Pregnancy and Giving Birth in Germany

Are you pregnant and new to Germany? Congratulations – what an amazing time in your life! Pregnancy and birth are among the biggest transitions in life that you can experience. It’s exciting, and maybe a bit scary, but even more so in a new and different country. Giving birth in Germany is likely to be very different from being pregnant in your own country since Germany offers a unique service to expectant mothers.

Preparing yourself and your partner for parenthood is an important task. Babies can only be born once, and it helps to have an understanding of the process and what your options are, giving you more confidence to face the big day.

Let me take you on a journey through all the different stages of your pregnancy, exploring how things work here when giving birth in Germany.

The gynaecologist

When you think you’re pregnant, your first stop is usually your gynaecologist. Unlike in other countries, it is the gynaecologist (who will also be trained in obstetrics) rather than your general practitioner (GP) who confirms your pregnancy, and takes you into their care. This doctor will set up the various appointments you need to attend during pregnancy, do the antenatal check-ups, including taking blood, conducting ultrasound scans and prescribing any medication needed, but they won’t actually deliver your baby.

The midwife

One of the questions you are most likely to hear is whether you have found a Hebamme (midwife). Alongside seeing a gynaecologist, as described above, you can – and should – find a midwife to guide and educate you throughout your pregnancy, and to support you during and after the birth.

At its core, the midwifery model of care, which the German system is based on, sees pregnancy and birth as normal physiological events rather than as medical emergencies.

In Germany, midwives are specialists, professionally trained in caring for women during pregnancy and birth, and in the period immediately after. They train directly in midwifery at a hospital rather than starting out in general nursing and then specialising. They must pass an exam to get a state diploma, and from 2022 they will have to undertake further study.

Midwives can practise both inside and outside hospitals, and offer a range of services. Germany has always had a strong midwifery profession, and legally it is only midwives who can attend when someone is giving birth in Germany, not nurses. Doctors can deliver a baby, but only in the presence of a midwife, whereas midwives can attend a normal birth without the presence of a doctor. This is why labour wards are staffed exclusively by midwives.

Let’s look at all the services midwives offer in Germany.

Prenatal care in Germany

While many women choose to go to their gynaecologist (Frauenarzt/Frauenärztin) for prenatal care, midwives also provide prenatal, or antenatal care, sometimes on their own or in partnership with a gynaecologist. Midwives can do everything that the gynaecologist does, except for conducting ultrasound scans. If you choose shared care, you will have alternating visits with your gynaecologist and your midwife.

Even if you are seeing a gynaecologist for all your antenatal care, it’s still worth consulting a midwife. She will offer you advice about nutrition and exercise in pregnancy. Some midwives offer alternative therapies such as acupuncture, homeopathy and herbal remedies. All of this is can be helpful right from the early stages of pregnancy, when you may be suffering from nausea, right through to the end.

Alongside the prenatal care, many midwives offer a range of courses on pregnancy, birth and the period immediately after birth. These could include pregnancy yoga, exercise classes, antenatal/birth preparation classes, hypnobirthing courses, breastfeeding workshops, postnatal recovery classes, baby massage and many more. The cost of some of these courses, like the antenatal classes, is completely covered by health insurance (but only partly covered for the partner). Some courses have to be paid for privately, but being well prepared physically, emotionally and mentally can bring great benefits at this important milestone in your life.

Care during giving birth in Germany

Whether you’re in a hospital, a birth centre, or at home, midwives are the principal caregivers during labour and giving birth in Germany. Whether you have met the midwife who will look after you during labour will depend on the setting:

• In hospital it is likely that you will not have met the midwife who attends you during the birth, but in general it will be midwives rather than other health professionals who look after you during the birth.
• Midwives who work in a birth centre (an independent centre run by midwives) or offer a home-birth service usually provide care throughout the pregnancy. They are keen to get to know you and establish a relationship of trust.
• Midwives with visiting rights (Beleghebamme) offer a private one-to-one service within a hospital. They have a contract with a hospital that enables them to take their clients to that hospital for the delivery. The advantage of this option is that you receive one-to-one care, and you know who will be attending the birth of your baby.

Postnatal care in Germany

You can also find a midwife to cover your postnatal care (Nachsorge). She will visit you at home in the period after birth, to support you with breastfeeding and your recovery, and to offer advice about looking after your baby.

Benefits of midwife care

Being in the care of a midwife gives you the opportunity to ask all your questions and get them answered by someone with a wealth of experience. Seeing her regularly means you can be better informed during this crucial stage of your life. Studies show that women who have been under the care of midwives are more likely to have a better outcome at the birth than those who haven’t.

Finding a midwife

Unfortunately Germany, like many countries, has experienced a shortage of midwives. However, during the coronavirus pandemic, Germany allowed midwives to offer online support, and this has opened up new opportunities. It means you can consult a midwife anywhere in Germany, no matter where you live, and get answers and support.

Your first step on discovering you are pregnant should be to find a midwife, and a place for the birth. Finding a midwife can be tricky, so it’s best to start looking as soon as possible.

Here are some options for finding a midwife in your area:

• Simply Google ‘Hebamme’ and the name of the area you live in
• Ask your doctor – they will be able to provide you with a ‘Hebbamennliste’: a booklet with the contact details of all the midwives in your area
• Ask your friends and colleagues for recommendations
• Have a look on Facebook: you will often find groups called ‘Hebammenvermittlung’ plus the name of your city
• International groups on Facebook can also be a useful source of information
• Take a look at these sites:
• hebammensuche.de
• gkv-spitzenverband.de/service/versicherten_service/hebammenliste/hebammenliste.jsp
• ammely.de

Although it would be great to have all your services in one place, it’s often not possible. It’s probably better to see a midwife during your pregnancy, even if she is not one who can take care of you in the postnatal period. You can always be looking for a postnatal midwife as your pregnancy progresses.

Birth is the start of life, and everyone deserves the best start in life.

Useful terms

• Antenatal care: Vorsorge
• Antenatal course: Geburtzvorbereitung
• Birth centre: Geburtshaus
• Gynaecologist/OB-GYN: Frauenartzt, Frauenärztin
• Home birth: Hausgeburt
• Labour ward: Kreisssal
• Midwife: Hebamme
• Midwife with visiting rights: Beleghebamme
• Postnatal care: Nachsorge/Wochenbett

Jutta Wohlrab has been an international midwife for 38 years and a hypnotherapist for 15 years. She has dedicated her career to guiding expecting parents to a joyful, safe and happy birth.  In her book “Happy Birthing Mind”, she shares all her tips and secrets about reducing pain, releasing fears and feeling calm and confident about giving birth. She is also an international speaker and teaches her methods to birth professionals all over the world.