Birth in Germany, step by stepStep by step,from first test to birth
26 min read · Last updated September 2026 · Written and reviewed by Emma, Birth & Mother
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Start here
The order, and what unlocks what
Most of this paperwork needs the step before it. So here it is in order, from telling your employer you are pregnant to the last form after the birth.
Before the birth · what triggers what
After the birth · one document, in order
Register the birth at the registry office (Standesamt). The hospital or birth house sends notice of the birth within a week; after a home birth, the notice comes from you. Ask for several certified copies of the birth certificate (Geburtsurkunde) at once, including the purpose-labelled ones (für Elterngeld, für Kindergeld, für die Krankenkasse) where they are offered.
You need that certificate for the next three. Parental allowance (Elterngeld) at the Elterngeldstelle; child benefit (Kindergeld) at the Familienkasse, not the tax office; and registering your baby with your health insurer (Krankenkasse).
Your baby's tax number (Steuer-ID) arrives by post a few weeks later, on its own. Kindergeld needs it, so that piece often follows once it lands.
The offices you will deal with
New to Germany and not sure where yours are? familienportal.de lists your local offices and has an English section. Your registration office (Bürgeramt) sets your Finanzamt when you register your address, and your Krankenkasse is the insurer you are already with. When you call or write, you can ask for English.
Your care, at a glance
How often will I be seen?
A check-up every four weeks until week 32, then every two weeks until the birth, and each one goes in your Mutterpass. The appointments are shared between your gynaecologist and your midwife, and how you divide them is your choice. Three ultrasounds sit inside the covered schedule. Anything offered beyond them is usually an individual health service (IGeL), paid privately, and it is always fair to ask the price and what it is for before you agree.
| Weeks | What happens |
|---|---|
| 5 to 8 | Confirm the pregnancy, receive your Mutterpass, and start looking for a midwife |
| 9 to 12 | First ultrasound, blood work, infection screening |
| 12 to 14 | Nuchal translucency screening, and NIPT, if you choose them (often paid privately) |
| 16 to 20 | Regular check-ups begin: fundal height and heart tones |
| 19 to 22 | Second ultrasound, the basic or the extended scan |
| 24 to 28 | Gestational diabetes screening (oGTT) |
| 29 to 32 | Third ultrasound |
| 30 to 34 | Hospital registration appointment (Anmeldegespräch) |
| 32 onwards | Appointments every two weeks; monitoring (CTG) may begin |
| 40+ | Post-term monitoring, if your pregnancy continues past your due date |
Each phase below takes these appointments one at a time, alongside what your body is doing.
Jump to your step
Wherever you are, start there
Each phase covers what your body is doing, how your care works, and what you need to sort out. The jobs are tick boxes, and they save in your browser, so you can come back to where you left off.
You don't have to do it all at once. Your midwife (Hebamme) and gynaecologist will walk you through much of it in their own time. If you are at the very start, read it through once. If you are already somewhere in the middle, go straight there.
First Trimester · Weeks 5 to 13The firsttrimester
You know. Almost nobody else does yet.
The first trimester, week by week
- 5–8Confirm the pregnancy and receive your Mutterpass · start the midwife (Hebamme) search · on private insurance, call to check your cover
- 9–12First screening scan · blood tests · infection screening
- 12–13First-trimester screening window (nuchal scan, NIPT), if you choose it
What is happening
A positive test, and then a lot at once. Nothing shows yet, but your body is already working hard. What women notice in these weeks varies enormously:
Tiredness, the kind that arrives like a wall in the afternoon.
Nausea, and sometimes vomiting, at any time of day. Or none at all.
Sore, full, heavy breasts.
A sharper sense of smell, and food you suddenly cannot face.
Needing the loo more often, mild cramping, light spotting, headaches, dizziness.
Joy, excitement, fear, ambivalence, low mood, often several in one day.
Some women have most of these. Some have almost none, which is also normal and not a sign that anything is wrong. If something worries you, or you have bleeding, severe pain, or a temperature, call your midwife (Hebamme) or gynaecologist.
