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Congratulations - you've found out you're expecting a new addition in Germany! In many ways, this is a fantastic country to go through pregnancy and birth, due to high standards for prenatal and postpartum care and excellent health insurance coverage.
Learn about compulsory German health insurance with TK here.
Pregnancy: first trimester
Once you have found out you are pregnant, there's a few things you should probably do as soon as possible. First and foremost, check your health insurance and see what is covered throughout pregnancy and birth. Most public insurances in Germany are extremely thorough in coverage.
In Germany you are entitled to the services of both a Frauenarzt (gynecologist) and a Hebamme (midwife) during your pregnancy. The Frauenarzt attends to most of your exams and blood tests and often is the one providing your ultrasounds, though some doctors will send you to a separate ultrasound clinic.
The Hebamme generally comes to your home or you go to pre-natal visits at a midwife center (Hebammenzentrum), and can provide some basic exams, prenatal counseling and sometimes alternative therapies such as acupuncture or homeopathy. If you are giving birth in a hospital or birth center and have limited German, you may also consider hiring a doula who is fluent in German to help advocate for you and explain to you what is going on.
If you don't have a Frauenarzt, you should find one as soon as possible and make an appointment. They will confirm the pregnancy and you will receive a Mutterpass, translating literally as "mother passport." It is a small booklet that will contain all the necessary medical information about you and your pregnancy - a very important document!
To find a Hebamme, you can ask local friends or your Frauenarzt for referrals, and if you live in an area with a shortage of midwives (such as Berlin or Munich), you should try to find one as soon as possible. There are also search websites for various regions throughout Germany, usually called "Hebammensuche."
Even though it is a bit early in the pregnancy, if you are interested, you can start looking into prenatal yoga classes or birth preparation courses ("Geburtsvorbereitungskurs"). Some prenatal yoga classes are partially reimbursable by your insurance, as are some birth preparation courses. These classes are also a fun way to meet other expecting parents.
Pregnancy: second trimester
By now, you will have had a few appointments already with your Frauenarzt and possibly also your Hebamme. If you haven't met with your Hebamme yet, it's a nice idea to meet up just for a preliminary meeting and make sure you "click" as you will see quite a lot of them after birth.
Now is a good time to figure out your birthing options. In Germany you can give birth at a hospital, a birth centre or at home. Hospital births are covered almost fully by insurance; birthing centres or home births involve extra costs. If you would like to give birth in a hospital, find out if your hospital of choice wants you to register, and when in the pregnancy you should do so.
Many hospitals and birth centres also provide information evenings where they tell you about what services are available at their facilities. If you are interested in a birth centre or home birth, you will need to find a place in advance or a Hebamme that specializes in home births.
This is a good time to also start to organize your paperwork. If you haven't informed your workplace yet and are working in Germany, it would be an ideal time to do so now you can determine your Mutterschutz ("mother protection") and Elternzeit ("parental leave") in accordance with your work and your insurance company.
In Germany, you are entitled to six weeks leave before the birth - determined by due date - and eight weeks after the birth, fully paid. You can opt to take up to almost two years reduced salary but paid leave after the baby is born, and a third year unpaid but with your position being retained. If your baby is premature or you are expecting multiples, you will get additional fully paid leave.
Pregnancy: third trimester
More paperwork to think about, unfortunately! If your baby will have multiple citizenships and you would like to get it taken care of as soon as possible, start looking into the consulate requirements for the necessary documents for citizenship. If you and your partner are not married, your partner will need proof of paternity paperwork for certain legal documents. You can also start filling out paperwork for Elterngeld, government money allotted to you for your child. If your German is not fluent enough or someone isn't able to help you out, there are paid services that can help you with these documents.
Make sure you have your hospital bag packed ("Kliniktasche") just in case, if you are going to a hospital! Some important things not to forget: your Mutterpass and any other important documents you might need for the birth certificate, your health insurance card, snacks, a phone charger, a going-home outfit for your baby, a camera and a journal or baby book. Keep in mind that unless you pay extra for a family room, the mother will likely have roommates, and generally partners don't stay overnight, which may be a bit different from what you are used to.
This is a good time in the pregnancy to take your birth preparation class, if you've decided to enroll in one, as well as start preparing some things for the baby. Many cities and towns in Germany have flea markets throughout the year that specialize in baby and children's items ("Flohmarkt") which are an excellent way to get affordable clothes, toys, bedding and furniture for your baby at a low cost. Some of these markets will even have special opening hours for pregnant women if you bring your Mutterpass!
During the third trimester you can enrol for an insurance-covered post-partum class called a "Rückbildungskurs." This class helps with pelvic floor muscles after birth.
Also make arrangements for childcare for older children if you have any; many hospitals and birth centres won't allow children to be present for the birth.
Birth: the big event
If you think you are in labour, get in touch with either your hospital, birth centre or home birth Hebamme. They will tell you how to proceed. In the case of showing up at a hospital or birth centre and you are not actually in labour, they'll let you know if they want you to stay or if you should go home. In any case, better safe than sorry. Ideally, if your partner or someone else cannot drive you to the hospital, it is best to go by taxi. Some insurances might reimburse you for the taxi fare!
If you are giving birth at a birth centre or at home, you will be fairly limited in medicated pain relief, so it's good to think in advance about what you may or may not want during a birth. Hospitals in Germany typically provide the option for a non-medicated birth if everything goes smoothly, offering homeopathy, birthing props like an inflatable ball, and birthing tubs (some with options for waterbirth), and occasionally acupuncture and even aromatherapy as natural pain relief methods; almost all of these will also be available at a birth centre as well.
Hospitals also offer epidurals ("PDA" in German") and pain relief in the form of pills or liquids. In a home birth, pain relief methods will be up to you and your Hebamme; it is sometimes possible to rent birthing tubs in Germany. If you are giving birth in the summer, be prepared for the many hospitals that do not have air conditioning - you might want to bring along a small hand fan with you.
Your birth will be primarily attended by the hospital's staff of Hebammen, with a doctor supervising the actual arrival of the baby. When the baby is born, its first check up is its Apgar score, referred to as the U1. You will receive a pediatric booklet for your child that keeps track of its medical appointments - another very important document.
If you are at a hospital, the amount of time you will stay at the hospital is determined by a couple of factors. If you have had a smooth birth with no complications, you are allowed to go home once "okayed" by the doctors after 6 hours, but are responsible for organizing the baby's U2, its second medical checkup that is supposed to be performed around its third day of life.
Otherwise, a typical hospital stay is three days, and the baby will receive its U2 in the hospital by a pediatrician while the mother gets a checkup in the hospital by a Frauenarzt. If you have had a C-section, a hospital stay will typically be 4-5 days. If you give birth at a birth centre, you will be expected to leave after about six hours if everything goes smoothly. Most hospitals will register the birth certificate for you during your stay, but this is something worth checking into beforehand. If you give birth at a center or at home, you will be responsible for this yourself.
For a few weeks after the birth, your personal Hebamme will visit you at your home. She will check the mother's recovery process (for instance, if there were stitches, she will examine the healing), help with umbilical cord care, weigh the baby to ensure it is gaining at a healthy rate, answer questions regarding breastfeeding, and much more. A good Hebamme is invaluable! Oftentimes they will also show you how to give the baby its first bath, and give the mother some post-partum exercises to do.
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Congratulations again, and good luck with your new baby in Germany!
Naomi Kaye Honova is an American writer and social worker living in Munich, Germany with her husband and young son.