What to expect from a hospital birth in Germany: Tips from a doula

I remember seeing my first positive pregnancy test shortly after moving to Berlin: I was elated, but also completely lost. I had no idea what to expect from the German system. The biggest question for me was: where and how would I give birth?

Now, as a professional doula, I support expat families in Berlin through pregnancy, birth and postpartum. I've witnessed many births across home settings, birth centres (Geburtshäuser), and hospitals. Today, I will focus on hospital births - the most common choice in Germany.

Which professionals support you for a hospital birth in Germany?

In Germany, you typically see a gynaecologist or a midwife for prenatal care. But at birth, the hospital team is usually different from the one you saw during pregnancy.

You will be cared for by the midwives on duty. Doctors may be involved, particularly if complications arise. While a personal midwife who accompanies you to the hospital (Beleghebamme) exists, they are rare.

Postpartum care in the hospital is then provided by a team of midwives, nurses and gynaecologists.

When and how to register for a hospital birth

Registration can happen at different points depending on the clinic, but it is generally fine to register at the start of your last trimester.

This is primarily an administrative appointment with a midwife rather than a medical consultation. You will need your insurance documents and your Mutterpass. Most families won’t interact with the hospital again until labour begins.

Choosing the right hospital for you

I believe that choosing where to give birth is one of your most important decisions: where means how and with whom. It’s not as simple as picking the closest clinic. Because you can register at multiple places, I recommend making an informed choice based on:

• The environment: Visit the maternity ward (Kreißsaal) and rooms. Get a sense of how you feel in the ambience and what amenities are available, such as birthing pools, ropes, pezzi balls,  etc.
• The culture: Attend information evenings (Infoabende) to get practical information and meet the teams. Bring up specific points of your birth plan to see if the team can accommodate your requests. This is a great way to gauge their approach to birth.
• Capacity: Ask about the midwife-to-patient ratio, how many delivery rooms they have, and how likely it is that you will have a family room or a private or shared room.
• Level of care: High-risk pregnancies are usually referred to Perinatalzentren (Level 1-3) for specialised neonatal care. But for low-risk pregnancies, you have the option to go pretty much anywhere. 

Getting one-on-one support

Midwives often care for multiple people at once and work in shifts. This makes continuous support challenging, but studies show that one-on-one support is beneficial during the intensity of labour.

For this reason, many families hire a doula, someone who is there just for them, from pregnancy through birth and postpartum. This continuity provides a reassuring and supportive presence, while also bringing professional knowledge and experience around birth.

Besides hiring a doula, consider who will support you during labour (partner, family, friend): choose someone calm, who isn’t afraid of birth and will truly advocate for you. Attend birth prep classes together and communicate honestly about your fears and expectations.

What to expect during birth and right after

While every hospital has its own protocols, here is what is standard:

During labour 

You will be monitored by one or more midwives, sometimes nurses. If needed, you will have access to pain relief ranging from epidurals or opioids to non-medicated methods like water immersion or acupuncture.

After birth

After skin-to-skin time and post-birth checks, your baby will "room-in" with you; you will be taking care of your baby on your own, around the clock (even after a tiring delivery). Staff will come regularly to check in on how you are doing.

These first days are often difficult for the new mother; many feel unprepared for the stay, having idealised expectations. So be prepared: attend a birth prep class focused on postpartum care, breastfeeding/bottle feeding, and newborn care, so you are not caught off guard. Don't hesitate to ask for help; no questions are ridiculous!

You can request a family room (Familienzimmer) so your partner can stay, though these are subject to availability and an extra fee. Because of this, some parents prefer to leave earlier with an outpatient birth (ambulante Geburt).

Being discharged from the hospital

Your baby will receive the U2 examination before you leave. Afterwards, your community midwife (Nachsorgehebamme) will continue care at home.

Be informed and empowered

Some procedures or interventions may be routine unless you express your preferences in a birth plan. This is why I strongly encourage you to inform yourself about common hospital practices and clarify what matters to you, so you can make empowered decisions during labour and beyond.

What to pack

Most hospitals provide the basics (baby clothes for the stay, diapers, hygiene essentials for the new mother…) and give you a list of items to bring.

From my experience, comfort items can make the difference: your favourite blanket or pillow to feel cosy, earplugs or an eye mask to protect your sleep (imagine sharing a room with another Mama-newborn duo!). Pack comfortable clothing: nursing bras, bathrobe, tracksuit bottoms, and cosy slippers.

For babies, some clinics even offer professional photo shoots for newborns; so, beyond your going-home outfit, you might want to pack something cute for photos.

You will need specific documents, such as your birth or marriage certificate, for the hospital to register the birth. Enquire and prepare these in advance! 

Last but not least…hospital meals aren't the most nutritious: your evening meal will be “Abendbrot”: cold cuts, cheese and bread. So plan ahead: pack snacks, your favourite comfort foods from home, and have someone bring fresh meals during your stay. This will boost your energy and morale during those first postpartum days!

Packing your bag around week 32–35 of pregnancy usually works well. 

Preparation is key

Birth and the first days after are a wild ride: the lows are low, but the highs are higher than anything you’ve ever felt. Having realistic expectations and adequate preparation for your hospital birth will help you feel more confident and grounded.