This INFOrmation Page exists as a guide through the legislation and administrative details of having a baby in Germany.

As soon as pregnancy is suspected visit a gynaecologist (Frauenarzt/Frauenaerztin) for confirmation.

Employers and Health Insurance

An employer should be verbally informed of the pregnancy as soon as possible. If the employer requires written confirmation of the pregnancy from a doctor (ärztliches Attest) it must be paid for by the employer.

The German health insurance company (Krankenkasse) must also be informed of the pregnancy. The health insurance pays for medical treatment throughout and is also responsible for maternity payments (Mutterschaftsgeld) along with the employer. In general the health insurance will cover all necessary costs of antenatal examinations as well as the cost of prescribed medicines during the pregnancy or at the time of the birth.

Non-German residents are not covered by the health insurance if they don't have a German employer, but women may be covered through their partner's employer.

Six weeks before the baby is due the gynaecologist will provide written confirmation of the expected date of the birth (Bescheinigung zum voraussichtlichen Entbindungstermin) to inform the health insurance company when maternity payments should commence. The employer does not require this confirmation.

Note: There is a difference between the statutory and private health insurance companies. Statutory health insurance companies cover all costs on production of the insurance card (Versicherungskarte). With private health insurance the ammount reimbursed depends on the level of cover agreed between the patient and the insurer. If a woman is unable to work due to pregnancy, abortion, miscarriage or as a result of the birth the private insurers do not pay sickness payments. For those who are self-employed, private health insurance does not cover pregnancy.

• More information on health insurance is available from the Federal Ministry for Families, Pensioners, Women and Youth (in German)

The Mutterpass

Following the initial consultation with the gynaecologist all pregnant women are given a mother's passport (Mutterpass). The Mutterpass records the immediate details of the pregnancy, birth and the mother's health in the period following the birth and can be used for up to two pregnancies. This serves as:

• Confirmation of the pregnancy
• A record of all medical procedures throughout the course of the pregnancy and can be used to provide third parties such as hospital and clinic staff with information prior to the birth
• A record of the mother's general state of health and of any pregnancy-related complications or chronic illnesses
• A document for administrative follow-up

Prenatal Care (Vorsorgeuntersuchungen)

Almost all prenatal examinations can be done by midwives or doctors, the only exception is the ultrasound examination which must be done by a gynaecologist. 

• At the initial examination a general case history is assessed from blood and urine samples taken and tested to determine iron levels, resistance to rubella and toxoplasmosis and other infections. Results are recorded in the Mutterpass
• At all regular examinations blood pressure and weight are monitored and urine samples analysed
• Blood is checked at least twice during pregnancy for iron levels and cell counts
• The heartbeat of the foetus is also monitored

Every pregnant woman is entitled to ten or more antenatal examinations on recommendation by the gynaecologist. These are reimbursed by the health insurance companies. For unemployed persons the welfare state covers these costs.

Three ultrasound examinations are given in the third, sixth and eighth month of the pregnancy. However, as most gynaecologists have ultrasound equipment in their surgery it is not uncommon for scans to be done at each visit. At 20 to 22 weeks some gynaecologists may recommend a 4D scan (Feinultraschall) usually performed by a specialist gynaecological practice which provides a more detailed image of the foetus.

• For full details of all tests and an explanation of information recorded in the Mutterpass: Click here (in German)

Finding a Midwife

Under the terms of German health insurance twelve advice sessions with a midwife (Hebamme) are paid for during pregnancy as well as the costs of aftercare for up to eight weeks following the birth. Daily visits by a midwife until the baby is ten days old are also covered.

The HebammenSuche website has a directory of midwives (in German) and a search facility for finding midwives based on the languages they speak, their location and the facilities they offer including antenatal (Geburtsvorbereitungs) and postnatal classes and home births. Hospitals and birthing clinics (Geburtshaeusern) also have lists of the midwives who work there. 

In some hospitals (check beforehand) it is possible for the patient to take their own midwife into the delivery room, but the hospital midwife must usually perform the delivery.

Where to give birth

There are three main options in Germany: a hospital birth, a birthing clinic or a home birth.

Hospitals

Many hospitals in Germany hold regular information sessions for pregnant women where doctors, nurses and anaesthetists explain their services and facilities (including water births). This is followed by a question and answer session and a visit to the maternity suite. Contact the hospitals for details.

