Childbirth in Germany: Now I will note that I am an American, and as such, found some differing customs between the US and Germany when a child is born. Starting a family in a foreign country may feel stressul but fortunately, similar to the excellence seen across various facets of German healthcare, the level of care is notably high. Whether you’ve recently learned of your pregnancy or are actively trying to conceive, the following article will try to provide an overview of what you can anticipate when expecting in Germany.
The German Health Insurance System
In the German health insurance system, expecting parents can navigate the process with comprehensive coverage. During your first appointment with the Frauenarzt (OB/GYN), which takes place about eight weeks after conception, an important document known as the Mutterpass (Mother’s pass) is given to you where every examination, blood test, daily check-up and CTG (electronic fetal monitor, EFM) scan throughout the pregnancy and birth is meticulously recorded.
Health insurance with the German system covers the costs associated with the services of a midwife, a specialized healthcare professional catering to a new mom and newborn babies. When opting for a private hospital, it is advisable to ascertain the extent of coverage provided by health insurance and the potential expenses for the baby’s delivery and care.
Popular private health insurance companies in Germany, known as Krankenkassen, such as Allianz Care and Cigna Global, offer diverse coverage options. Additionally, the German government has introduced the ElterngeldPlus package to support new parents working part-time post-birth. This comprehensive system ensures that both mothers and babies receive the necessary care, making the process of having a baby in Germany well-supported and widely accepted.
Before the Baby Arrives
You are supposed to attend 12 standard check-up sessions during your pregnancy before the baby’s due date (Termin Datum): initially scheduled every four weeks until week 32 and subsequently shifting to biweekly appointments. Your employer is obligated to grant you time off to facilitate your attendance at these appointments. Standard care typically encompasses:
- Ultrasounds
- Urine analysis
- Blood pressure assessments
- Weigh-in
- Blood tests
- Pelvic floor examinations
Near your due date, the baby’s heartbeat and any contractions will be measured more often as well.
Non-Invasive Prenatal Testing
A special test called Non-Invasive Prenatal Testing (NIPT) has been around in Europe since about 2012. This test helps check if the baby might have certain conditions, like Down syndrome.
In Germany, they are still figuring out how to include this test in their regular healthcare for pregnant women. In 2019, the important German Federal Joint Committee suggested that public insurance should pay for NIPT.
However, it’s not like a routine test for everyone. Instead, a pregnant woman can choose to have it after talking with a counselor. They decide if it’s needed for their situation. This is different from how some other countries are doing it, where NIPT is either offered to women with high-risk pregnancies.
Prenatal Classes
Typically, you start your birth preparation classes around the 25th week of pregnancy. In Germany, the Dick-Read Method is widely embraced, emphasizing relaxation techniques to alleviate pain during childbirth.
Alternatively, Lamaze, yoga, partner sessions, and other classes focusing on breathing techniques are also accessible. Notably, German state health insurance has expanded coverage to include birth preparation courses tailored for fathers. Your midwife serves as a valuable resource to explore specific classes available in the local vicinity.
Also, most hospitals host an information evening (Infoabend), providing prospective patients with the opportunity to tour the facilities, interact with the staff, and pose inquiries. After settling on a choice of a hospital and midwife, it is advisable to pre-register at your selected hospital to streamline all necessary arrangements beforehand. You will be required to present your Mutterpass, passport, and potentially a copy of your birth certificate (as well as a marriage certificate, if applicable).
Announcing Your Pregnancy
There is a delightful tradition in certain regions where families announce the arrival of their newborn to the world. This is done by placing a sign in front of their house or apartment, featuring a stork alongside baby-related items like clothes and a crib. Unlike discreet announcements, this sign is often prominently displayed for weeks, either in windows, on doors, or even on the exterior of the house.
Baby Showers
Baby showers are NOT held in Germany, out of a belief it is unlucky to celebrate the birth of a child before the child is actually born. Also, similar to French mothers, German mothers often find it perplexing to purchase gifts before the baby’s arrival.
In many European countries, the tradition involves friends, family, and acquaintances visiting the new mother and baby once they return from the hospital and in the subsequent weeks. During these visits, guests typically bring gifts, and the new parents are expected to host them to some extent. While this can be demanding for the new parents, considerate guests may bring food or offer assistance. Gifts are often sent by more distant acquaintances who may not be able to visit in person.
