Your orientationBirth in Germany,in English
12 min read · Last updated September 2026 · Written and reviewed by Emma, Birth & Mother
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Welcome
This guide is your orientation
If you are having a baby in Germany, this guide is for you.
I came to this system as an international mum myself, and I work in it now as a doula, in English and German. Most of what you are given is in German, and a lot of it assumes you already know how things work here. The first appointments can feel like walking into a room where the conversation started without you.
So this is the orientation I wish someone had handed me. It does not cover every detail. It tells you who is in your care team, what you get to choose, what happens through pregnancy, birth and the weeks after, the German words you will hear, and the things that catch international families out.
If you want more depth on any one part of it, the Guides go further.
01
Finding your way through maternity care in Germany
Here is the shape of it in order, from a positive test through to the weeks after the birth. If you do one thing before you read the rest of this page, start looking for a midwife.
Early pregnancy (weeks 5 to 13)
Your pregnancy is confirmed by your gynaecologist, usually by an internal scan before six weeks. If you already have a midwife, they can also confirm your pregnancy and issue your Mutterpass. Begin the search for a midwife straight away, because midwives here book up months ahead. If this pregnancy was not planned, there are services in Germany you can turn to.
Alongside your midwife, your gynaecologist performs the routine ultrasound scans and any fine diagnostic tests, which a midwife cannot do. Beyond the scans, how much of your prenatal care they provide is your choice.
Your pregnancy record: the Mutterpass
Early in pregnancy, you will receive a Mutterpass, a small maternity record booklet that you carry to every appointment. It contains important information about:
Your pregnancy history
Test results and scans
Your baby's growth and development
Information your healthcare team may need during pregnancy and birth
I have made three pocket-sized booklets that fold into it, one for pregnancy, one for the birth, and one for the weeks after, so the questions you want to ask are in your hand when you need them. They are yours to print.
Mid pregnancy (weeks 14 to 27)
The middle months are usually where the practical planning starts, because most of what you need to arrange has a waiting list attached to it.
You decide when to tell your employer about your pregnancy. There is no fixed deadline to announce it, but once your employer knows, the protections of Mutterschutz (maternity protection) apply. These protections are designed to keep you and your baby safe at work and include rules around workplace safety, working hours, and protection from dismissal.
This is when to settle where you want to give birth: a hospital (Krankenhaus or Klinik), a birth house (Geburtshaus), or a planned home birth (Hausgeburt). Most places run information evenings and tours, and going to two or three tells you more than any website will.
If you have not found a midwife (Hebamme) yet, this is late rather than early. They care for you through pregnancy, at the birth, and at home in the weeks after, and in most areas they are booked months ahead.
Book a birth preparation course (Geburtsvorbereitungskurs) around now too. They cover labour, birth, newborn care and feeding, your insurance pays for yours, and many take partners as well.
Late pregnancy (weeks 28 to 40+)
Appointments come closer together from here, every two weeks from week 32.
If you are booking a hospital birth, the registration appointment (Geburtsanmeldung or Anmeldegespräch) happens between weeks 30 and 34. You do the paperwork, hand over your medical history, and get to ask how they do things.
You may finish your Geburtsvorbereitungskurs (birth preparation course), reflect on your preferences for birth, and write down any wishes or questions you would like to discuss with your care team as your birth preferences (Geburtsplan).
From week 36, pack your bag, put your documents together, and sort out who is doing what in the first days at home.
If you want a doula, this is about the last point it is worth starting to look. We take only a few births a month, because being on call around a due date is what the work asks for.
If you are taking Elternzeit (parental leave), you usually need to inform your employer at least seven weeks before it begins.
Birth and the first days
Labour and birth. Hospital stays are typically one to three days; after a birth house or home birth you are usually at home within a few hours.
The first weeks with baby
The German postpartum tradition is six to eight weeks of protected rest. Your midwife visits you daily for the first ten days, then less often through the first eight weeks. Around week six your gynaecologist sees you for the postnatal check-up, and the postnatal recovery course (Rückbildungskurs) begins from then.
Whether you give birth in hospital, a birth house, or at home, you will receive postpartum midwifery care (Hebammenhilfe). Your midwife supports your physical recovery, breastfeeding or feeding choices, your baby's development, and your transition into parenthood.
Your baby's birth is registered at the local registry office (Standesamt). The hospital or birth house sends notice within a week; after a home birth, the notice comes from you. You will also begin organising important paperwork, including the application for parental allowance (Elterngeld), child benefit (Kindergeld), and health insurance registration for your baby.
