All you need to know about the process of giving birth in Germany, from finding a gynecologist to delivery costs, postnatal classes, German birth certificates and citizenship, maternity leave, health insurance for new mothers and child benefits and allowances.
If you’re having a baby in Germany you will find that the German healthcare system is highly developed and offers a great deal in terms of both clinical care and organization to ensure the best possible outcomes for parents and their newborn baby in Deutschland. Expatica explains what you need to know when giving birth in Germany and what services are provided by the public German healthcare system.
This guide explains each stage of childbirth in Germany:
- Pregnancy and childbirth in Germany: an overview
- Accessing maternity services
- Insurance for maternity services in Germany
- Pregnancy tests
- Abortions in Germany
- Prenatal care in Germany
- Aftercare in Germany
- Parental leave in Germany
- Birth registration
- German maternity and paternity leave
- Important German words for new mothers
- Useful links
Cigna Global provides comprehensive health insurance to over 86 million customers in over 200 countries. They have a wide access to trusted hospitals, clinics and doctors and provide expats with help on tailoring a plan to suit your individual healthcare needs.
Approximately 785,000 babies were born in Germany in 2017, with a total fertility rate of 1.57 children per woman. Data from the nation’s Federal Statistical Office shows that nearly every fourth child born in Germany the previous year had a foreign mother, while one in five German residents has foreign roots.
Giving birth in Germany combines the best of birth worlds. Expectant mothers are told about essential oils and feel-good home remedies, but also have access to the latest technology. While midwives (Hebammen) are your essential point of contact, expect to have a minimum of three and up to nine ultrasound tests over the course of your pregnancy. At all points, expect to receive a barrage of information about the process, what you’re going through, and more – German law requires medical professionals to advise patients of what they’re dealing it.
Women can choose to give birth in a hospital, birth house or at home, with all the options covered by health insurance. Private maternity options are also available for foreigners who want a risk-free delivery. Anyone living in Germany will need to be registered with a German health insurance scheme to have costs covered. If you’re also working in Germany and paying into the German social security scheme, you will be eligible to claim maternity leave or paternity leave in Germany. There are also other benefits available once you have a baby in Germany, such as child benefits and childcare allowances.
After giving birth in Germany, you will need to arrange your baby’s registration and apply for a German birth certificate. A child born on German soil or to German parents can claim German citizenship if they meet certain conditions.
In Germany, both state-funded and private health insurance schemes cover an annual visit to the gynecologist (Frauenarzt) for every woman over the age of 20. You can choose to either consult the same gynecologist you see every year or book an appointment with another, either through your GP or by ringing one close to you.
Once they’ve decided they want to have a baby, many German women also visit their gynecologist for advice on conception.
Keep in mind that gynecologists and obstetricians are different professionals in Germany. Pre-natal checkups are carried out by your gynecologist, but they will only attend a birth if they’re registered with your hospital of choice. An obstetrician will only attend the birth if there are complications.
Expatica’s guide on visiting a specialist in Germany covers how to go about the process.
Your state German health insurance will typically cover the basic costs of pregnancy and childbirth. You may, however, be charged additional costs for some of the paperwork involved in giving birth in Germany. If you choose to give birth in a private hospital, you should check what is covered by your private health insurance or what costs you will have to pay for the baby’s delivery and care.
Some of the largest health insurance companies in Germany, called Krankenkassen, include:
You can compare private health insurance providers in Germany and get free quotes on our special Expatica health insurance page.
Think you might be pregnant? In Germany, you need a Schwangerschaftstest! A standard urine test is available at a supermarket or pharmacy (Apotheke) – and in the major cities, at vending machines at train stations! Such tests have an accuracy rate of about 98% and are largely accurate from the first day your period is due. There are also tests you can use earlier – ask the pharmacist which works for you.