Giving Birth in Germany
If you believe you are in labor, go to your selected hospital and bring along your Mutterpass. Upon arrival, a thorough examination will be conducted to confirm labor, and if confirmed, you will be admitted to a delivery room (Kreißsaal). The midwife then takes over and if you are privately insured or if necessary, the head doctor will also oversee the process.
Following your baby’s birth, you’ll be allotted time for recovery before being transferred back to the maternity ward with your new baby. The standard post-birth hospital stay in Germany ranges from three to seven days (or up to 14 in the case of a caesarean section), although early release can be requested.
Unless covered by private insurance or opting for additional payment, you may share a room with another patient; however, family rooms with double beds are typically available in maternity wards for fathers. Throughout this period, dedicated nurses will regularly check on you the entire time, providing assistance with postpartum care, breastfeeding, and bathing.
Your baby will undergo various health checks to ensure their well-being. The midwife can also teach you how to handle the umbilical cord stub and do a baby massage as part of the comprehensive care provided in German hospitals.
All Natural
You will probably notice that holistic medicine, particularly homeopathy, enjoys broader acceptance in Germany and receives endorsement from the medical community. Your healthcare team, including your doctor, midwife, and other medical professionals, may advocate and administer therapies such as acupuncture, acupressure, and massage to address various medical conditions, particularly during the labor process. Home births often make use of such methods and alternative medicines. Instead of resorting to antibiotics as a routine measure, herbal teas, and homeopathic medicines are frequently prescribed or recommended for both you and your baby.
Also, if you were considering a water birth, there’s a chance it could be a viable option. Many German hospitals are equipped with bathtubs in their delivery rooms. However, the availability of a bathtub typically hinges on whether one is unoccupied at the time of your arrival.
Registering a Childbirth: Germany and its Birth Certificate Procedures
To get a child’s birth certificate, the baby has to be registered within a week with the Standesamt in the city where the child was born. Registration can be personally done or delegated to a doctor or a relative. In the event of medical assistance, a registered nurse will guide this process within the maternity unit.
The resulting document, often referred to as a Geburtsbescheinigung, is essential for further administrative procedures. It may involve providing additional documents like parents’ birth or marital certificates, potentially requiring translations if you are foreigners.
Subsequently, upon submitting the required paperwork, the Standesamt issues both a German Birth Certificate and an International Birth Certificate in multiple languages, including French, German, or English. These certificates play a crucial role in obtaining identity cards, passports, and make it easier to enroll the child at nurseries and schools.
Non-residents Having a Baby in Germany
Non-residents having a baby in Germany navigate a well-established and supportive healthcare system. While residency status is not a prerequisite for receiving medical care, it’s essential to consider potential financial implications.
Tourists in Germany need to have health insurance, and European Union (EU) citizens can leverage the state-provided European Health Insurance Card (EHIC). Non-residents or visitors seeking a Schengen Visa must secure travel cover, typically amounting to €30,000.30 per year. Those not requiring a visa in advance should opt for Prepaid Travel Insurance. It is crucial to note that while some insurance policies cover pregnancy during the first trimester, these policies do not extend beyond that period without adding additional components. Understanding documentation requirements is really important for non-residents, ensuring a smooth and well-supported childbirth experience in Germany.
Parental Leave in Germany
In Germany, when a family welcomes a new baby, they are entitled to 14 weeks of paid maternity leave. The EU also passed a directive in 2022 requiring all EU countries to give two weeks of paid paternity leave.
Distinct from paternity leave or maternity leave that begins at the child’s birth, parents can take up to three years of unpaid leave before the child turns 8. Payments during parental leave, known as Elterngeld, range from a minimum of €300 to a maximum of €1800 each, covering 65–100% of their salaries.
This leave typically spans a year but can be extended to 14 months if both parents are residing together. During this period, both parents have the option to take baby time, contributing to a flexible and family-friendly approach to parental leave in Germany.
Maternity benefits, serving as a form of income replacement, apply during pregnancy and the post-birth period. Eligibility for this benefit commences six weeks before the due date and extends for an additional eight weeks after childbirth or during maternity leave.