Almost none of this is explained to you in advance, and most of it arrives in German in the week you are least able to read it. That is why it is set out here, while you still have time to read it.
For the pregnancy and birth journey step by step, from your first weeks to the Wochenbett, see Step by Step.
02
Where to Give Birth
You have three settings to choose between, and statutory health insurance covers all of them: a hospital (Krankenhaus), a midwife-led birth house (Geburtshaus), or your own home (Hausgeburt). The best one is whichever fits you, your family, and your wishes for this birth. For a birth house or home birth there is usually one extra cost, the midwife's on-call fee (Rufbereitschaftspauschale), which many insurers reimburse in part; your Krankenkasse can tell you what they cover.
Most births here happen in hospital, partly because the other two take early planning to arrange. Whichever one you want, start early: birth-house places and home-birth midwives fill up quickly.
A midwife attends the birth in all three settings. What changes between them is who else is in the building.
| Hospital birth | Birth house | Home birth | |
|---|---|---|---|
| When labour starts | Contact the Kreißsaal. The midwife will advise when to come in. | Contact your birth house midwife, who will guide you on when to arrive. | Contact your midwife, who comes to your home when labour is established. |
| During labour | You are cared for by the hospital midwife team, with medical support available if needed. | A calm, home-like environment with continuous midwifery care. | You labour and give birth in your own familiar surroundings with your midwife supporting you. |
| Monitoring & support | Your baby's heartbeat, your wellbeing, pain relief options, and medical care are available. | Your midwife monitors you and your baby throughout labour. Transfer to hospital happens if needed. | Your midwife brings equipment, monitors you and your baby, and supports the birth. |
| After birth | Usually a 1 to 3 day stay in the maternity ward (Wochenbettstation). | Usually home within a few hours after an uncomplicated birth. | You remain at home after the birth. |
| Postpartum care | Midwife support continues after discharge. | Your midwife visits you at home during the Wochenbett. | Your midwife provides ongoing home visits. |
Hospital birth
- When labour starts
- Contact the Kreißsaal. The midwife will advise when to come in.
- During labour
- You are cared for by the hospital midwife team, with medical support available if needed.
- Monitoring & support
- Your baby's heartbeat, your wellbeing, pain relief options, and medical care are available.
- After birth
- Usually a 1 to 3 day stay in the maternity ward (Wochenbettstation).
- Postpartum care
- Midwife support continues after discharge.
Birth house
- When labour starts
- Contact your birth house midwife, who will guide you on when to arrive.
- During labour
- A calm, home-like environment with continuous midwifery care.
- Monitoring & support
- Your midwife monitors you and your baby throughout labour. Transfer to hospital happens if needed.
- After birth
- Usually home within a few hours after an uncomplicated birth.
- Postpartum care
- Your midwife visits you at home during the Wochenbett.
Home birth
- When labour starts
- Contact your midwife, who comes to your home when labour is established.
- During labour
- You labour and give birth in your own familiar surroundings with your midwife supporting you.
- Monitoring & support
- Your midwife brings equipment, monitors you and your baby, and supports the birth.
- After birth
- You remain at home after the birth.
- Postpartum care
- Your midwife provides ongoing home visits.
The team you will meet
If you give birth in a hospital or birth house, you will also meet the team there: the midwife on shift, and in hospital the obstetrician on call. Most families do not meet their birth midwife in advance unless they have arranged continuity care.
For how each setting works, what they tend to feel like, and how to choose between them, see Where to Give Birth.
03
Your Rights in the Birth Space
You have the right to informed consent (informierte Einwilligung) for every medical intervention during birth: an explanation of what is being proposed, why, what else you could do, and what happens if you accept or decline. That is a duty on the people caring for you. It is worth knowing it in advance all the same, because labour is not the easiest moment to work out what you are being asked.
A simple tool for any decision in the moment is BRAIN. It gives you time to think and a structure for the conversation:
Benefits
What are the benefits?
Risks
What are the risks?
Alternatives
What are the alternatives?
Intuition
What does your intuition say?
Nothing
What if we wait, or do nothing for now?
Writing down your birth preferences is worth doing too. Nobody can plan how a birth will go, but writing them down opens the conversation with your care team while there is still time to have it.
For the full rights framework across every birth setting, see Your rights in every setting. There is also a printable booklet that fits in your Mutterpass: The Birth (booklet).
04
The Wochenbett
The Wochenbett, literally “childbed” or “bed of weeks”, is the German name for the weeks after birth, and here they are treated as a phase of their own. The principle is rest: the first weeks are for healing, feeding and being with your baby, with visitors and housework kept low. You are looked after as well as the baby, and a midwife comes to your home as standard care, not as something you have to ask for.