Berlin vending machine features Capri-Sun, condoms, pregnancy test kit and a sausage wrapped in bread. pic.twitter.com/2AiuiLmPUr
— Stephen Lowman (@StephenLowman) June 23, 2013
If your test’s positive, or if you don’t want to fiddle about your gynecologist will be able to carry out a more comprehensive blood test instead. Like urine tests, these look for the beta HCG hormone, which is produced by the placenta, but blood tests usually detect the hormone earlier. In most cases, your doctor will need to prescribe the lab work for insurance to cover it. Read Expatica’s guide to finding a doctor in Germany.
The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth provides several services to women who need support and advice regarding their pregnancy. A 24-hour, free hotline is available on 0800 40 40 020 in 18 languages, as well as online support.
Abortion (Abtreibung) is a controversial topic in Germany, but in middle European style, the two parties have reached a compromise. The German penal code – the Nazi-era provision is known as Paragraph 219a – now defines abortion under certain circumstances as “illegal, but without threat of punishment”. What this means is that a woman and her gynecologist may decide upon an abortion together in three cases. These are, on criminal grounds following sexual abuse (within 12 weeks), on medical grounds (within 22 weeks), and if the child is likely to be born with a physical or mental disability, in which case the doctor must give the pregnant woman detailed information on caring for children with disabilities before she opts for an abortion. These procedures are usually covered by insurance companies.
Women have the legal right to terminate their pregnancy or undergo an abortion in Germany but are expected to attend schwangerschaftskonfliktsberatung (pre-termination counseling). About 96% of abortions carried out in Germany are through this program. Women may have an abortion within 12 weeks after conception, provided they meet the following conditions:
- The mother must have written consent from a recognized center as proof that she has attended the necessary counseling sessions.
- There must be three days’ minimum between counseling and operation.
- The abortion must take place within 12 weeks of conception.
As of February 2019, it has become easier to find abortion clinics in Germany, following a revision to the country’s abortion law. Doctors and clinics can now say they offer abortions on their websites, but not what sort of procedures they use.
Women who elect to have an abortion must pay for the procedure themselves, but some low-income women may be eligible for state support.
The abortion pill is legal in Germany for the first 63 days of a pregnancy – but not all clinics offer it.
In all cases, women are entitled to ask as many questions as needed to understand the legal and medical situation as well as the procedure and possible complications.
Find more information on the family planning website (in German).
The main point of contact during your pregnancy in Germany is the community midwife, who coordinates arrangements on your behalf with a team of midwifes, GPs, obstetricians and other hospital staff. The midwife is the person who will arrange appointments and tests on your behalf.
Your community midwife will arrange an antenatal appointment for you to be seen by the hospital consultant. At this appointment you will be asked to complete the hospital registration process, which usually takes around 45 minutes. This is important as it will allow you to go straight to the maternity unit when the time comes for giving birth in Germany.
Parents-to-be can visit the hospital as part of a scheduled tour of the maternity unit (Info-Abend). During this you will have the opportunity to visit the delivery suite and also meet with the hospital midwives and medical staff, giving you a chance to discuss any aspect of your care during the childbirth in Germany.
Health professionals who are providing care for you will record your and your baby’s progress on a maternity record (Mutterpass). This will have details of each medical appointment.
This is an important document and you must bring it with you to each appointment and to the delivery suite when you are having a baby in Germany. After the baby is born the midwife will store it for safekeeping.
Hospitals, birth houses, or home births?
Women having a baby in Germany can choose to give birth in a hospital, birth house or at home. All the options are covered by health insurance. Depending on where you live, you may have varying degrees of options available.
Hospitals and clinics are for those women who like the comfort of knowing everything is on the spot, to offer epidurals and deal with emergency services. From birthing balls and water births to more traditional ways of delivery, all options are available. The birth itself is handled by your midwife – check that she works with the hospital you want to give birth in – and doctors will step in should there be an emergency. Typical hospital stays last three nights, or five nights for C-sections. Maternity wards have two to four beds, with bathroom facilities on the same floor. Many hospitals offer family rooms at an extra charge, where your partner or a companion can stay overnight.
