Pregnancy and giving birth

Start by arranging prenatal care and a midwife, then plan where to give birth and what support you may need afterwards. You may also need to arrange protection at work, maternity payments and your baby’s registration with different offices.

In short

• Book a pregnancy appointment and start looking for a Hebamme early. A midwife for home visits after birth is not automatically provided by the hospital.
• Statutory insurance covers pregnancy care and midwife help under section 24d. Private cover follows your contract; optional tests, an on-call midwife fee or a family room can cost extra.
• You choose which prenatal examinations to accept after counseling. Ask about their purpose, limits, risks, covered alternatives and any private charge.
• Mutterschutz normally includes six weeks before the expected birth and eight afterwards, with the extensions and exceptions below. Maternity pay depends on employment and insurance status.
• Seek financial-hardship help during pregnancy. Foundation support normally needs an application before birth; benefits, parental leave and the birth register are separate processes.
• Arrange postpartum care, the baby’s early examinations and health insurance. Use the dedicated family guides for birth registration, Elterngeld, Elternzeit and Kindergeld.

What you need to know

This guide is for pregnant people and their families planning care in Germany. Care arrangements are not restricted to employees. Employment protection and maternity payments have their own scope; a student, a self-employed person, a person without work and an employed statutory member do not automatically have the same payment rights.

Ask your health insurer which providers, services and payment arrangements apply before booking planned care. If you have no settled insurance cover, or are unsure which authority pays, contact a pregnancy counseling centre and an insurance-advice service promptly. Do not delay urgent medical help while resolving paperwork. The health-insurance guide explains the different routes; a registration address or a visitor’s insurance card alone does not settle coverage for a move to Germany.

What to do

1. Contact a gynecology practice or a midwife for the first pregnancy appointment. Tell the team about existing conditions, medicines, previous pregnancies and any need for language or accessibility support.
2. Search for a midwife for pregnancy and postpartum care, and confirm which services she offers. Ask the insurer or the official midwife directory for local options.
3. Agree a prenatal appointment plan, obtain the Mutterpass and discuss screening choices. If you work, arrange the necessary pregnancy protections and time off for covered examinations.
4. Choose a birth setting with the care team, contact it about registration and prepare the journey, contact numbers and support at home. Ask the provider when to book.
5. Check maternity-pay and leave applications, financial help and any parenthood documents before the birth. Ask the relevant office what evidence it needs and keep submission receipts.
6. Before going home with the baby, confirm follow-up care, newborn screening and a pediatric appointment. Then complete the separate birth-registration and benefit applications.

Prenatal care, the Mutterpass and informed choices

Routine prenatal care can be shared between a midwife and a doctor; ultrasound examinations are performed by a doctor. The usual schedule becomes more frequent towards the end of pregnancy, and additional care depends on individual needs. At the first visit, discuss the due date, medical history, blood and urine tests, ultrasound, infection screening and the rest of your care plan. The official prenatal-care overview explains the examinations. Ask the team about nutrition, supplements, medicines, vaccinations, physical activity and any existing illness rather than choosing treatment from a generic checklist.

Your doctor or midwife issues the Mutterpass, the pregnancy record. Bring it to appointments and the birth, and keep it accessible for an emergency. Ask what unfamiliar entries mean. It contains sensitive health information; use the relevant certificate for an employer or benefit application rather than sharing unnecessary medical details.

Prenatal examinations are voluntary. Discuss what a test can and cannot establish and what a result would mean for you. Extra screening or an IGeL offer is not automatically covered by showing a health card. Before agreeing to self-pay care, ask for the expected costs in writing and check reimbursement. See paid extras and patient information. Medical explanations must be understandable under section 630e: arrange language support with the provider early and ask who pays for any interpreter; do not assume it is included.

Find a midwife early

A Hebamme can support pregnancy, birth and recovery, but not every independent midwife offers all three. Ask explicitly about home visits after the birth, whether she attends births, which hospitals she works with and who covers absences. A hospital’s delivery-room midwife is not an automatic home-care booking. If no one is available, ask your insurer, maternity hospital or local midwife network about alternatives.

