Pregnancy, Childbirth & Family Planning in Germany

Navigating pregnancy and childbirth can be exciting, but also overwhelming, especially in a new country. 

Germany’s healthcare system offers comprehensive support throughout the journey, from fertility treatments to postpartum recovery.

In this guide, you’ll learn:

• What prenatal, birth, and postpartum care is covered by German health insurance
  
• The differences between public and private plans
  
• Which fertility treatments are eligible for reimbursement
  
• What’s not included—and when you’ll need to pay out of pocket
  
• How to access family benefits like parental leave and child allowance
  
• Your options if you’re considering abortion or adoption

By the end, you’ll have a clear picture of how Germany supports families and what steps to take at every stage.

Pregnancies: What public and private health insurance covers

Both public and private health insurance cover a standard set of medical services to monitor your health and your baby’s development:

• Three ultrasound scans: Usually performed in the 9–12th, 19–22nd, and 29–32nd weeks of pregnancy. These monitor fetal growth, organ development, and placenta position.
  
• Urine, blood sugar, and bacterial screenings: Help detect gestational diabetes, urinary tract infections, or asymptomatic bacterial infections that could complicate the pregnancy.
  
• Blood tests: Determine your blood group and screen for infections like rubella, syphilis, and HIV. These early checks are vital for ensuring proper prenatal care.
  
• High-risk pregnancy screenings: If there’s any sign of complications, your doctor may recommend more advanced procedures like:
  
  • Cardiotocography (CTG): Measures fetal heartbeat and uterine contractions.
    
  • Amniocentesis: A test that analyzes amniotic fluid for chromosomal disorders or infections.
    
• Sonographic examinations: Additional ultrasounds may be prescribed if your pregnancy requires closer monitoring.
  
• Birth preparation classes: Mothers are entitled to 14 hours of classes, led by certified midwives. However, this coverage does not extend to partners, who must typically pay out of pocket if they wish to attend.

Most private health insurance (PKV or Privaten Krankenversicherung) plans cover the Non-Invasive Prenatal Test (NIPT), Pränataldiagnostik. This test can detect common genetic abnormalities (such as trisomy 21, 18, and 13) and allows parents to learn the baby’s sex early in pregnancy, typically from the 9th week onward.If you’re covered by public health insurance (GKV, or gesetzlichen Krankenversicherung), the NIPT is only reimbursed when there’s a medical indication, like advanced maternal age or abnormal ultrasound findings. Without such a risk factor, you must pay for the test yourself (from €130 to €300).

Coverage during birth

Whether you’re planning a hospital delivery or a home birth, both public and private insurance cover essential care:

• Maternity care
  
• Obstetric care
  
• Midwife support for home births
  
• Hospital delivery costs
  
• Birth centers run by midwives

Coverage after childbirth

Postnatal care is an essential part of recovery, and Germany’s health system provides generous support in the weeks and months after birth:

• Midwife visits:
  
  • Up to 20 visits within the first 10 days after birth.
    
  • 16 more visits are available until your baby is 12 weeks old.
    
  • Additional visits may be approved if your baby is premature or there are medical concerns.
    
  • If you’re having trouble breastfeeding, your midwife can provide further support at no extra cost.
    
• Gynecological follow-up: Includes a check-up about six weeks after delivery to ensure your recovery is on track.
  
• Postnatal exercises (Rückbildungsgymnastik): Up to 10 hours of classes with a physiotherapist or midwife. These help rebuild abdominal and pelvic floor strength and must be completed within 9 months of birth.

What is not covered?

There are a few services that are not included under either public or private health insurance unless medically indicated:

• Prenatal yoga and pregnancy-specific exercise classes (except in rare cases when prescribed).
  
• Doulas: These birth companions are not licensed medical professionals, so their services are out of pocket.
  
• Extra ultrasounds or optional blood tests: For example, if you want more than the three standard ultrasounds or genetic testing for reassurance, you’ll likely need to pay yourself.
  