Alternatively, you can seek out a specialized midwife to deliver your baby at home, in what is called a Hausgeburt. Many women prefer this option, which is best suited to pregnancies with few complications. In case of an emergency, you’ll immediately be transferred to a hospital.
A birth house or a Geburtshaus is somewhere between the two options, providing a fuzzy, homely atmosphere managed by midwives. There are no emergency services on site, so in case of complications they’ll call an ambulance, but many also offer outpatient treatments so you can leave within a few hours of giving birth.
Scans, tests and checks
Typically, pregnant women will see their gynecologists every four weeks or so until the end of the second trimester (i.e. the seventh month). On these visits, weight and blood pressure are measured and urine and blood tests are taken. These tests will include, among other things, checking blood groups and Rh factors (for both mother and baby), immunity against rubella, toxoplasmosis and the presence of the cytomegalovirus, gestational diabetes, as well as a standard strep test. However, not all tests are covered by every type of insurance policy, so it’s worth checking both with the doctor and the insurer.
Women with standard health insurance in Germany will be offered three ultrasound scans. Doctors are required to discuss the advantages and disadvantages of ultrasounds before carrying them out, and women have the right not to have the scans without giving a reason, to refuse to see imagery from such procedures, and to stay uniformed about the gender of the foetus. The first scan, carried out between the 9th and 12th week, confirms that you are indeed pregnant, checks for the baby’s heartbeat and provides a delivery date. The second, between weeks 19 and 22, and the third, between weeks 29 and 32, also measure the fetus’ head, belly and thigh while determining the position of the placenta, among other checks. Women may also be offered extensive ultrasound procedures, which are usually not covered by insurers unless there is a specific medical reason for these.
Vaccinations during pregnancy
Vaccines are not mandatory in Germany, however pregnant women will be offered the injectable influenza vaccine. Other vaccines are offered after birth, including tetanus, diphteria, whooping cough or pertussis (combined as DTP), Haemophilus influenzae b (Hib), polio (poliomyelitis), Hepatitis B, pneumococcus (Streptococcus pneumoniae), rotavirus, meningococcus C (Neisseria meningitidis), measles, mumps, rubella and chickenpox (varicella). More about vaccinations in Germany is available at the Robert Koch Institut, whose STIKO committee sets the national recommendations each year.
Doulas as birth companions and post-birth supporters give help, advice and other support during pregnancy, during birth and after the birth. While they have received general nurse training, their role lies more within the practitioner and emotional aspects of pregnancy. The GfG-Doula (Gesellschaft für Geburtsvorbereitung – Familienbildung und Fraugesundheit) has been offering doula support since 2005.
You’ll want to start taking birth preparation classes by the 25th week or so. In Germany, the Read Method is popular, which prioritises relaxation over breathing techniques, but Lamaze, Yogic breathing and more are available through the hospital or the Red Cross. Your midwife is a good point of contact for specific classes in the nearby area. Berlin has a range of birth preparation classes, compiled by Berlinforallthefamily.com, and BabyinFrankfurt.com has a similar list for the financial capital.
If you have the time it can help to phone ahead to the delivery suite (Kriessal). Although this is not required, it lets them know you are on your way. When you arrive you will be asked to give your maternity record to the hospital midwife, who will confirm your hospital registration. You will also have an opportunity to advise the medical staff of your birthing preferences if these are not included in your maternity record, and these will be accommodated as much as possible while giving birth in Germany.
Remember to bring the following with you to the hospital:
- Maternity record
- Child Health Record to record the baby’s measurements, examinations and test results
- Your birth certificate (advisable)
- Marriage certificate (advisable, if applicable).
National policy in German hospitals prohibits the use of gas or air for pain relief but a range of alternatives are used instead, including epidurals, heat treatments, massage, acupuncture, as well as birthing pools and also TENs (transcutaneous electrical stimulation) in some hospitals.