Statutory maternity care includes midwife services. Discuss covered birth-preparation classes, breastfeeding support and postnatal exercises. Partners’ course places, optional activities and on-call arrangements may have different fees. Private patients should check their policy before contracting. Avoid booking overlapping services without clarifying who will bill for them.

Pregnancy at work, in training and in study

Tell the employer about the pregnancy and expected due date so protective measures can be arranged. Section 13 puts measures in order: adapt unsafe work, offer suitable alternative work if that cannot remove the risk, and only then impose a workplace employment ban if neither solves it. Discuss lifting, harmful substances, infection risks, shifts and other specific duties with the employer and care team; the responsible Land supervisory authority can advise on disputes.

Sections 7 and 23 give necessary time off for the covered pregnancy examinations without lost pay or making up the hours. The examination rule also covers employees outside statutory health insurance. When breastfeeding after a return to work, request the protected breastfeeding time during the first twelve months; it is paid and does not replace ordinary rest breaks. A qualifying employment ban outside the protection periods can bring employer-paid Mutterschutzlohn under section 18; this is different from maternity benefit or a sick note.

Students and school pupils should contact their institution about the protection arrangements. Section 3(3) allows an express, revocable request to participate in school or university education during the post-birth protection period; that is a separate exception, not a general permission for an employer to schedule work. Self-employed people should check their insurance and income-protection arrangements separately.

Maternity-protection periods and dismissal

Section 3 calculates the six weeks before birth from the expected date on a doctor’s certificate or a midwife’s certificate. If the birth is earlier or later, that protection period shortens or lengthens to match. You can agree to work in those six weeks, and you can revoke that agreement for the future. The eight weeks after birth are not optional for the employer. They become twelve weeks for a premature birth, a multiple birth, or, if you apply, when a disability of the child is medically established before the eight weeks end. An early birth also adds the unused pre-birth days onto the post-birth period. The twelve-week extension does not apply to a stillbirth. A miscarriage has its own shorter protection periods in subsection 5, measured from the week of pregnancy the section states.

For the twelve-week rule, medical prematurity must be certified by a doctor. The ministry’s maternity guide, section 2.3.2, defines this as birthweight below 2,500 grams, or a heavier baby needing substantially extended care because signs of maturity are incomplete. A birth before the due date is a different test for adding unused pre-birth days; it does not by itself establish medical prematurity.

Section 17 normally bars employer dismissal during pregnancy, until the end of the post-birth protection period and for at least four months after birth. It also protects for four months after a miscarriage after the twelfth week of pregnancy. The employer must know of the pregnancy, qualifying miscarriage or birth when dismissing, or be told within two weeks after you receive the dismissal. A late notice is accepted if the delay was not your fault and you notify the employer without delay afterwards. In a special case unrelated to the pregnancy, miscarriage or birth, the competent Land authority can exceptionally permit dismissal.

Give the employer the due-date certificate and actual birth date so the dates can be calculated. If you choose to work in the six-week pre-birth period, state your agreement clearly and withdraw it if you change your mind.

Maternity payments and applications

Section 19 refers statutory members to the Mutterschaftsgeld rules in Book V. Section 24i requires a qualifying entitlement, such as entitlement to sickness benefit or loss of employment pay because of the protection periods. For eligible members employed at the start of the pre-birth period, the payment uses the average daily net pay of the last three settled calendar months and is capped at 13 euros per calendar day from the insurer, with an employer supplement above that amount where due. Section 24i also provides payment at the sickness-benefit rate for other eligible members, including those whose employment ends immediately before the protection period. Membership alone does not establish the amount. Eligible employees who are not statutory members can apply to the Federal Office for Social Security for up to 210 euros in total. That office says people working exclusively as self-employed do not qualify for its payment. Under section 24i (4), statutory Mutterschaftsgeld rests to the extent and for the days that contributory remuneration is still paid during voluntary work in the six weeks before birth. The claim also rests to the extent and for as long as the member receives other contributory pay, work income, or compensation for unused leave. A one-off payment does not cause it to rest.