The first trimester is mostly invisible and mostly internal. That is part of why it can feel lonely, especially far from family and in a country where you are still learning the language.
Your journey through this trimester
It starts with one appointment, and there is no rush to it. A positive home test is enough. Confirmation usually comes a little later, so you needn't be seen the same week you find out.
A midwife (Hebamme) can confirm the pregnancy, though few women have one this early. Most start with a gynaecologist, usually between weeks 5 and 8. Either way you come away with your Mutterpass.
That is a small booklet, your “mother's passport”. Every check-up and every scan goes in it, and you will be asked for it at each appointment for the whole pregnancy. Keep it in your bag. You never have to show it to an employer or a landlord.
How you split the rest of your care is your choice. A midwife can do almost all your check-ups. Only the scans and fine diagnostics stay with the gynaecologist. A midwife attends the birth, because a doctor may not conduct one without calling a midwife in. And all of it is covered, so there is no bill at the end.
The first routine ultrasound falls between weeks 9 and 12. You may also be offered extra first-trimester screening, the nuchal scan or NIPT. Whether you have it is up to you.
What to decide and sort out
There is very little paperwork this early. Two things matter now. The rest can wait.
Yours to decide
To sort out
What I would hold in mind
The families I work with who feel steadiest later are almost always the ones who started looking for a midwife early and let everything else wait. So if you do one thing this fortnight, make it that one. Otherwise these are quiet weeks. Not much is asked of you until the first scan, and all the new German words can wait. One more thing I have seen again and again, sitting with international families through these first weeks: you don't have to feel ready, or even happy, to be doing this well.
Read more from Birth & Mother
Emma's guidance and printables for this stage
From the Journal· 6 min readWhat your Hebamme doesMidwifery care is one of the best things about giving birth in Germany.Help beyond Birth & Mother
Trusted, independent resources across Germany:
Second Trimester · Weeks 14 to 27The secondtrimester
You settle in. This is where the decisions start.
The second trimester, week by week
- 14–19
- Check-ups every four weeks
- First movements
- Tell your employer in writing (any time across weeks 12–20)
- 19–22The second ultrasound
- 20–24
- Decide where to give birth
- Register with a hospital or birth house (Geburtshaus), or contract a home-birth midwife
- Tour, or attend an information evening (Infoabend)
- 24–27
- Glucose screening (oGTT, weeks 24–28)
- Book your birth-prep class (Geburtsvorbereitungskurs)
What is happening
For many women this is the easiest stretch. Energy comes back, nausea often eases, and the early worry settles, though if it doesn't, that is normal too. You start to show. Somewhere in here you feel the first movements, fluttery and strange at first, then unmistakable.
You tell people, and it stops being a secret you carry on your own. There can be grief mixed in with the excitement: for the life that is changing, for family far away who cannot put a hand on your bump. Both can be true at once. They usually are.
Your journey through this trimester
Your care settles into a routine now. Check-ups (Vorsorge) come every four weeks, shared between your gynaecologist and your midwife however you have arranged it. Blood pressure, urine, your baby's heartbeat, and a measure of your bump, all written into your Mutterpass.
The second ultrasound falls between weeks 19 and 22. You choose the basic scan or the extended scan, which looks at your baby's organs more closely. A more detailed organ scan (Feindiagnostik) is covered when there is a medical reason, and your gynaecologist refers you. Between weeks 24 and 28 you are offered the gestational diabetes screening (oGTT).
This is also when birth preparation starts. An antenatal class (Geburtsvorbereitungskurs) covers what labour involves, your options for pain relief, and the early days with a newborn. Your place is covered by insurance. A partner's place is usually not, and you pay for it yourself. Classes fill up, so book once you know roughly where you will give birth.
Where to give birth is the decision this trimester asks for. Germany has three settings, all legal, all midwife-attended, all covered for a healthy pregnancy: a hospital (Krankenhaus) with full medical backup, a midwife-led birth house (Geburtshaus), or a home birth (Hausgeburt).
