (i.e. if you have private health insurance or are co-insured as a family member of another statutory health insurance policy holder), you may be entitled to receive maternity benefit from the Federal Insurance Office, in a lump sum of up to 210 euros.
Employer’s maternity benefit top-up payment (“Arbeitgeberzuschuss”)
If your average take-home pay before you went on maternity leave exceeded 13 euros per day (or 390 euros per month), your employer is legally obligated to make up the difference. This is paid to you as a monthly “top-up” payment for the duration of your statutory maternity leave.
In other words, if you were a fully employed person and take maternity leave, you will receive an average of the last 3 months of pay each month during the protection period of Mutterschutz.
In order to prepare for this time away, it is best to notify your employer early of your pregnancy and anticipated delivery date. You can do so verbally or your employer may request a Certificate of Expected Date of Delivery “Bescheinigung über den mutmaßlichen Tag der Entbindung” from your Frauenarzt.
Your employer must forward the information to the Employment Protection Office “Arbeitsschutzämter” or the Business Supervisor's Office “Gewerbeaufsichtsämter”. Both of these offices ensure that all Mutterschutz provisions are properly regarded, just as they serve to assist both employer and employee on all issues pertaining to Mutterschutz.
Black Forest Family Tip
Are you a student? Make sure to notify your University of your pregnancy. You are also entitled to the same Mutterschutz time away from classes and any special accommodations necessary (i.e. change of examination schedule).
Parental Leave with “Elterngeld”
Just like the second trimester is a great time to start planning out your Maternity Leave, you and your partner should also start considering your plans to take an additional extended time off to take care of your little one.
In Germany, new parents may be entitled to Elterngeld (roughly translated to parental allowance) which is funded by the federal tax system. In general, this is a fund which is accessible to new parents during the first 12 or 14 months after giving birth.
The amount the parents receive is a complicated equation based on the net income of the parent dedicated to caring for the newborn and is to be viewed as a limited income subsidy.
However, Elterngeld is not only for one parent to take. The system utilized in Germany is very similar to the system in other Scandinavian countries, which allow for both parents to take time off to care for their little one and receive Elterngeld by sharing the allocated 12 to 14 months, either simultaneously or consecutively.
Who Can Get Elterngeld?
Employed, self-employed and bureaucrats
Unemployed parents
Students and apprentices
Parents of adoptive children
To apply for Elterngeld, we recommend applying in writing approximately 7 weeks prior to giving birth (although you can apply retroactively up to 3 months).
To find the government office responsible for your application in your Bundesland (state) go to this link.
Eligibility for Elterngeld
Follows these criteria:
Residence in Germany or an Aufenthaltstitel (residence permit) that allows you to work in Germany
You and your child reside together
You care for your child personally
You do not work more than 30 hours per week during the time Elterngeld is issued
How Much Elterngeld will I earn?
The Elterngeld amount is 67% of the applying parent's net income, averaged over 12 months before the child's birth.
Maximum amount monthly is 1,800 EURO
Minimum amount is 300 EURO (even for unemployed parents!)
For each multiple birth, 300 EURO per child issued.
Coming from the United States, this sounded quite generous to us. However, there are a few factors you should be aware of. For starters, while you may work part time (up to 30 hours) during this time, any income you earn will most likely be calculated against your Elterngeld.
Furthermore, any parent who elects to take Elterngeld must commit to taking off at least 2 months. While these months do not need to occur consecutively, if you are a single income family the 1800 euro maximum may be a considerable income “hit” during those two months.
Remember, this program is meant to be a limited income subsidy and not a wage replacement program.
Calculate your potential Elterngeld subsidy by using a handy calculator provided by the Bundesministerium für Familie, Senioren, Frauen und Jugend.
Do you have a large family?
For families that already have children an additional 10% of the Elterngeld is paid or a minimum amount of 75 EURO monthly as a "sibling bonus". The requirements for multi-child families are:
For 2 children, they have to be under 4 years of age
For 3 children, they have to be under 7 years of age
How Long is Elterngeld Paid?
Single parents that qualify will receive a total of 14 months of assistance from the German government. However, this 14 month time period includes the time you receive Mutterschutz. You cannot receive both Mutterschutz and Elterngeld money simultaneously after giving birth.
For parents jointly taking care of their newborn, they may also receive 12 months of Elterngeld for the designated partner caring for the child and can receive an additional 2 months of Elterngeld for the other partner, but only when they reduce their hours of work to less than 30 per week. Partners that want to split the Elterngeld as they wish may do so, but only 12 months will be paid.
ElterngeldPlus – Partnership Bonus with More Flexibility
Interested in taking more than just 12 to 14 months off to take care of your little one? It is also possible to reduce the Elterngeld by 50% and have it paid over twice the amount of time.
In 2015, Germany rolled out the ElterngeldPlus program. For parents of children born from July 1, 2015 on, there is a variety of flexible leave times that can involve both parents.
The amount of time that can be taken off can be extended up to double the time offered in the regular Elterngeld program (up to 2 years). The basic idea of this program is to make it easier to combine parental allowance and part-time work.