Ask the insurer or the Federal Office for Social Security for the right application and due-date evidence; coordinate the employer’s supplement separately. Check the route promptly if a job ends, you have a Minijob, you are unemployed or self-employed. Confirm entitlement and dates with the payer rather than assuming that pregnancy or insurance membership alone guarantees a payment.

Before choosing Elterngeld months, account for maternity benefits. Statutory Mutterschaftsgeld and the employer’s supplement for the same child are credited against the receiving parent’s Elterngeld from birth. If Elterngeld is higher, only the difference is paid in addition. A life-month with entitlement to relevant maternity benefits even for one day counts as a Basiselterngeld month for that parent. The federal one-off payment of up to 210 euros is not credited in this way; an employer supplement remains relevant. Use the Elterngeld guide and Familienportal’s explanation when planning; ask the Elterngeldstelle about your exact benefits and dates.

For the full application and planning rules, use Elterngeld and parental leave. Applying for maternity pay does not notify Elternzeit to the employer.

Financial and practical help before birth

If money is short, contact a pregnancy counseling centre early. It can help identify the responsible benefit office, support with applications and connect you with practical help. Ask about your own eligibility, including any residence or study-related conditions.

• Foundation hardship support: Bundesstiftung Mutter und Kind support is needs-tested and has no automatic legal entitlement. The first application normally must be made during pregnancy through a counseling centre in your Land of residence. The foundation’s application FAQ explains the route; its federal office does not process individual applications. Do not wait until the baby has arrived. If you contacted a centre before an unexpectedly early birth, ask it promptly about the exceptional or follow-up routes.
• Pregnancy and baby-equipment needs: ask the competent Jobcenter about the pregnancy additional need under section 21(2) and initial equipment under section 24(3). Initial-equipment assistance can be relevant even without an ongoing living-cost payment if you cannot meet that need from your own means and meet the conditions. Ask before purchasing and obtain a decision; there is no single national equipment allowance or guarantee of reimbursement. If another support system applies, ask its responsible office.
• Help at home: under section 24h, a statutory member can receive household help when pregnancy or birth prevents her from running the household and nobody else living there can do it. Ask the insurer about the application and evidence. Frühe Hilfen and pregnancy support can also connect families with local practical assistance.

Use the existing housing-benefit and child-benefit guides for those separate applications. An application for one payment does not automatically claim the others.

Choose a birth setting and prepare for delivery

Discuss hospital, birth-centre and home-birth options with your doctor and midwife. Out-of-hospital birth requires assessment of medical risks and a transfer plan; it is not suitable for every pregnancy. A hospital has different emergency and pain-relief facilities. If specialist neonatal care may be needed, ask which facility can provide it. The official comparison of birth settings explains the differences.

Contact the chosen provider early about its registration appointment, referral requirements, documents, language support, birth partner, accessibility and costs. Ask what to do if labor starts, the waters break or the team is unavailable; save the delivery-room number and plan the journey and care of other children. Birth preferences can cover pain relief, support and feeding, while leaving room for clinical changes. A preparation class can help you discuss those choices.

Statutory insurance covers eligible inpatient or outpatient birth care under section 24f. Optional family rooms, a particular on-call midwife and other private extras need a separate cost check; private cover depends on the contract. Take the Mutterpass, insurance details, identity documents and the provider’s requested papers, plus practical items for you and the baby. The birth-preparation overview provides a packing checklist. Confirm what your own hospital supplies rather than buying everything on a commercial list.

Prepare parenthood documents and applications

Ask the Standesamt of the expected place of birth which parental documents it needs, particularly for foreign certificates or a previous marriage. Check documents and translations before paying for them. If parents are not married to each other, discuss Vaterschaftsanerkennung and, if desired, a separate Sorgeerklärung with the Jugendamt or competent office before birth. Paternity acknowledgment normally requires the mother’s consent, unless she has died; the child’s separate consent is also required, with representation rules for a child. It does not itself create joint custody. Different parenthood situations need individual advice; the official unmarried-parents overview explains the routes.

Prepare applications and a task list before the birth, then add the actual birth evidence where required. The separate guides explain birth notification and certificates, Elterngeld, Elternzeit and Kindergeld. The hospital’s birth report does not make those benefit applications. Ask the insurer how to enroll the baby; free statutory family cover has conditions and is not guaranteed in every family. If the child needs a passport or residence document, ask the relevant consulate and foreigners authority about the applicable route.