Which hospital matters as much as which setting, because they differ in how quickly they turn to intervention. Visiting them, and asking real questions while you are there, tells you more than any brochure will.
What to decide and sort out
This is where the arranging starts, though none of it is urgent all at once. The order below is a workable one.
Yours to decide
To sort out
What I would hold in mind
This is the phase where you have to choose, and the pressure to choose “right” can be heavy. The thing I find myself saying most often in this work is that none of it is fixed. You can change your birth setting. You can change your plan. What helps is knowing what is actually on offer where you live, rather than committing to the first option you read about. And when you visit a hospital or birth house, it is worth asking directly whether they have English-speaking midwives on the team, then listening to how they answer.
Read more from Birth & Mother
Emma's guidance and printables for this stage
From the Journal· 7 min readChoosing where to give birthHospital, birth centre, or home birth? Explore the options available to you in Germany and discover how to choose the setting that feels right for your birth story..PrintableOpen & printBefore the Birth (antenatal)One sheet, folded twice: how your care works, the words you will hear, and how to choose where to give birth.
Help beyond Birth & Mother
Trusted, independent resources across Germany:
Third Trimester · Weeks 28 to 40+The thirdtrimester
Your body is working hard now. This is also the busiest stretch for arrangements.
The third trimester, week by week
- 28–32Third scan (weeks 29–32) · check-ups now every two weeks · monitoring (CTG) may begin
- 30–34Hospital registration appointment (Anmeldegespräch) · register parental leave (Elternzeit) with your employer, at least seven weeks before it starts
- 34–36Maternity protection (Mutterschutz) begins six weeks before your due date · reconnect with your Wochenbett midwife and confirm arrangements · line up a paediatrician (Kinderarzt) · pack your hospital bag · finalise your birth preferences
- 37–40+Full term · if you pass your due date, extra monitoring is usual, and whether to wait, be induced, or ask for an induction is your decision with your care team
What is happening
Your body is hard to ignore now. Sleep gets lighter, the baby is busy at all hours, and heartburn, aches and a sudden urge to sort out the house all turn up. Everything starts to revolve around the due date.
Strangers will comment, and people will ask whether you are “ready”. Underneath the arrangements there is often impatience, nerves and awe, all at the same time. That is a reasonable amount to feel about what is coming.
Your journey through this trimester
Your check-ups get more frequent around now. The third ultrasound falls between weeks 29 and 32, and from week 32 you are seen every two weeks. Heart-rate monitoring (CTG) may start. Between weeks 30 and 34 you go to the registration appointment (Anmeldegespräch) at your chosen hospital, where your details and your preferences go on file.
If you go past your due date, there is no single path. Some women go into labour on their own in the days after. Some are offered an induction (Einleitung). Some ask for one, for their own reasons, physical or emotional. What the monitoring involves, and what the conversation about induction covers, are in Past your due date. Your care team will usually offer extra monitoring so you can both see how you and the baby are doing, and what happens next is decided by you together.
Alongside all that is the quieter preparation: finishing your classes, writing down what you want, confirming who is looking after you afterwards. Writing down your birth preferences (Geburtsplan) starts the conversation with the people who will be in the room.
What to decide and sort out
This is the busiest stretch for paperwork, and the point where families most often feel behind. Here is what needs doing, and roughly when.
Yours to decide
To sort out
Understanding Mutterschutz
Maternity protection (Mutterschutz) is a legal protection for employed women. The protected leave runs from six weeks before your due date to eight weeks after the birth, or twelve weeks after twins, a premature birth, or if your baby is born with a disability. You do not work during it and you are still paid, through maternity pay (Mutterschaftsgeld from your insurer, topped up by your employer). In the six weeks before the birth you can keep working if you want to, and you can change your mind at any point.
Protection from dismissal is a separate thing, and it is broader. It runs from the start of your pregnancy until four months after the birth, and it applies once your employer knows you are pregnant. That is why the written notification in the second trimester matters. The current rules and figures are at familienportal.de, and your employer's HR or works council can tell you how it applies to you.