Generally speaking, with ElterngeldPlus you receive half of the monthly Elterngeld sum to which parents without part-time income would be entitled. In this way, mothers and fathers can also remain more flexible over and above the 14th month after the birth of their child in order to combine the needs of the child with the requirements of their jobs.
Additionally, the ElterngeldPlus program makes it possible for parents to take some leave over a greater span of the child’s early life. In fact, you can claim ElterngeldPlus anytime between a child's third and eighth birthdays and can even divide the leave time into three phases per parent.
It's possible to choose either the Elterngeld or ElterngeldPlus or even to combine them both. Each parent can apply for either program individually.
Prenatal Care in Germany: The Third Trimester
The finish line is in sight as you enter into the third trimester. Along with all of the nursery building and anticipation for your little bundle of joy, you can also anticipate a few changes to your healthcare routine at the end of your pregnancy.
Pregnancy in Germany: Second Trimester Checklist
Third in-depth Ultrasound (between weeks 29-32)
Regular Appointments Move to Every 2 Weeks
Begin Regular Cardiotocography (CTG) Scans
Additional Optional Testing for:
Group B Streptococcus
Registering at Your Hospital of Choice
Finding Your Child's Pediatrician (Kinderarzt)
Third in-depth Ultrasound
The third ultrasound, which occurs between weeks 29 and 32 and is covered by statutory health insurance, is for most parents the last “in depth” look at your little one before his or her birthday. However, as I mention in above in the First Trimester section, if you would like more ultrasounds or a 3D ultrasound, these are generally available but you will need to ask for it directly and pay out of pocket.
During this ultrasound you can anticipate your Frauenarzt to check the growth development of your baby and to make sure that many of your little one’s digestive systems are beginning to function.
For example, your frauenarzt may remark that there is now fluid visible in your baby’s digestive track and/or bladder, indicating that he or she is practicing swallowing amniotic fluid and peeing it out.
Speaking of amniotic fluid, your doctor will also check the amount of fluid surrounding your little one as well as the blood flow within the umbilical cord. Each of these tests are checking to make sure that your baby is happy and healthy during pregnancy.
Changes in Your Examination Routine
Just like in your second trimester, you may also notice that there are a few changes in your standard examinations during your third trimester of pregnancy. For starters, you will still be seeing your Frauenarzt or midwife “Hebamme” every 2 weeks right up until your due date.
Unlike in the United States, you will not see your physician every week in the final month unless there are noted fetal abnormalities or conditions that put your pregnancy at risk. Should you go over your due date, this will accelerate to every 2 days.
In addition, during your third trimester your Frauenarzt may also suggest that you begin regular CTG Scans. CTG stands for Cardiotocography (and goes by the same acronym in Germany) and serves two primary functions. First, it measures your baby's heart rate. At the same time, it also monitors the contractions in the womb (uterus).
It is best to get used to the CTG, as it is used both before birth (antenatally) and during labour, to monitor the baby for any signs of distress.
Black Forest Family Tip
I recommend wearing a top and bottom (rather than a dress) during your appointments in the 3rd trimester where you will receive regular CTG scans. Your belly will need to be bare for these scans lasting 20-30 minutes and you will want your midsection to be easily accessible without making you feel over exposed.
Like in your second trimester, your healthcare provider will continue checking your cervix “Gebärmutterhals” at each examination. He or she will be looking to make sure that you do not have any abnormalities and infections.
As with all of your examinations, your healthcare provider will still be taking regular urine samples “Urinprobe”, checking your blood pressure “Blutdruck”, and weight “Gewicht”.
Additional Optional Testing
A cornerstone of women’s healthcare in Germany is an emphasis on preventative testing done to insure the health of you and your baby. In the third trimester, you should anticipate to be asked about an optional test for Group B Streptococcus.
Group B streptococci colonise the large intestines in humans and can move to the vagina from there. For this reason, your Frauenarzt will take samples for a bacteriological culture from both the vagina and the rectum in order to ensure that Group B streptococci are identified.
All in all, about 1 in 4 women carry GBS bacteria in their body and it is recommended by the German Society of Gynecology and Obstetrics that they are tested for this bacteria when they are between 35 to 37 weeks pregnant. While this is not covered by statutory health insurance, the cost of the group B Streptococcus test in Germany is generally between 10 to 30 euros. Again, while this is not necessarily expensive, it does contribute to the overall cost of your pregnancy.
Should you find yourself testing positive, it is recommended that you receive antibiotics during labor to minimize transmission to your newborn after the mother‘s water breaks.
Registering at Your Hospital of Choice
One of the aspects of pregnancy in Germany that I was always so thankful for was the support and options you are provided as an expecting mother. Whether you would like to give birth at home with the support of a midwife, at a birthing center, or at a major hospital you are strongly encouraged to make the choice that is best for you without any judgement or pretence.
However, should you make the decision to give birth at a hospital, it is recommended that you register ahead of time in anticipation of giving birth. In principle, there is no obligation to register for the birth. However, it makes the process easier (and less stressful) if the staff gets to know you and your preferences beforehand.