• Dietary supplements: Items like folic acid or prenatal vitamins aren’t reimbursed.
  
• Partner support:
  
  • Birth preparation courses for partners are not covered.
    
  • The partner’s hospital stay (e.g., sleeping over in the maternity ward) is not reimbursed either.
    
• Pregnancy gymnastics: May not be covered by all public insurers—check with your provider for specifics.

If you’re a private customer at Feather, we recommend checking out this FAQ for more on what’s included under your plan.

Fertility treatments and reproductive services in Germany

Germany offers structured but limited fertility treatment support through public and private health insurance systems. 

However, eligibility rules, cost-sharing, and legal restrictions shape what’s available and who qualifies. 

Public health insurance: What’s covered and who qualifies

Under Germany’s public insurance system, fertility treatments are only partially reimbursed, and only if strict requirements are met. 

These rules are laid out in §27a of the Fifth Book of the Social Code, which governs financial support for medically justified fertility interventions.

Eligibility requirements are:

1. The couple must be legally married.
   
2. The female partner must be 26 to 39 years old, while the male partner must be 26 to 49 years old.
   
3. A doctor must confirm infertility and give a favorable prognosis for treatment.
   
4. Only the couple’s egg and sperm can be used (no donors allowed).
   
5. Medical or psychosocial counseling is mandatory before treatment begins.

If you fulfill these requirements, you can be approved for these treatments:

• Insemination (IUI):
  
  • Up to 8 rounds without hormone stimulation.
    
  • Up to 3 rounds with hormone stimulation.
    
• IVF: Up to 3 treatment cycles.
  
• ICSI: Also up to 3 treatment cycles.
  
• GIFT (Gamete Intrafallopian Transfer): Up to 2 cycles.

Before starting, the treating physician must submit a detailed treatment and cost plan to the insurance provider. If approved, the plan is valid for 12 months and must be completed within that time.

Public insurance typically covers 50% of approved treatment costs. The couple is responsible for the rest, plus any non-covered services or medications.

Private health insurance: Coverage varies by plan

For privately insured couples, benefits vary significantly depending on your insurance and contract. 

For example:

• On Feather’s standard private plan, fertility treatment is excluded.
  
• Feather’s Plus and Premium plans offer much broader support:
  
  • 80–100% reimbursement depending on the plan tier.
    
  • Up to 8 insemination attempts without hormones, and 3 with hormonal stimulation.
    
  • Up to 3 treatment cycles for IVF, ICSI, or GIFT (max. 2 attempts each).
    
  • Further attempts may be reimbursed after a live birth, as long as all requirements are met.

Yet, there are still some conditions to meet for coverage. They vary from one company to the next. At Feather, they are:

• Treatment addresses natural infertility and is medically necessary.
  
• The female partner is under 39.
  
• The couple is either married or in a stable partnership.
  
• Only the couple’s genetic material is used.
  
• A treatment and cost plan must be submitted and approved in advance.
  
• You must have had private health insurance for at least 24 months.

Always confirm coverage details with your provider before starting treatment. Conditions and reimbursement rates vary more widely in private insurance than in public.

What isn’t covered by private or public?

Whether public or private, several fertility-related services are excluded or only partially reimbursed:

• Egg donation and embryo donation: Illegal in Germany. Only the couple’s eggs and sperm may be used.
  
• Fertility preservation: Procedures like egg freezing for non-medical reasons (e.g., delaying parenthood) are not covered.
  
• Surrogacy: Also illegal in Germany.
  

Unmarried couples: Not eligible under public insurance. Some private plans may allow it, but coverage is not guaranteed.

Recommended resources

• German IVF Register (Deutsches IVF-Register, DIR): Offers comprehensive data on success rates, treatments, and clinics in Germany.
  
• Bundesärztekammer (German Medical Association): Publishes guidelines on medical eligibility and ethical oversight of fertility treatments.

Timeline of pregnancy care in Germany

Germany’s prenatal care follows a structured, trimester-based schedule, balancing routine checkups with optional screenings. 

