Pregnancy and Birth in Germany: Midwives, Money and the Paperwork After

1. Book a Midwife Before You Book Anything Else

Germany has a genuine shortage of midwives, and it hits hardest in the postnatal weeks when you need one most. Midwives in Berlin, Munich, Hamburg and Cologne routinely fill their calendars for a due date six or seven months out. Some rural districts have no free capacity at all.

Start calling in the first weeks of pregnancy, before the first ultrasound, even if all you want is the postnatal care. Your Hebammenzentrale, the local midwife exchange, keeps lists for the district. Your gynaecologist and other parents in your neighbourhood usually know who still has slots.

Statutory insurance covers her work in full. Postnatal care at home gives you up to two visits a day until the eleventh day after the birth, then a further 16 contacts until the end of the twelfth week. She can also run your pregnancy check-ups alongside your gynaecologist, and the birth preparation class for the mother is covered, though partners usually pay their own share.

Your insurer settles all of it directly with the midwife. Money only changes hands for extras such as a personal Beleghebamme for the delivery itself.

2. What Prenatal Care Looks Like

At the first confirmed appointment your gynaecologist issues the Mutterpass, a small booklet holding every result from then on. Carry it. Every clinic in the country reads it, and in an emergency it replaces a conversation you may not be able to have in German.

Check-ups run every four weeks until the 32nd week, then every two. Statutory insurance covers three ultrasound scans, one per trimester, plus the standard blood work, and the practice bills your fund directly.

Anything beyond that arrives as an IGeL offer, an individual service you pay for yourself: extra scans, toxoplasmosis screening, additional blood tests, typically 20 to 200 euros each. Ask which risk the test addresses in your case before you agree to it.

The birth costs you nothing on a statutory contract, whether you deliver in a hospital, a Geburtshaus or at home with a registered midwife.

3. Mutterschutz: The Dates That Set Your Last Working Day

Maternity protection under the Mutterschutzgesetz is not something you apply for. It applies to every employee, including part-timers and Minijobbers, and it starts the moment you inform your employer.

• Six weeks before the calculated due date your protection period begins. You may keep working if you want to and say so in writing, and you can withdraw that any day.
• Eight weeks after the birth you must not work at all. This half is absolute, and no request changes it.
• Twelve weeks after the birth applies to premature and multiple births, and when the child is born with a disability. If your child arrives early, the days you lost before the birth are added to the period afterwards.

Dismissal protection runs from the start of the pregnancy until four months after the birth, and it holds through the probation period. Tell your employer in writing once you decide to, since the protection depends on their knowing.

Self-employed women fall outside the Mutterschutzgesetz entirely. Freelancers with a statutory fund can claim Krankengeld from a doctor-certified inability to work, so plan the income gap around your due date rather than assuming a benefit covers it.

4. Mutterschaftsgeld and Who Pays It

During the protection period your income is replaced from two sources, and which fund you belong to decides the split.

| | Statutory insurance (GKV) | Private insurance or family cover | |---|---|---| | Paid by the insurer | Up to 13 euros per day | One-off, up to 210 euros | | Paid by the employer | Difference up to your full net pay | Difference up to your full net pay | | Where you apply | Your Krankenkasse | Bundesamt für Soziale Sicherung, Bonn | | When | About seven weeks before the due date | About seven weeks before the due date |

The net result is the same for both groups: you receive your usual net salary throughout. Only the paperwork differs, and privately insured mothers are the ones who forget the federal office exists.

You need a medical certificate of the expected date of delivery, issued no earlier than the seventh week before it. Send it with the application, not afterwards.

5. Germany Still Has No Paid Leave for the Second Parent

Expat parents from Spain, Sweden or the UK arrive expecting a paid leave entitlement for the partner. Germany does not have one in 2026.

The Familienstartzeitgesetz would have given ten paid days directly after the birth. It stalled with the previous government, stayed out of the current coalition agreement, and the EU has an infringement procedure running against Germany over the missed deadline.

The second parent uses annual leave, unpaid Elternzeit, or whatever the employer offers voluntarily. Larger companies increasingly pay one or two weeks as a benefit, so check your contract and works agreement rather than the law. Elternzeit must reach the employer at least seven weeks before it starts, which means filing well before the due date if you want the weeks straight after the birth.