Typically, you will be advised to complete the registration around 1 month before your due date. Your Frauenarzt will issue you a referral form, called an “Überweisung” that you take with you to the hospital along with your Mutterpass, insurance card “Versicherungskarte” and any other letters from your physician(s) “Arztbrief” describing any medical conditions you may have.
During your registration process, you can anticipate completing the following steps:
Update your address, contact information and insurance information with the hospital.
Meet the hospital staff, midwives, and doctors who may be there when you give birth.
Complete a comprehensive medical history file of your pregnancy
Indicate your preferences regarding pain management and birth plan
Complete a prenatal exam with ultrasound “Ultraschall”, CTG, urine test “Urinprobe” and vital signs.
Answer lingering questions regarding the processes, procedures and steps for giving birth or your pregnancy.
Optional: View the delivery ward or “Kreißsaal”
Making the Decision on Which Hospital to Choose
It is important to underscore that making the decision on which hospital to choose for giving birth involves much more than just proximity.
For starters, not all hospitals have the same capabilities for neonatal care. You may find that smaller hospitals and birthing centers are not as well equipped for a premature birth or for babies with potential complications. On the other hand, you may find that their facilities are more relaxed and comfortable. Your Frauenarzt or midwife “Hebamme” should consult you on which they think is best in your area given your individual needs.
In addition, not all hospitals are the same in regards to the involvement of chosen midwives. For example, in Frieburg’s University Hospital, the midwife and doctors who will assist you in giving birth are whoever happens to be on call and working that day.
Even if you have been working with a midwife during your prenatal care, they will not be allowed to accompany you into the delivery ward or “Kreißsaal”.
However, your personal midwife may be able to join you at smaller hospitals or birthing centers. It is important to ask beforehand and speak to your midwife about the facilities where they are allowed to work.
Considering these variables, it is also important to note that unlike the United States, insurance does not dictate which hospital you may visit when it comes to giving birth. Regardless of whether you are insured publicly or privately, you may choose whichever hospital you would like.
Furthermore, you also have complete control over how long you would like to stay in the hospital for recovery purposes. While it is recommended that you stay in the Kreißsaal for 2-3 days for a vaginal birth and 5-7 days following a cesarean birth, you can also request to go home within 12-24 hours of birth with follow up care provided by your midwife.
Selecting a hospital over a birthing center or home birth does not have to mean that you will receive a clinical experience. Once more, you are strongly encouraged to advocate for the birthing experience you desire, balanced with the care needs of you and your new addition.
Finding Your Child’s Pediatrician
One of the final steps in preparation for your new arrival is to find your child’s pediatrician (Kinderarzt). Just as with your own healthcare needs, you will want to find a doctor that suits your needs and approach to health and wellness, in addition to practical matters like proximity to your home or ability for online appointment booking. If you are feeling lost or need a recommendation, your Frauenarzt may be able to give advice on local practitioners who are well regarded.
One of the biggest considerations that we had as expats was making sure that there was a physician on staff that spoke English. While generally most doctors do speak English in Germany, it was nice having the peace of mind to know that we would not struggle to understand the important medical decisions we would be making on our child’s behalf.
In addition, we also wanted a pediatrician that was within walking distance of our home and who would be able to complete the U2 (U2-Untersuchung), or second check-up between 3-10 days old, at our home.
We recommend reaching out to a pediatrician’s office once you are in the final 4 weeks of your pregnancy. There is nothing formal you need to do, such as filling out paperwork, but you will want confirmation that they are taking on new patients.
Once you have given birth at the hospital or birthing center, you will relay their contact information to your care team. They will send over all necessary birth records and U1 (U1-Untersuchung) check-up information for your child.
Final Thoughts on Pregnancy in Germany
Overall, I had a very positive experience during my pregnancy in Germany. While I cannot necessarily draw personal comparisons to pregnancy and giving birth in the United States, I can speak to the level of care and follow up that the healthcare providers offer.
First, I cannot stress enough how supportive the work and healthcare system is towards pregnancy. Coming from a country where time off is NOT a given, to a “mandated” time off for at least 6 weeks prior and 8 weeks after giving birth was a godsend. I entered into labor feeling rested and relaxed and knew that I had at least 2 months off with my little one with pay was great.
Second, I appreciated the emphasis on individualized care. From selecting a midwife to a free choice of how and where I would like to give birth in Germany, I felt completely empowered to pursue the best birthing experience for myself and my son.
Finally, it is important to stress that giving birth and pregnancy in Germany does come with its fair share of hurdles. While many expats/immigrants may find it difficult to “speak up” in the face of language and cultural barriers, it is imperative that you find your voice and advocate for yourself and your baby.
I found that quite a good deal of medical advice was not freely offered, but only discussed when I initiated the conversation. With so many changes happening to your body, you should always feel secure and confident in your care.
Enjoy your pregnancy!
Next Steps
Congratulations on your newest addition!
Curious what you need to do after you have had your baby in Germany? Check out our post How to Register a Birth in Germany - Complete Guide. Here you can complete your registration and get their German birth certificate.