German Birth CultureWhat your midwife does,and doesn't

One of the very first things you will hear when you announce a pregnancy in Germany is: “Have you found a Hebamme yet?” It comes from your doctor, your colleagues, your neighbours. There is a good reason everybody asks. Midwifery care is one of the very best things about having a baby in this country.

A midwife (Hebamme) is a specialist in birth itself, and Germany gives them a central place in your care. Having had midwifery care through my own pregnancies here, I have enormous respect for the work. So this is about knowing their role clearly, and knowing it early, so you can build the rest of your support around it.

If you are new to Germany, perhaps still learning the language, there is a lot to take in at once: what a midwife will do for you at each stage, the different kinds you can book, and how to find one. That is what the rest of this is for.

So, What Is a Hebamme?

A midwife is a certified healthcare professional whose role is protected by German law. Germany is one of the few countries that puts midwives at the centre of birth: a doctor may not conduct a birth without calling a midwife in. Their training is rigorous: a bachelor's degree in midwifery that includes extensive clinical placements in hospitals, birth centres, and community settings. They are experts in the physiology of pregnancy, birth, and the postpartum period.

In the German system, your midwife can play a role at every stage: prenatal care, birth, and the postpartum weeks. But what that looks like in practice is often quite different from what international families expect.

Prenatal Care with Your Midwife

In Germany, your midwife (Hebamme) can carry out all of your routine prenatal check-ups, except the ultrasound scans and certain fine diagnostic tests, which are done by a gynaecologist. That gives you a real choice in how your care is shaped: some women see their midwife for every check-up and the gynaecologist only for the scans, some alternate between the two, and some have their care led by the gynaecologist. Whichever you choose, the checks are documented in your Mutterpass, and your midwife is the right person to walk you through what theirs will involve.

What these visits generally do not include is extended time to talk through your fears, your birth preferences, and the questions that change as your pregnancy goes on.

Your midwife cares about you, but their appointments are structured and time-limited.

There is often simply not enough time within a prenatal visit for the longer conversations that help you feel truly prepared, not just medically, but in yourself too.

During Birth: Types of Midwife

“Midwife” is the general term in Germany, but when it comes to who is actually with you during birth, there are several different types worth understanding.

There is always a midwife at a hospital birth. In most cases it is the midwife on shift (Klinikhebamme), whom you meet on the day. Hospital midwives work on a rota, and on a busy ward one midwife may be looking after more than one woman in labour, so they come in and out of the room.

A Beleghebamme is a freelance midwife with a contract (Belegvertrag) at one hospital, who attends births there. It comes in two forms, so ask which one you are being offered. Some work that hospital's rota, and whoever is on duty cares for you. Others you book yourself during pregnancy, and they come on call to be with you one-to-one at your birth.

Begleithebamme is a loose term for a freelance midwife who knows you through pregnancy and comes with you for the birth. The limit is the contract: without a Belegvertrag at your hospital they cannot take clinical charge of your birth there, so the midwife on shift does and yours is with you as support. Midwives who offer this are the hardest to find, and many are fully booked months ahead.

If you are planning a home birth, you will need a home-birth midwife (Hausgeburtshebamme), an independent midwife who specialises in attending births at home. They will care for you throughout your pregnancy, attend your birth at home, and continue visiting through the postpartum weeks.

There are also midwives who work at a birth house (Geburtshaus), providing midwife-led care in a setting that sits between hospital and home. And beyond these, freelance midwives may offer prenatal and postnatal care without attending your birth at all, focusing instead on check-ups during pregnancy and home visits after your baby arrives.

None of this was explained to me. I worked it out afterwards, which is the wrong order.

All of these midwives fill up quickly, so begin your search as early as possible, ideally in the first trimester.

Whichever type of midwife accompanies you during birth, their focus is on the medical safety of you and your baby. They are the right professional for the clinical work that holds birth safe, and they will walk you through what that involves in your specific care. It is vital, skilled, medical work.

But continuous emotional support (holding your hand through every contraction, helping you breathe, speaking up for your preferences when the room fills with unfamiliar faces speaking rapid German) is a different job altogether.

After Birth

One of the best things about the German system is the postpartum home visits from your midwife, fully covered by health insurance. In the first ten days after birth, your midwife can visit you daily. After that, they can go on visiting until twelve weeks after the birth, and further visits are available for breastfeeding support.

These visits are a lifeline. In many practices, a midwife's postpartum visits focus on your physical recovery and your baby's wellbeing, with the specifics shaped by their own training and what they see on each visit. They are the right person to walk you through what theirs will look like, and this matters enormously.

But these visits are typically thirty to forty-five minutes long. They focus on physical health. There is rarely time for your midwife to sit with you while you cry about how hard breastfeeding has been, to cook you a warm meal, to hold the baby so you can shower for the first time in three days, or to help you process a birth that did not go the way you had hoped.

These are not failures of your midwife; they are simply not their role.

Where a Doula Fills the Gap

A doula does not replace your midwife. I want to say that clearly and without hesitation. Your midwife's clinical expertise is irreplaceable, and I have deep admiration for the work they do within a system that often stretches them impossibly thin. What a doula offers is everything that falls outside the clinical work: the emotional side, the practical help, and the personal care.

• Continuous presence during labour: I am with you from the moment you need me until your baby is in your arms and you are settled. I do not leave for shift changes. I do not divide my attention between other labouring women.
• Birth preferences advocacy: I help you work through your birth preferences and then support you in communicating your wishes during labour, especially when the conversation is happening in German and moving quickly.
• Emotional support before, during, and after: the long conversations about your fears and hopes, the reassurance at three in the morning when contractions begin, the unhurried postpartum visits where I am there for you as a whole person, not only for a body that is healing.
• Language and cultural bridging: for international families, working out the German birth system in a second language adds a layer of vulnerability. I help bridge that gap, ensuring you understand what is happening and that your voice is heard.
• Extended postpartum care: practical help at home, nourishing meals, being there with you through the big changes of new parenthood, and supporting the whole family as you settle in.

When a doula and a midwife work alongside each other, it works well. Your midwife can focus fully on their clinical expertise, knowing that your emotional support is covered. And you get to experience birth and postpartum care that feels complete, with both the medical and the human side well looked after.

What If You Can’t Find a Midwife?

I wish this were not a section I had to write, but Germany is facing a significant midwife shortage. In many regions, women struggle to find a midwife for postpartum care, let alone a continuity-of-care midwife for birth. If you are reading this while frantically refreshing Hebammensuche websites and hearing nothing back, please know: you are not alone, and you are not doing anything wrong.

If you cannot find a midwife for postpartum care, a doula can help fill some of that gap, offering the emotional support, breastfeeding encouragement, and practical guidance that you need during those vulnerable early weeks. I cannot perform the clinical checks that a midwife would, but I can ensure that you are not going into new motherhood without any support at all. And I can help you connect with lactation consultants, paediatricians, and other professionals who can address the medical side.

Start your midwife search early, ideally as soon as you have a positive test. Register on multiple lists. Ask your gynaecologist's office for recommendations.

And in the meantime, know that building your support team is not all-or-nothing.

A doula and a midwife are complementary rather than competing roles. It really helps at such an important time.