6. Insuring the Child, and the Trap for Mixed Couples

A newborn needs cover from day one, and how that works depends on the parents' contracts.

Both parents in statutory insurance. The child joins the Familienversicherung of one parent at no extra cost. You notify the fund after the birth and send the birth certificate.

Both parents privately insured. The child needs an own contract. Register within two months of the birth and the insurer must accept the child without health questions, waiting periods, risk surcharges or exclusions. Miss the window and a normal application with underwriting follows, which matters enormously if the birth brought any complication.

One parent statutory, one private. Free family cover is blocked when the privately insured parent both earns more than the statutory-insured parent and earns above the annual threshold of €77,400. In that case the child needs a paid policy, statutory or private. Run the numbers before the birth, because the answer changes what you file and when.

If you want the whole conversation in English, including what a private policy for the child costs over 20 years, a broker who works with expats is worth an hour of your time.

Our comparison of public and private health insurance sets out the long-term consequences for the whole household.

7. Unmarried Parents Sign Two Documents, Not One

German law treats the two questions separately, and both are free at any Jugendamt, Standesamt, district court or notary.

Vaterschaftsanerkennung establishes legal fatherhood. Without it, an unmarried father is not the legal parent, no matter what the couple agree between themselves.

Sorgeerklärung establishes joint custody. Recognising paternity does not grant it. Until both parents declare joint custody, the mother holds sole custody by law.

Do both before the birth. The Standesamt then enters the father directly on the birth certificate, and you skip a round of appointments in the weeks when you least want them. Married parents need neither document.

8. Registering the Birth With Foreign Documents

Hospitals report births to the Standesamt themselves, usually within a week. For a home birth or a birth centre delivery, the parents report it, and the deadline is one week.

The part that catches international couples is the document check. The Standesamt needs proof of identity and, if you are married, your marriage certificate. Foreign records generally require a certified translation by a translator sworn in Germany, submitted with the original, and depending on the issuing country an apostille or legalisation on top.

Sorting that out takes weeks, and offices in some countries answer slowly. Ask your Standesamt which documents they want during the pregnancy, not after the birth. Our guide to certified translations explains who may translate what and roughly what it costs.

Order at least five copies of the birth certificate, and say they are for Elterngeld, Kindergeld and insurance purposes. Several offices each want an original, and the copies you order later cost another trip.

9. The Order of the Paperwork Afterwards

1. Tell your health insurer and register the child. Statutory family cover after the birth, private cover within two months.
2. Send a short written notice to the Elterngeldstelle as soon as the child is born. Elterngeld pays back three months at most, and one line preserves the claim while you collect documents.
3. Apply for Kindergeld once both Tax IDs exist. The child's Tax ID arrives by post automatically after birth registration. Kindergeld backdates six months only, so filing late costs real money. Our Kindergeld guide has the forms and the document list for foreign parents.
4. File the full Elterngeld application with the income proof for the twelve months before the birth.
5. Register the child's residence if your Bürgeramt does not do it automatically from the birth entry.
6. Notify your employer about Elternzeit, seven weeks ahead of the leave you want.

10. The U-Untersuchungen

Children in Germany go through a fixed schedule of check-ups recorded in the gelbes Heft, the yellow booklet you receive at the birth. U1 and U2 happen in the hospital, so your first appointment to book yourself is U3.

| Check-up | When | |---|---| | U2 | Day 3 to day 10 | | U3 | Week 4 to week 5 | | U4 | Month 3 to month 4 | | U5 | Month 6 to month 7 | | U6 | Month 10 to month 12 | | U7 | Month 21 to month 24 |

Later appointments follow at U7a, U8 and U9, up to the fifth year. Statutory insurance covers the programme in full.

Most federal states run an invitation and reminder system. Parents who skip an appointment receive a letter, and if no appointment follows within about a month, the state passes the child's details to the local health and youth office. Book U3 while you are still in the hospital, since paediatricians in the cities are as booked as midwives.

11. Before the Due Date

1. Call midwives in the first weeks, for the postnatal care at minimum.
2. Ask your Standesamt which foreign documents they need, and start any apostille early.
3. Apply for Mutterschaftsgeld around seven weeks before the date, at your fund or the federal office.
4. Sign paternity and custody declarations if you are not married, and ask your insurer in writing what the child costs under your contract.