The German federal government has adopted a Scandinavian-inspired policy to encourage both parents to spend quality time with their newborn. This approach allows the entitlement to parental allowance to be shared between the child’s parents, facilitating the opportunity for both partners to take time off work to care for the new addition to the family.
Requirements for Parental Allowance
To qualify for such allowance, certain criteria must be met:
- You personally care for your child from birth.
- Your paid work does not exceed 32 hours per week during the allowance period, and it can be granted even if you were not employed before having a child.
- You reside with your child in the same household.
- You are a German/EU/EEA citizen, hold a permanent residence permit, or possess a residence permit allowing you to work in Germany.
- The combined annual income of you and your partner does not surpass 300,000 euros (or 250,000 euros for single parents).
- This allowance can also be claimed if you care for a child immediately from birth, even if it is not biologically yours, or if you adopt a child up to eight years old.
Moreover, the government has implemented the following initiatives:
- Maintenance Advance (Unterhaltsvorschuss): Additional support for children not receiving maintenance payments, commonly known as child support.
- Parental Allowance Plus (ElterngeldPlus): Further assistance designed to aid parents wishing to transition back to part-time work after the initial period has concluded.
- Partnership Bonus (Partnerschaftsbonus): An extension of four extra months for the Parental Allowance Plus payment if both parents opt for part-time employment over a four-month period. Notably, single parents are also eligible to apply for this bonus.
- Improved flexible working hours: Parents can now avail up to 24 months of unclaimed parental leave, which can be taken between the child’s third and eighth birthday, offering enhanced flexibility.
For detailed information on childcare allowances and benefits in Germany, you can refer to the BMFSFJ website.
Child benefits in Germany (Kindergeld)
The state offers child benefits, known as “Kindergeld,” to all German and, to some extent, foreign families. Parents receive a monthly child allowance of €250 for each underage child.
The quantity of child allowance is determined by the number of children, and it is not influenced by the parents’ income or earnings; whether or not you have an income has no bearing on the amount of child benefit you receive. For more information on child benefits in Germany and to find your local office, visit the Bundesagentur Fur Arbeit (Federal Agency for Work).
Nurseries and Childcare
Childcare options in Germany vary in terms of costs and availability. Many families opt for nannies who care for children up to 3 years old in their homes, while the state provides subsidies for these services.
Free childcare is available for young people aged 14 or 17, and children between three and seven can attend pre-Kindergartens and after-school clubs, although not all schools offer wraparound services for school-aged children (6+). As of 2013, there is a legal right for all children from the age of 12 months to have a partially subsidized childcare place. The primary types of German childcare include nurseries or crèches (Kinderkrippe) for children aged 0-3, preschools (Kindergärten) for children aged 3-6, childminders (Tagespflege), or nannies (Kinderfrau) for children of all ages, and after-school care (Schulhort) for primary school children.
The Baby’s Gender
Also, in Germany there is the option of a “blank gender” (“X”, alongside “M” and “F”) on birth certificates, meant for infants born with ambiguous genitialia, which is simply not an option in the United States. Germany has become the first country to permit parents to leave the gender designation on their baby’s birth certificate unspecified. The law grants parents of infants displaying characteristics of both sexes the option to refrain from assigning a specific gender to their child.
The primary objective of this legislation is to counteract “normalization” surgeries, a practice criticized by human rights groups and the United Nations for its potential harm. This significant law marks the first official recognition of individuals who do not conform strictly to male or female categories, according to law professor Konstanze Plett of Germany’s University of Bremen.
This recognition ensures that individuals outside traditional gender norms will not be compelled into conventional sex categories in various contexts. The law’s implications on matters such as marriage and civil unions remain undetermined, particularly given the absence of legalized gay marriage in Germany. Additionally, the legislation enables amendments to official documents like passports, allowing the use of an “X” designation for third-gender individuals.
Circumcision
Also, the practice of infant male circumcision has been debated in German courts for the last few years – while commonly done in the United States for medical and/or religious reasons. In Germany the practice has been seen as a battle between various religious authorities, the legal system, longstanding custom, and various medical and children’s rights organizations.