During your 1st Trimester (Weeks 1–12)

• Initial OB-GYN visit and Mutterpass issuance
  
• First ultrasound (9–12 weeks) to confirm pregnancy and heartbeat
  
• Blood and urine tests
  
• Risk screening (e.g., rubella, HIV, syphilis)
  
• Optional: NIPT (non-invasive prenatal testing) and nuchal translucency scan (not always covered by GKV)

During your 2nd Trimester (Weeks 13–26)

• Check-ups every 4 weeks
  
• Second ultrasound at 19–22 weeks
  
• Screening for gestational diabetes (~24–28 weeks)
  
• Optional: Toxoplasmosis, cytomegalovirus (CMV), and group B strep testing—not reimbursed by public unless medically necessary
  

During your 3rd Trimester (Weeks 27–40)

• Check-ups become biweekly after week 32
  
• Third ultrasound at 29–32 weeks
  
• CTG (cardiotocography) for fetal heartbeat monitoring
  
• Birth planning consultation
  
• Most hospitals in Germany require pre-registration between 30 and 34 weeks of pregnancy to schedule your delivery.

Germany’s Federal Joint Committee (G-BA) provides detailed maternity guidelines that all statutory insurers follow. These help define which services are mandatory, which are optional, and how often they are offered.If you’re privately insured, check with your provider (contact us here) to see what extra tests or services may be reimbursed beyond the public health insurance standard.

First steps after a positive pregnancy test

A positive pregnancy test marks the beginning of an exciting (and often overwhelming) journey. 

In Germany, there’s a clear roadmap of medical, legal, and administrative steps to follow early on. 

This section will walk you through the essentials, from your first doctor’s visit to workplace protections. 

Toward the end of the article, we’ll also provide resources for those exploring options beyond parenthood, such as abortion or adoption.

What to do first: appointments, insurance notifications, documents

Your first steps should prioritize confirming the pregnancy and activating healthcare coverage. 

Here’s a step-by-step checklist:

1. Schedule an OB-GYN (obstetrician-gynecologist) appointment: Aim for your first appointment between the 6th and 8th week of pregnancy. At this visit, your doctor will confirm the pregnancy via ultrasound and issue the necessary paperwork.
   
2. Notify your health insurance: Contact your insurer to activate prenatal care benefits. This ensures that services like ultrasounds and blood tests are fully reimbursed.
   
3. Request a proof of pregnancy certificate (Schwangerschaftsbescheinigung). Your doctor issues it and states your expected due date.
   
4. Residence registration (Anmeldung): If you’ve recently moved or are new to Germany, make sure your residency is registered with the local Bürgeramt. This is a prerequisite for accessing many services.
   
5. Employer notification:
   
   • There’s no legal deadline for notifying your employer, but it’s required to trigger workplace protections.
     
   • Most people notify their employer after the 12th week (first trimester) unless earlier workload adjustments are needed.
     
   • You’ll need to submit your proof of pregnancy (Schwangerschaftsbescheinigung).
     
   • Written or verbal notice is valid, but a written record is advised for HR and legal purposes.

Getting a “mother passport” (Mutterpass)

The Mutterpass is a central tool in Germany’s maternity care system. It is a pregnancy medical passport that documents your health and the baby’s development throughout the pregnancy.

It’s typically issued at your first OB-GYN visit, after the pregnancy is confirmed by ultrasound.

It contains;

• Blood type and test results
  
• Ultrasound and screening findings
  
• Weight and blood pressure records
  
• Risk assessments (e.g., gestational diabetes, infections)

This information serves as an up-to-date record for any healthcare provider. In emergencies or hospital visits, the Mutterpass ensures consistent and informed care.

It is also helpful in future pregnancies to identify recurring patterns or complications.

Adding your Mutterpass to your everyday carry is a good idea. Most doctors and hospitals request it during check-ups or emergencies.

How to find a midwife (Hebamme)

Midwives play a key role in Germany’s maternity care. They can help with:

• Prenatal care: Home visits or clinic consultations before birth.
  