If your parents and closest friends are in another country, the part the system does not cover is the rest of it: the meals, the laundry, the person who sits with you while you feed. That has to be arranged rather than assumed, and the time to do it is the weeks before the birth.
Your midwife (Hebamme)
Your midwife is the constant thread through all of this. They can carry out all of your routine prenatal check-ups, except the ultrasound scans and certain fine diagnostic tests. German law also puts midwives at the centre of birth: a doctor may not conduct a birth without calling a midwife in, which is a duty on the doctor rather than a rule about you, so wherever you give birth with professional care there is a midwife there, whether you have met them before or not. After the birth, a midwife comes to your home, daily for the first ten days and then across the first twelve weeks, to support your recovery and feeding. Midwife care is fully covered by statutory health insurance.
Midwives across Germany are in high demand, and many are fully booked by the second trimester. Start looking by 12 weeks if you can, even if you are not yet sure you will be here for the birth.
Your partner
Your partner is the familiar face in an unfamiliar room: the one who stays with you through it and remembers the day with you afterwards. If neither of you speaks German easily, that is where a bilingual doula or an interpreter takes the weight off them. The parental-allowance system adds two bonus months when both parents take leave, which is worth knowing when you plan who is at home in the weeks after birth.
For full preparation guidance, including the 40-day principle, what to set up before birth, and how to build support when family is far, see The Wochenbett.
05
The system that holds it all
Underneath the people and the choices is a structure that mostly stays in the background: your health insurance (statutory GKV or private PKV), which covers routine maternity care, all three birth settings, and midwife care; the legal protections and payments around leave (Mutterschutz, Elternzeit, Elterngeld, and Kindergeld); and the schedule of baby check-ups (U-Untersuchungen) that begins the moment your baby is born.
You do not need to hold all of this in your head now. Knowing the shape of it is enough, and the detail is there when you need it.
For the full system reference, including detailed insurance comparisons, the prenatal appointment schedule, the legal entitlement framework, and the complete U-check schedule, see The German Maternity System.
06
Key German Vocabulary
A short reference for the terms you will encounter most often.
07
What I see catch international families off guard
Language fatigue at appointments
Clinical German is hard even for fluent speakers: unfamiliar vocabulary, spoken fast, with decisions attached. Bring your partner, a German-speaking friend, or a doula, and you have someone whose only job in the room is to follow what is being said.
The Wochenbett expectation
Six to eight indoor weeks is a lot slower than the postpartum many families are used to. Some find it a relief to be told to rest. Others find the quiet lonely, particularly without family nearby. Both happen, and neither means you are doing it wrong.
Paperwork density
Three offices handle the paperwork after a birth: the Standesamt (registry), the Elterngeldstelle (parental allowance), and the Familienkasse (child benefit). Each has its own forms, its own deadlines, and writes to you in German. Give it more time than the forms suggest.
The absence of casual mum-friends
The friends you would ring at short notice took years to collect, and here they have to be found again from a standing start. It rarely happens on its own. Baby groups (Krabbelgruppen), antenatal classes and English-speaking parent groups are where most people I work with find theirs.
The gap between “covered” and “easy to access”
Statutory health insurance covers midwife care, birth in any of the three settings, the postnatal recovery course, and most of the rest. What it does not do is find you a midwife with space. Something being paid for and something being available are two different questions here, so start early and keep asking.
The feeling that everyone else knows the rules
Most people do not. German friends get caught out by the paperwork too, midwives explain things differently to different families, and some rules genuinely change from one Bundesland to the next. If something is not making sense, that is usually the reason, not a step you have missed. Ask again, and write down what you are told.
08
How a Doula Fits In
A doula gives no clinical care and replaces nobody on your medical team. What I do is the other part: staying with you, knowing what you wanted, and being the one person in the room who is there for you rather than for the birth.
Working in English and German adds a second part to that. I can follow what is being said in an appointment and tell you afterwards what it meant, and I am still there when the medical team has handed you over and gone home.
What I see is that it changes how a birth is remembered, whichever way the birth itself goes.
Go further
The guides that take it further
- By topicThe German Maternity SystemThe whole system mapped, subject by subject.
- By trimesterStep by StepThe journey in order, appointment by appointment.
Welcome to Birth & Mother. I am glad you are here.
You can’t know exactly how your birth will unfold.But you can prepare for how you want to meet it.
Birth & Mother, there with you through the life-changing moment of birth, and on into motherhood