Bringing a few personal items will make your stay more pleasant and comfortable. You will need to bring your own nightclothes, dressing gown, slippers and personal toiletries including towels. However, the hospital will provide clothes for the baby. You may also wish to bring portable electronic devices, books or magazines to help you relax during your hospital stay.
Hospital staff in Germany are not allowed to give out details about your labour or the baby’s condition to any callers. Therefore your birth partner will need to inform people about your progress.
You should be aware that in Germany, hospitals will ask for the name of the newborn baby soon after the birth. This differs from some other countries where parents have time after the baby is born to think of a name.
German maternity wards generally have two to four beds and are equipped with washing facilities, a telephone and a television. Showers and bathrooms are located on the main ward.
You may find that nurses appear not to be checking on you regularly. However, this is because rest is valued in German hospitals and nurses expect to be called by patients if help is required. Therefore feel free to use the bedside call system.
Once the baby is born nurses support mothers with their newborn babies, including help with feeding and general care.
After giving birth in Germany, hospitals run a number of tests on newborns via the heel prick test to detect any deficiencies or abnormalities. In addition, they will be given vitamin K to prevent a bleeding condition and possibly also vaccinations to protect against Hepatitis or TB.
Generally, after having a baby in Germany, mothers stay in hospitals for up to five days after the birth. Before going home you must collect a notification of birth (Geburtsmeldung) so that you can register your baby in Germany, which is a legal requirement. You can collect this from the German Administration Office in the hospital.
Also, make sure that the car you are leaving it has a suitable child seat. Similar to the UK, it is a legal requirement in Germany for cars carrying children to have one.
Your community midwife will generally visit you at home the day after you have been discharged from hospital. This is in order to assess and provide care for both you and your baby at home. The midwife will also check the hospital tests and help you with the general care of your baby. Thereafter you will be supported by a Health Visitor who can assist you with health and immunization advice along with providing information on baby groups in your area.
Most children will have nine check-ups (Vorsorgeuntersuchungen) with a doctor, up until the age of five. After this there is another check-up when they are 12 or 13 years old. The appointments are usually referred to as U1, U2, U3 etc. and are recorded in a yellow booklet, similar to the Mutterpass.
Breastfeeding in Germany
In general, Germans have few issues around nudity, and public breastfeeding is widely accepted. You might often be approached by older ladies with unsolicited advice about whether or not the baby is warmly dressed and what to do about it.
You must register your baby’s birth within one week of birth. This must be done at the Standesamt (registry office) in the town where you delivered your baby. You can do this yourself, otherwise it can also be done by your midwife, the baby’s father, your doctor, a relative or friend. If deemed necessary, an official from the registry office may attend the maternity ward to register your child while still at the hospital.
The registration office will require confirmation of the birth (provided by the doctor or midwife). This is called a Geburtsbescheinigung in German. They will also ask for a copy of the parents’ birth and marriage certificates (some may ask for a translated version).
Multiple copies of the Geburtsurkunde (birth certificate) will be made available to you so you can arrange child benefit and health insurance for your child. Your child’s birth certificate will also be used for arranging identity cards, a passport and registration at nurseries and schools.
Should you wish for your child to have an international birth certificate, this can be requested at the Standesamt for the same fee and is often produced in French, German and English.
Non-residents and tourists giving birth in Germany – and citizenship
Tourists in the Germany must have health insurance or pay for health expenses themselves. EU citizens are covered by the European Health Insurance Card. Non-residents and tourists applying for a Schengen visa will be asked to take out a travel insurance policy with a coverage value of up to €30,000. Anyone who doesn’t need to apply for a visa in advance is advised to take out a travel insurance policy – particularly if they’re planning to stay for a few months.
