Pregnancy in Germany

Starting a family in a foreign country can be a daunting prospect - after all, there are lots of logistics to navigate during your pregnancy in Germany, from health insurance to social security. Luckily, as with all aspects of German healthcare, the standard of care is very high. If you have discovered you are pregnant or you are trying for a baby, this page gives an overview of what to expect when you’re expecting in Germany.

Having a baby in Germany

Germany offers a good system of pregnancy support, with everything from prenatal checks to giving birth in a hospital, maternity unit or at home covered by health insurance. After having a baby in Germany, you will be entitled to take maternity and parental leave, so long as you have been paying into the social security system. You can also take advantage of other family allowances. Once you have given birth, you will also need to register your newborn child and apply for a birth certificate. 

Pregnancy care & health insurance

The first step for any planning or expectant mother should be to make sure you are covered by German health insurance. Statutory health insurance provides comprehensive cover for expectant mothers, everything from check-ups to childbirth - although there may be some extra costs involved depending on your preferences, for instance if you want to give birth in a private hospital. 

If you have private health insurance, you should check with your provider to see exactly what is covered.

So long as you’re covered by public or private insurance, as an international living in Germany you will have access to the same maternity services as German nationals. If you are only in Germany short-term as a visitor or tourist, you may get cover through your travel insurance, or your European Health Insurance Card (EHIC). 

Pregnancy tests in Germany

If you think you might be pregnant, you can take an at-home pregnancy test in Germany. These can be bought from most supermarkets or pharmacies. You might even see them in vending machines in some public places. 

At-home pregnancy tests have an accuracy rate of around 98% from the first day your period is due. For more advice, speak to your pharmacist. 

Emergency contraception in Germany

Whether due to a mishap, accident or lapse of memory, you may find yourself in need of emergency contraception in Germany. The emergency contraceptive pill (the “morning after” pill or “die Pille danach” in German) offers good one-off protection from an unwanted pregnancy if contraception has failed or after unprotected sex. 

It is available without a prescription from pharmacies in Germany and costs between 18 and 35 euros. On evenings, weekends and public holidays, you can also get it at emergency pharmacies. If you are under the age of 22 can also obtain the morning after pill free of charge with a prescription issued by a doctor. Your pharmacist can offer more advice. 

Making an appointment with your gynaecologist

If you get a positive result on an at-home pregnancy test, you can then book an appointment with your gynaecologist (Frauenarzt). In Germany, all public health insurance schemes cover an annual visit to the gynaecologist for every woman over the age of 20. If you think you are pregnant, you can visit your regular gynaecologist, or choose a different one. You can normally make an appointment directly with them, but you may need a referral from your regular doctor (GP). 

Your gynaecologist can confirm your pregnancy test result with a more accurate blood test. This appointment usually takes place around week six. During the appointment, your gynaecologist can also give you a rough idea of your estimated due date (Entbindungstermin).

Receiving your Mutterpass

At your appointment, you will also receive a document known as a Mutterpass (mother’s passport or maternity log). This is an important piece of paperwork that tracks the progress of your pregnancy and documents important information such as test results and examinations. 

You must keep it safe and bring it with you to every doctor’s appointment. You also need to bring it to the hospital when you give birth.

Prenatal care in Germany (Schwangerschaftsvorsorge)

After this first appointment with your gynaecologist, you will attend 12 regular check-up appointments (either with your gynaecologist or midwife): one every four weeks until week 32 and then every two weeks thereafter. Your employer is obliged to give you time off to attend these appointments. Routine care usually includes:

• Ultrasounds
• Urine analysis
• Blood pressure checks
• Weigh-ins
• Blood tests
• Pelvic exams

Tests and checks

At each appointment, the doctor or midwife will check your blood pressure and take a blood and urine sample. They will want to check blood groups and Rh factors, as well as immunity against rubella, toxoplasmosis and gestational diabetes. 

Note that not every health insurance covers every type of test; it’s worth checking with your doctor and health insurance company to be sure. 

Ultrasounds

Women with statutory health insurance in Germany are offered three ultrasound scans during their pregnancy. Your doctor should walk you through the advantages and disadvantages of having an ultrasound, and you have the right to refuse a scan. 

The first scan, which takes place between the ninth and 12th week, confirms that you are pregnant, checks for the baby’s heartbeat, and will give you a better estimate of your due date. If you are working in Germany, you can request a confirmation of pregnancy (Schwangerschaftsbestätigung) at this appointment to present to your employer (see more below about informing your employer).

At the second (carried out between weeks 19 and 22) and third (between weeks 29 and 32) scans, the doctor will measure the foetus's head, tummy and thigh while looking at the position of the placenta. 

Your doctor may offer you additional ultrasound scans, which will only be covered by your health insurance if they are deemed medically necessary. 

Vaccinations

Your doctor may recommend some vaccinations to you when you are pregnant. They are not mandatory but can help protect you and your baby. Recommended vaccinations for pregnant people in Germany include the flu vaccine, whooping cough and a COVID booster. 