Deciding about Elternzeit and Elterngeld
These two get mixed up constantly, so they are worth separating. Elternzeit is unpaid leave with your job protected: up to three years per child, which you can spread out any time between the birth and the child's 8th birthday. Elterngeld is the money during that leave, paid for up to 14 months per family. It is for every parent living in Germany who is caring for their child, including parents who have never worked here. If you had an income, it replaces part of it. Current rates and a calculator are at familienportal.de.
The Elternzeit request goes to your employer in writing at least seven weeks before it starts, and it is binding for the first two years. The Elterngeld application goes to the parental allowance office (Elterngeldstelle) after the birth, within three months. How both work in full is in Benefits and entitlements.
What I would hold in mind
This is where families feel the squeeze: forms, everyone's opinions, and the sense that there is a “ready” you are supposed to have reached by now. I have sat with families through a lot of these last weeks and I have never seen anyone arrive fully ready. It has never mattered. What helps is knowing your rights, knowing who is on your team, and knowing where to go when labour starts. The rest you work out as you go, and that is allowed.
Read more from Birth & Mother
Emma's guidance and printables for this stage
From the Journal· 6 min readBirth without your villagePreparing for birth far from family is one of the hardest parts of expat life.Help beyond Birth & Mother
Trusted, independent resources across Germany:
Birth · The week around your baby's arrivalBirth and thefirst days
The day you meet your baby, and the day you become a mother.
Around the birth, and the first days
- Birth dayMidwife-led wherever you are · your companion beside you · pain relief as you choose · first check (U1) right away
- Days 1–3A short hospital stay, or home within hours after a birth house or home birth · second check (U2), days 3 to 10 · midwife home visits begin
- First weekRegister the birth (Standesamt) and order several Geburtsurkunde copies · add your baby to your Krankenkasse
- First weeksApply for parental allowance (Elterngeld) within three months · apply for child benefit (Kindergeld) at the Familienkasse (from 2027, often without an application)
What is happening
Labour, birth, and the first few hours. It might build slowly or start all at once. It might go the way you planned, or it might not. In Germany, if you and the baby are well, you usually stay in hospital one to three days. After a birth house or home birth you are often home within hours. Either way the postpartum visits from your midwife start almost straight away.
The feelings here are rarely tidy. Elation and shock, tenderness and exhaustion, and sometimes grief or disappointment running right through the love. All of it is allowed, and none of it is a verdict on how you did.
Your journey through these first days
A midwife is with you in labour wherever you give birth. In a birth house or at home the birth stays entirely midwife-led. In hospital a doctor usually comes in for the birth itself, and earlier if they are needed.
For pain, German hospitals offer the epidural (PDA), and many offer gas and other options too, alongside movement, water, warmth and breathing. What is available differs between settings, so it is worth asking beforehand.
You have the right to have someone with you, your partner or a doula or both. You also have the right to understand every intervention, and to agree to it or refuse it.
One way to have that conversation in the moment is BRAIN:
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?
Your baby's first check (U1) happens right after the birth, and the second (U2) between days 3 and 10. The U2 is usually easiest to do before you leave hospital, where there is a paediatrician (Kinderarzt) on hand. After a birth house (Geburtshaus) or home birth, the midwife may not do this examination, so you may have to arrange it yourself, and finding a paediatrician appointment at short notice is stressful. It is worth sorting out beforehand with your birth place and a paediatrician.
Then the daily home visits start, for the first ten days. Your midwife checks your recovery and the baby's, helps with feeding, does the weighing, and answers the questions that always seem to arrive at 3am.
Admin & paperwork
In the days after the birth, the paperwork all comes off one document. The full order is in Start here at the top of this page. These are the parts that begin straight away.
To sort out
What I would hold in mind
Birth rarely looks like the plan, and from everything I have seen in this work, preparing is still what gives you something to come back to when the day changes course. The first 48 hours are loud and disorienting even at their best, so you will not remember all of it. You will tell the story of this birth many times over the years, and the version that matters is the one that is true for you.