Some travel insurance policies cover pregnant women in the first trimester, but coverage rarely extends beyond that period unless you add on an extra component. Miscarriages are often not covered either, so it’s worth checking with your insurer when planning your trip. The average uninsured birth costs upwards of an estimated €1,500 depending on the facilities, and between €2,500 to €5,400 for a C-section.
In emergencies or life-threatening situations, you can call the free emergency number 112. The call center will send the help you need: ambulance, police or the fire service.
A baby is registered German by birth if they were born to at least one Germany parent, irrespective of whether the child was born in Germany or abroad. If neither parent is German, a child born on German soil automatically takes German nationality provided that at least one parent has been living in Germany for eight years, is Swiss, or has a permanent right of residence in Germany. For more information read our guide to German citizenship and permanent residence.
Germany is keen to encourage parents to have children as a way of addressing under-population issues – women have 1.6 children on average.
A parent who interrupts his or her career to raise a child receives 67% of their last net income (up to €1,800 per month). The Elterngeld (parental allowance) payment ranges from a minimum of €300 to a maximum of €1,800 per month. This benefit lasts for one year, which can be extended to 14 months if the second parent likewise stays at home for at least two months. The aim is to allow both parents to take time off.
Parents also have the legal right to take up to three years leave from work. During this time a parent can receive a reduced monthly allowance from the government. Furthermore, as long as there are no valid company reasons against it, parents can choose to work part-time. Other benefits are offered to mothers, such as nursing breaks and restrictions on overtime or evening hours.
The government has also introduced the ElterngeldPlus package with the aim to help parents who work part-time following the birth of their baby in Germany. This offers additional financial support options. Read more family policies on the government website.
German maternity leave
Following the standard five days stay in hospital, women who give birth in Germany receive 14 weeks of paid maternity leave. This is broken into six weeks before the expected birth date and eight weeks after. The initial six weeks of maternity leave in Germany provides the mother with time to mentally and physically prepare for giving birth. The final eight weeks allows her to recover, get settled at home with her new child, and allow for the midwife to visit.
Paternity leave in Germany
The law enables both parents to take time off should they wish to, enabling fathers to also pause their careers to raise a child and claim a reduced income. If a father’s employer agrees, he may also choose to work part-time for a certain period if desired, while taking parental leave in Germany.
Childcare and benefits in Germany
The monthly child benefit in Germany is €190 for the first and second child, €196 for the third, and €221 for every other child under the age of 18. For more information regarding child benefit in Germany, including the application form, visit the Bundesagentur Fur Arbeit (Federal Agency for Work) website.
There are a wide range of childcare options in Germany but costs and availability vary. Typically, care for ages up to three years old will be with child minders, a nanny or other in-home care, or in a private nursery. Since legalisation in 2013, children aged from 12 months have a legal right to a childcare place, which will be partly subsidised by the state. Children age three to six are also entitled a place in preschool, known as kindergarten, and some after-school clubs. School-aged children (6+) have the additional option of wrap-around care at school, although not all schools provide this. Read Expatica’s detailed guide to childcare in Germany.
- Pregnancy test: Schwangerschaftstest
- Abortion: Abtreibung/Schwangerschaftsabbruch
- Health insurance: Krankenkasse
- Ultrasounds/Sonograms: Ultraschall/Ultraschallaufnahmen
- Birth preparation classes: Schwangerschaftsvorbereitung
- Baby due date: Termin Datum
- Mother’s pass/pregnancy book: Mutterpass
- Hospital: Krankenhaus
- Midwife: Hebamme
- Nurse: Krankenschwester
- OB/GYN: Frauenartz
- Head doctor: Chefarzt
- Delivery room: Kreissaal
- Cesarean section: Kaiserschnitt
- Forceps: Forzeps/Zange
- Push: Pressen
- During labour: Geburtsverlauf
- The birth: Geburt
- I want an epidural-anaesthesia: Ich möchte die Epidural-Anaesthsie
- I do not want strong medicine: Ich möchte kein starkes Mittel