Choosing a midwife in Germany (Hebamme)

During your pregnancy, you will start meeting regularly with a midwife (Hebamme). They will come to your home, administer check-ups, and support you before, during and after the birth of your child. A midwife is usually the responsible person at your child’s birth, although it may not be the same midwife who administers your home visits.

You can select your own midwife, or be assigned one by your doctor. It is worth searching for one in advance (usually at around 12-15 weeks), as many can only take on a few patients at a time. In larger German cities, it is usually possible to find English-speaking midwives. The website Hebammensuche allows you to search for midwives according to location, language ability and specialism.

You should look for a midwife who offers both pre- and postnatal care. They can then examine you during your pregnancy and come to your home regularly after you give birth to help you with taking care of the baby, including offering support with breastfeeding. 

Choosing a hospital

In Germany, you have three options for giving birth:

• In a hospital
• At a birthing house
• At home

Most hospitals offer an information evening (Infoabend), during which prospective patients are able to have a look around the facilities, meet with the staff and ask questions. Once you have made your decision, it is a good idea to pre-register with your chosen hospital so that all arrangements can be made in advance. You will need your Mutterpass, your passport, and possibly a copy of your birth certificate (and marriage certificate, if you are married).

Prenatal classes (Geburtsvorbereitung)

You should complete a prenatal course (Schwangerschaftsvorbereitung or Geburtsvorbereitung) four weeks before your due date. As courses can be oversubscribed, it’s best to register for your chosen course between two to three months before you wish to take it - i.e., around five months into your pregnancy. 

The cost of taking the course should be reimbursed for both you and your partner by your health insurer, but double check with your insurance company to make sure, and remember to ask for an invoice. 

There are many different types of courses in Germany. You can either take them at your chosen hospital, or through an alternative provider such as the German Red Cross. An increasing number of providers are now also offering online or hybrid formats. 

There are several different types of courses, i.e. for first-time parents or single parents, and usually English-language options as well. Some courses focus on specific techniques such as the Dick-Read Method or yoga and breathing techniques. Your hospital or midwife will be able to advise you on the courses available to you locally.

Informing your employer and health insurer

During one of your appointments with the gynaecologist, you will be given a confirmation of pregnancy to present to your employer. Later, you will also receive a confirmation of the presumed due date. You are not obliged to tell your employer about your pregnancy, but you are only covered by maternity protection regulations if your employer is aware of your pregnancy. 

In order to go on maternity leave and receive your maternity benefit and parental allowance, you will need to inform your employer (when you are ready) and provide them with the certificate of presumed delivery date. You will also need to let your health insurance company know. 

Your employer is required to inform the office for Health and Safety Management about your pregnancy. They in turn will contact you to conduct an evaluation of your working conditions, to make sure they comply with the Maternity Protection Act.

Do a paternity recognition (Vaterschaftsanerkennung)

In Germany, a man is only legally considered a father if he is married to the mother of the child at the time of birth. If you and your partner are unmarried, your partner should acknowledge paternity of your baby during the pregnancy in order to be entered on the birth certificate as father as soon as you register the birth. You can also do it after the birth, but in this case a new birth certificate will have to be issued. 

You can submit a declaration of recognition of paternity to a competent authority, such as:

• Your local youth welfare office (Jugendamt)
• A registry office (Standesamt)
• Your local court (Amtsgericht)
• With a notary

The mother is also required to personally declare her consent to the recognition of paternity. A fee may be charged for this service. 

Note that the recognition of paternity does not mean that the father is entitled to custody. If the parents are not married, then initially only the mother is entitled to custody. A joint custody arrangement can be made by making so-called custody declarations to a youth welfare office or a notary. This can also be done before the child is born. 

If the mother is married, her spouse is automatically considered the legal father of the child. For cases where the child was conceived using a donor, in Germany the donor is not considered a legal parent. The legal parent is always the person who gave birth to the child. For the time being, parents must apply to adopt their child if they were born using a donor or via a surrogate, but efforts are being made to change the law. 

Get in touch with potential daycare providers (Kitas)

Mandatory schooling in Germany doesn’t start until your child is five or six. In the meantime there are several options for early childhood education. 

Since 2013, all children in Germany aged 12 months and above have a legal right to a childcare place, which is partially or fully subsidised by the government depending on the German state you live in. However, you may want to start looking into options before your child is even born, as spaces in daycare facilities are in short supply.

Going on maternity leave

Maternity leave is more of a requirement than a right in Germany - from six weeks before birth to eight weeks after (longer in the case of multiple or premature births). During this time, if you are employed, you continue to be treated as an “active employee” and receive your full salary as part of your maternity benefit. After your maternity leave period ends, you can apply for parental leave.

If you wish to take maternity leave and parental leave (your partner is also entitled), you need to inform both your employer and your health insurance fund in advance. It is wise to take care of this at least several weeks before you intend to go on leave.