• See the KIDSgo! website for information on these sessions (in German)

A mother may choose to stay in hospital for a few days following the birth (stationaere Geburt). The usual length of stay is three to five days but it may be longer at the mother's request. Alternatively she can opt for an "out-patient" birth (ambulante Geburt). An out-patient birth may take place in a hospital, birthing clinic or at a midwife or doctor's surgery. After the birth the health of the mother and baby are monitored for a period of no less than four hours before they are allowed home.

As the number of maternity beds is limited in each hospital, pre-registration with the preferred hospital is recommended between the 33^rd and 36^th week of pregnancy.

Birthing Houses

A birthing house (Geburtshaus) is a non-clinical establishment for out-patient births and antenatal care. Most are operated by midwives and occupational therapists, but some have links to a doctor. There are approximately 100 of them in Germany and most are located within easy reach of a hospital for emergency care. They offer an alternative to hospital and home births for those who prefer a more holistic approach.

• For more details and a full list: Click here (in German)

Home Births 

Home births (Hausgeburt) are possible depending upon the qualification of the midwife to carry out the procedure. When choosing a midwife check to see if she offers home births.

Postnatal care

After the birth the midwife will visit daily until the baby is ten days old. She will check the physical health of the mother and baby and provide practical advice on baby care. Even once the baby is ten days old home visits or telephone advice can be sought from a midwife and the costs are covered by the health insurance.

In addition to the midwife's visits a statutory examination by a gynaecologist is given eight weeks after the birth to check the physical wellbeing of the mother and is recorded in the Mutterpass. Some midwives also hold postnatal classes for strengthening the pelvic floor (Beckenbodenrueckbildung) and the costs of these are covered by the health insurance.

The child's health record 

A child health record (Kinder-Untersuchungsheft) is given to the mother following the birth and must be taken to every medical consultation (untersuchung) the child has until they are five years of age. It is used to record the developmental progress of the child including height, weight, vision and hearing as well as any tests which may be carried out. The health record also lists how old a child should be for each statutory developmental examination.

The first examination "U1" is done as soon as the baby is born. Its immediate status of health and the technical details of the birth are recorded on the first page. The baby must be taken to a paediatrician (kinderarzt) for a second examination, "U2" when it is between three and ten days old.

Vaccinations

In Germany vaccinations are voluntary not mandatory.

Vaccinations are recorded in a small international (printed in German, English and French) certificate of vaccination (Internationale Bescheinigungen ueber Impfungen und Impfbuch) which accompanies the child's health record. This details the manufacturer and batch number of the vaccine, the date the vaccine was given, the disease it protects against and the signature of the person administering it.

The first course of vaccinations starts when the baby is approaching thee months old. In Germany a "6-in-1" vaccination is given against whooping cough, tetanus, diphtheria, meningitis (Hib), hepatitis B and polio and the dose is repeated twice at approximately six weekly intervals.

The first dose of the MMR vaccine is recommended for babies between 12 and 15 months old followed by a second dose between the ages of 16-24 months.

Registering the Birth

The birth must be registered within one week at the registry office (Standesamt) of the district where the child was born. The birth can be registered by the following people:

• the midwife who was present the birth
• the father if he has joint parental responsibility
• the doctor who was present
• any other person present at the birth or who has been informed of the birth
• the mother once she is physically able to do so
• In some cases officials visit hospital maternity units and can register the birth during the mother's hospital stay

In order to register the birth the following documents are required:

• Confirmation of the birth (Geburtsbescheinigung) given by the hospital, doctor or midwife
• A copy of the birth and marriage certificates of the parents. Some registry offices require official German translations of these documents while others will accept the original versions

Normally several copies of the birth registration document (Geburtsurkunde) are given for official purposes (such as for child benefit or health insurance). A parent may request (and pay for) additional copies which may be needed in future years when the parents and child may no longer live in the country. An international birth certificate (in French, German and English) should be available from all registry offices at no extra charge. This can save the expense of having a birth certificate produced by the embassy of the child's nationality. The registry office will also automatically inform the relevant tax authorities of the child's birth so that income tax data can be changed.

The birth registration document is used to obtain identity cards, passports and make registration at nurseries and schools.