During birth and when to seek urgent help

Labor, delivery of the baby and delivery of the placenta are different stages. Pain relief, an assisted vaginal birth or a planned or urgent Caesarean section may be discussed according to your circumstances. Ask the care team about the reason, benefits, risks and alternatives, and tell them if you do not understand. The federal health portal’s birth overview explains these options; it does not replace your individual birth plan.

Follow the contact plan agreed with your maternity team when labor starts or your waters break, and contact it promptly about worrying symptoms rather than waiting for an ordinary appointment. Call 112 for a life-threatening emergency. For urgent non-life-threatening medical help when practices are closed, 116 117 can direct you to on-call care; the phone service is in German. See emergencies and doctors. Do not delay an emergency call while looking for documents or a translator.

Recovery, feeding and the baby’s first checks

Before discharge, confirm who will visit at home, whom to contact if problems arise and which maternal follow-up appointment is needed. A midwife can help with recovery, wounds, feeding and the baby’s early development. Section 24d provides statutory postpartum midwife care through twelve weeks after birth; further postpartum care requires a doctor’s order. Separate help with breastfeeding or infant-feeding difficulties can be covered beyond twelve weeks within limits. Ask the midwife or insurer about the conditions and any extended care. A Caesarean section, a premature baby or a baby staying in hospital needs its own discharge and follow-up plan.

Ask for help with breastfeeding or bottle feeding rather than struggling alone, and discuss postnatal exercise, contraception and returning to usual activities with the care team. Tell a midwife or doctor about persistent sadness, anxiety, a distressing birth experience or difficulty coping; the mental-health guide explains access to further care. Practical help and recovery matter alongside the baby’s care.

Confirm which newborn examinations and screenings have been completed and who will do the remaining ones, especially after an early discharge or an out-of-hospital birth. The BIÖG examination schedule places U1 after birth, U2 on days 3–10 and U3 in weeks 4–5. Arrange the pediatric appointments promptly and bring the yellow examination booklet, the baby’s insurance information and vaccination record where available. Ask the pediatric team about screening, vaccinations, safe sleep and feeding rather than waiting for a later routine appointment to raise a concern.

Pregnancy loss, uncertainty and confidential support

After a miscarriage, stillbirth or the death of a baby, ask the care team about medical follow-up, midwife support and grief counseling. Employment protection and civil registration use their own rules; have the provider establish the applicable medical facts rather than classifying the loss yourself.

Section 3(5) gives employment-protection periods after miscarriage of two weeks from the 13th week of pregnancy, six weeks from the 17th and eight weeks from the 20th, unless you expressly agree to work; you can withdraw that agreement for the future. A stillbirth does not trigger the twelve-week extension described above. After a child’s death, section 3(4) permits a return only after the first two weeks following delivery, on your express request and with medical clearance. Ask the payer about maternity benefits and the birth-registration guide about the separate stillbirth-reporting rules.

If the pregnancy is unplanned, you are uncertain about continuing it, or your safety or privacy is at risk, seek confidential pregnancy counseling promptly. The official counseling locator includes filters for recognized counseling certificates and other services. Ask the centre directly about language help and the relevant time limits. If nobody may learn of the pregnancy, confidential birth offers a medically supported route with protected identity; a qualified counselor explains the procedure and the child’s later right to know their origins. It is not the same as simply omitting birth registration.

Common mistakes

• Waiting until late pregnancy to look for a postpartum midwife, or assuming that the hospital has booked one for home visits.
• Signing for optional tests or a family room without checking coverage and private charges.
• Treating Mutterschutz, maternity pay, Elternzeit and Elterngeld as one application, or assuming one payment rule covers every employment and insurance status.
• Treating every early birth as medically certified prematurity, or every birth as qualifying for twelve weeks of protection.
• Waiting until after birth to make the first foundation-hardship application, or making purchases assuming reimbursement is automatic.
• Leaving U2, the baby’s insurance or birth-notification arrangements until after discharge without agreeing who will handle them.