• Birth: Available at home, in birth centers, or alongside hospital teams.
  
• Postnatal care: Support with breastfeeding, newborn care, and maternal recovery.
  

There are two main types of midwives you may encounter during your pregnancy:

• A standard midwife provides prenatal and postnatal care but does not usually attend hospital births. If you give birth in a hospital, you’ll typically be supported by whichever midwives are on duty at the time.
  
• A Beleghebamme (affiliated midwife) offers continuous care before, during, and after birth. This means they can accompany you to the hospital and deliver your baby there — offering consistent support throughout your maternity journey. Beleghebammen are in especially high demand.

However, there’s a significant shortage of midwives, particularly in urban areas. That means you should ideally find and book a midwife between weeks 8 and 12 of pregnancy, or even earlier, depending on where you live.

Here are some of our favorite resources for finding a midwife you can trust:

• Ammely.de: A nationwide matching platform that’s especially helpful for English speakers, thanks to a language filter.
  
• Hebammenverband: The German Midwives Association.
  
• Local hospital networks and women’s health centers: These often maintain midwife directories or can refer you to affiliated Beleghebammen.

Choosing where and how to give birth

In Germany, expectant parents can choose from several birth settings, depending on their medical needs, personal preferences, and access to facilities. 

Whether you prioritize access to emergency care, a homelike environment, or continuity with a trusted midwife, understanding your options helps you prepare with confidence.

Germany offers three main birth settings:

Setting	Pros	Cons	Percentage of births
Hospital (Krankenhaus)	24/7 access to obstetricians, anesthesiologists, and neonatal care Complete pain relief options, including epidural anesthesia Ideal for high-risk pregnancies or first-time births	May feel clinical or impersonal Medical interventions like induction or continuous monitoring are more common	98% of all births
Birthing center (Geburtshaus)	Calm, home-like atmosphere Focus on natural birth and continuity of care. Midwife-led, with a strong emphasis on personal autonomy	No epidural or surgical options Emergency transfers to a hospital can delay critical care	1.5% of all births
Home birth (Hausgeburt)	Familiar environment, minimal disruptions Personalized, one-on-one care	No access to medical pain relief Emergency response times depend on location and logistics	0.5% of all births

​​Note: Not all hospitals have a neonatal intensive care unit (NICU). If you have a high-risk pregnancy or anticipate complications, it’s important to confirm in advance whether your chosen hospital offers specialized neonatal services.

Regardless of where you plan to give birth, it’s highly recommended to also register with a hospital in case complications require a transfer. Most hospitals in Germany require pre-registration between weeks 30 and 34, though some may require it earlier.

What happens after childbirth?

Postnatal care (Wochenbett) and home visits

The Wochenbett, or postnatal period, spans the first 6–8 weeks after birth and is seen as a time for healing and adjustment. 

You’ll benefit from midwife visits, up to 20 home visits in the first 10 days, and 16 additional visits until your baby is 12 weeks old.

Around 6 weeks after delivery, your obstetrician-gynecologist typically performs a postpartum exam..

Registering your child’s birth

Most larger hospitals will have an office where you can register the birth directly and receive the birth certificate right away. If the place you are giving birth does not have such an office, all births must be registered with the Standesamt (civil registry office) within a week of delivery. 

Required documents include:

• Birth certificate from the hospital
  
• Parents’ passports and residence permits
  
• Marriage certificate (if married)
  
• Acknowledgment of paternity (Vaterschaftsanerkennung) and custody agreement (Sorgerechtserklärung) if unmarried

Once you’ve done this, you’ll receive a birth certificate (usually multiple copies). You’ll need it to apply for a Child ID or passport, health insurance, and parental allowance (elterngeld). 

Pediatric care in the first months

Germany follows a national vaccination plan set by STIKO (Standing Committee on Vaccination). Your pediatrician (Kinderarzt) administers vaccines and monitors early development.