Employment Protection (Mutterschutz)

Under the German law on employment protection (Kuendigungsschutz) an employer cannot terminate employment during the pregnancy and in the four months following the birth. It is therefore advisable to inform the employer of the pregnancy as soon as possible.

Before and after the birth there is a period of protected maternity leave (Mutterschutzfrist) plus a right to maternity payments (Mutterschutzgeld).

In addition, even if a pregnant woman does not have statutory health insurance the employer is obliged to allow time off for any prenatal appointments which occur during work time without any financial penalties. The maternity leave period and other maternity related restrictions on employment are counted in the calculation of convalescence leave as a period of employment. Any salary increases which become effective during the maternity leave period should be taken into account.

Maternity leave

The protected period for maternity leave is six weeks before the birth and eight weeks after (or twelve weeks after in the case of premature or multiple births). There is no option to alter this split. The period of protected employment is automatically increased if the mother takes extended maternity leave.

Maternity Pay 

For the six weeks preceding the birth employed women receive statutory maternity pay (Mutterschaftsgeld). This is paid jointly by the health insurance company (Krankenkasse) with a contribution from the employer (Arbeitgeberzuschuss). Small businesses receive a full refund of their costs from the relevant health insurance company.

Privately insured and self-employed women can claim maternity leave and the employer contribution. Maternity pay in these cases is limited to a maximum sum and is paid by the Federal Office for Insurance (Bundesversicherungsamt). Pregnant women with no health insurance and working part-time must contact the Office direct.

• Bundesversicherungsamt
  Mutterschaftsgeldstelle
  At: Reichpietschufer 74-76, 10785 Berlin

Parental Leave (Elternzeit)

In addition to the protected maternity leave a period of parental leave may be taken until the child reaches the age of three. If the employer agrees, one of these years may be "saved" and used when the child is between the ages of three and eight. Parental leave rights apply to all employees regardless of full- or part-time status, fixed term contracts or casual employment. No salary is paid during this period and the employer must be informed in writing seven weeks prior to the start of intended parental leave. The employer is legally obliged to keep the job open for the period of parental leave.

Parental leave can be taken by either parent and can also be shared for the period. The law on employment protection also applies for the duration of parental leave. It is also possible for parents to work part-time for up to 30 hours a week without affecting the terms of parental leave or employment protection rights.

Child Allowance 

Since January 2007 new laws have come into effect whereby the former child raising allowance (Erziehungsgeld) has been replaced by an allowance for parents (Elterngeld). However, the old regulations still apply to children born in 2007. In order to qualify for this allowance an application must be made to the Federal Office for Youth (Jugendamt).

Elterngeld is assessed as 67 percent of the net income of the mother or father (the average of the previous 12 months before the birth) up to a maximum of €1800 per month. Elterngeld is paid for a period of 12 months or 14 months if both parents take leave to care for the baby. The aim is to encourage fathers to take time off to care for their children. It is also possible for both parents to claim Elterngeld and the number of months reduces accordingly. Alternatively, it can be paid for twice as long and the monthly amounts reduced by half.

• For more information see the Elterngeld web portal (in German)
• For an online calculation tool: Click here (in German)

Child Benefit

A copy of the birth certificate (Geburtsurkunde) must be sent to the Families Office at the Department of Employment (Familienkasse beim Arbeitsamt) to register for child benefit. Child benefit is paid until the child reaches 18 (or 21 if unemployed) or until 27 if in educational training. There is no limit for disabled children who will never be able to support themselves financially. It is paid irrespective of the parents' income.

Citizenship

Since 1 January 2000 any child born in Germany to non-German parents can acquire German nationality if the parents have been resident in the country for eight years and if they are from an EU Member State. Children of non-German nationals may have dual nationality, but must choose between the two after their 18^th birthday.

Further Information

• Bundeszentrale für gesundheitliche Aufklärung (BZgA): the Federal Centre for Health Education has a comprehensive guide to pregnancy (in German)
• KIDSgo!: an informal magazine site for pregnant women with information on midwives and prenatal classes. It also contains useful links to midwives, birthing clinics and hospitals including details of public information sessions
• The Federal Ministry for Families, Pensioners, Women and Youth provides information on becoming a parent in Germany
• Rund ums baby: online magazine for parents to be

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