German lawmakers approved a law to safeguard the right to circumcise infant boys, demonstrating support for Muslims and Jews who were upset by a local court’s ban on the practice beforehand. The ban, based on the argument that circumcision constituted “bodily harm,” ignited a heated discussion on the treatment of Jews and other religious minorities. As of 2012, non-therapeutic infant male circumcision has been explicitly approved in the German Civil Code.
The Wedding Tree to celebrate a Girl’s birth
In lighter customs, sometimes when a baby girl is born in Germany, there is the tradition of a “wedding tree” – trees are planted in honor of the girl’s birth. When their daughter comes of age and decides to get married, the idea is that the family will sell the trees and the earnings will be used to help their daughter start her new household as a married woman. In terms of the gendered customs, these may be slowly changing, but since by and large German society expects people to be gendered male or female (or eventually identify on the binary) and because of the naming laws, this may be a slow change indeed.
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Peculiarities of the German Naming Law
Speaking of naming law, this is a major difference between the United States especially that I found. While each country tends to have different regulations in terms of names, in Germany these regulations are a bit more stringent. For example, the first name of a child must be gendered male or female – meaning you cannot have a gender ambiguous first name in Germany, so names like Hunter or Paige would be rejected.
The name chosen must also not cause offense or discomfort for the one using it, you cannot use last names as first names or the names of objects as first names, and in addition to all of this, it is the local Standesamt (magistrate/civil office) which approves or rejects names. Yes, the parents or individual may be able to appeal a decision, but because of these regulations and the inconvenience of appealing (every time a name is submitted you pay a fee, so it can add up in terms of inconvenience and cost), many names in Germany have a traditional sound to them. So don’t be surprised if you know a lot of Michaels or Sophies – whether they are adults or children! If you want to learn more about living and working in Germany, check out the other articles in the SmarterGerman blog for lots of details and insights.
FAQs about giving birth in Germany
Here are also some of the questions people ask about giving birth in Germany
Are baby showers a thing in Germany?
Baby showers are not as common or traditional in Germany as they are in some other cultures, such as in the United States. However, the concept is becoming more popular, especially in urban areas where people may be influenced by global trends. In general, Germans celebrate the impending arrival of a baby with family and friends, but the formalized event of a baby shower is not deeply rooted in German tradition.
What is the policy for pregnant women in Germany?
Germany has a well-established and comprehensive healthcare system that provides support to pregnant women. They typically receive regular medical check-ups, including ultrasounds and prenatal care, all covered by health insurance.
Maternity leave is also well-regulated, allowing expectant mothers to take time off work before and after childbirth while still receiving a portion of their salary. The country places a strong emphasis on the health and well-being of both the mother and the child during pregnancy.
What are the benefits of giving birth in Germany?
Giving birth in Germany comes with various benefits. The country boasts a high standard of medical care, with well-equipped hospitals and skilled hospital staff.
Women have the option to choose a water birth or a home birth too. Trained medical professionals and midwives play a crucial role in providing support throughout the birth process. Additionally, the German healthcare system covers most of the medical expenses related to pregnancy and childbirth. If you choose a private hospital, check what your health insurance covers.
Do I need private health insurance in Germany?
In Germany, health insurance is mandatory for residents. You can choose between statutory health insurance (public) and private health insurance.
Most residents opt for statutory health insurance, which provides comprehensive coverage and is based on a percentage of your income. However, if you meet specific criteria, such as being self-employed or earning above a certain income threshold, you have the option to choose private health insurance.
Summing Up: Traditions around Childbirth in Germany
Some life milestones such as starting a family and having a baby can feel daunting when living outside your home country. This exploration wanted to reveal the country’s commitment to good healthcare practices, from simple doctor’s office visits and prenatal classes to post-partum care and loving care for the new crying babies.
Also, the legal aspects around childbirth, including naming laws and the groundbreaking option for a “blank gender” on birth certificates, showcase Germany’s progressive stance. The comprehensive overview also covered maternity benefits and parental leave policies, making it easy for new parents to navigate the system and enjoy their new family members as a stress-free experience. If you’d like to learn more about German culture, come check us out on the SmarterGerman blog!