Read more from Birth & Mother
Emma's guidance and printables for this stage
Help beyond Birth & Mother
Trusted, independent resources across Germany:
If your birth was not the one you hoped for, or you just want to put words to what happened, going back over it in your own time, with your midwife or a counsellor who specialises in this, can help. Schatten und Licht supports women through emotional crises around birth, across Germany.
Fourth Trimester · PostpartumThe fourthtrimester
The weeks after the birth need as much planning as the birth itself.
The weeks after birth
- 1–2
- Daily midwife visits (the first ten days)
- Rest, feeding, and healing
- 3–5
- Midwife visits taper off
- U3 baby check (weeks 4 to 5)
- Arrange food and help; ask about home help (Haushaltshilfe)
- 6
- Postnatal check (Nachuntersuchung)
- Recovery course (Rückbildungskurs) can begin
- 6–12
- Recovery course continues
- Breastfeeding support carries on
- Finish your Elterngeld and Kindergeld
What is happening
The Wochenbett is the German word for the first weeks after the birth, and it is treated here as a protected, slow, mostly indoor time. Healing, feeding round the clock, broken sleep, a body that is your own again but not quite the same, and a baby who knows nothing yet about day and night.
There is love that floors you, and often tears, loneliness or anxiety alongside it, especially with no grandparents down the road and nobody cooking the food you grew up with. None of that means you are doing it wrong. And this is exactly the stretch where the care in Germany is meant for you, not only for the baby.
Your journey through this trimester
Your midwife is at the centre of this phase. Daily visits for the first ten days, then less often through the first twelve weeks, and breastfeeding support (Stillberatung) for months after that. They are there for you as much as for the baby, and they are the right person to ask anything, however small and however late at night. Your baby's check-ups carry on, with U3 around weeks 4 to 5, and at about six weeks a postnatal check (Nachuntersuchung) closes the medical side of the postpartum.
From around week six you can start a postpartum recovery course (Rückbildungskurs), covered by your insurer. Underneath all the appointments, the real work of these weeks is rest, food and being looked after.
What to decide and sort out
Most of the big paperwork is behind you. What is left is finishing what you started, and asking for the help you are entitled to.
Yours to decide
To sort out
What I would hold in mind
In my postpartum work, what separates a gentle Wochenbett from a brutal one is whether the parents have help and rest in the weeks afterwards, more than how the birth itself went. If your family is far away, that help can be put together from other people: a friend running a meal rota, a neighbour doing the shopping, someone paid to do the laundry, a doula for a few hours a week. And it is much easier to ask before you are desperate than after. Of everything I have learned alongside the families I work with, that is the one I most wish everyone knew going in.
Read more from Birth & Mother
Emma's guidance and printables for this stage
Help beyond Birth & Mother
Trusted, independent resources across Germany:
At a glance
Everything that needs doing, in one list
Every practical job from this page, pregnancy through to the early weeks, in order, to print or save. When to ring your health insurance is in What your insurance covers.
PrintableOpen & printEverything that needs doingThe whole checklist, from the first weeks of pregnancy to the first months with your baby.For families across Germany
Trusted resources
Rules and figures change, and your own city has its own offices and groups. These are the places to check for the current official word, and to find the people near you whose job this is.
When to call for help
If something feels urgent
These are worth putting in your phone before you need them. In Germany you usually ring first rather than going to the hospital and waiting.
In labour: call the labour ward (Kreißsaal) of your registered hospital directly. The number is in your Mutterpass after your registration appointment. For a birth house or planned home birth, call your midwife.
A note on this guide
Your midwife (Hebamme) and gynaecologist are your care, and this page is information, not medical care. If you are still looking for a midwife, Ammely is the national search, by due date and postcode, and near Potsdam I can help you find one who speaks English. For that, or for someone who speaks English and German beside you through any of these phases, get in touch.
Where to begin
Your guide to birth in Germany
- Start hereBirth in GermanyA gentle orientation to how it all works.
- By topicThe German Maternity SystemThe whole system mapped, subject by subject.
- By trimesterStep by StepThe journey in order, appointment by appointment.you're reading this