Pediatric appointments also include regular U-examinations (U1–U9) and a standardized schedule of preventive child health check-ups.

Learn more about pediatric care in Germany.

Family benefits, leave options, and prenatal rights

Prenatal rights at work

German law offers strong workplace protections for pregnant employees under the Maternity Protection Act (Mutterschutzgesetz). These include:

• Job protection: From the moment you notify your employer.
  
• Adapted working conditions: Exemption from heavy lifting, night shifts, and stressful environments.
  
• Flexible hours and breaks: Required by law for prenatal medical appointments.
  
• Medical leave: Available with a doctor’s note if pregnancy-related complications arise.

Your doctor can issue work restriction notes if your job is not pregnancy-safe. Employers are obligated to find alternatives or put you on paid leave.

Maternity leave

Maternity leave (Mutterschutz) begins 6 weeks before the expected due date and ends 8 weeks after birth.

It can be extended to 12 weeks in cases of premature, multiple births, or births involving disabilities. 

You’ll receive 100% of your salary, funded by your employer, and health insurance.

Paternity leave

Germany does not offer separate “paternity leave.” Instead, partners share the available parental leave with their significant other.

Talking of which…

Parental leave

Parental leave lasts up to 3 years of unpaid leave per parent, per child. It can be taken all at once or in parts. 

For example, 12 months after birth, then 12 months before the child turns 3. With your employer’s consent, up to 24 months can be deferred between the child’s 3rd and 8th birthday.

You must notify your employer at least 7 weeks before starting parental leave. Make sure your application clearly states how long you plan to take it.

It’s relatively common to see parents distribute their time off in any of the following ways (though it’s not limited to the below):

• One parent takes 12 months; the other takes 2 “partner months”
  
• Both parents take 7 months each and share part-time care.
  
• One parent works part-time while the other is on leave

If both parents take leave at different times, it ensures there is always someone for your child while maintaining a decent income.

Indeed, while parental leave is unpaid, you can apply for a parental allowance (Elterngeld). 

More on this below… 

Can your employer refuse your parental leave?

Generally, no. Employers must approve parental leave, provided proper notice is given (7 weeks). Worker protection laws apply throughout the leave period.

Can I be dismissed or fired during pregnancy or parental leave?

In almost all cases, no. You cannot be dismissed during pregnancy or parental leave in Germany.

§17 Mutterschutzgesetz (MuSchG) Prohibits dismissal from the moment pregnancy is announced until four months after birth. 

At the same time, §18 of the Parental Allowance and Parental Leave Act (BEEG) extends this protection through the duration of parental leave.

Dismissals are only allowed with prior approval from a state labor protection authority, and these are rarely granted.

If you feel your rights are at risk, contact:

• Pro Familia: Offers legal and counseling support.
  
• Local labor unions (Gewerkschaften): Especially if you’re part of a trade organization.
  
• Employee legal services: Many offer free consultations during pregnancy.

While the risks are low thanks to strong regulations and safeguards, you could consider legal insurance to defend yourself if anything goes south.

Financial benefits for families

Parental allowance

Parental allowance, or “Elterngeld,” replaces part of your income while caring for a newborn.

Before we explain how it works, you should know parental allowances are subject to eligibility, and the rules are becoming stricter by the year. Starting April 2025, your household will be ineligible if its total taxable income exceeds €175,000 in the year before the child’s birth.

You can receive Elterngeld for up to 12 months. If both parents share the leave and each takes at least 2 months, the family receives 2 bonus months, for a total of 14 months.

The amount is based on your net income before the birth. Depending on your income level, it varies between 65% and 100%.

It’s usually capped at €1,800/month, and has a minimum payment of €300/month, even for low-income individuals.

Try to apply for parental allowance within the first 3 months after birth. Payments can be backdated, but only for this period.

Child benefit

All legal residents with children can receive benefits from the state (called “Kindergeld”). 

It’s a monthly payment of €255 per child (as of 2025). It’s paid until the child turns 18 (or up to 25 if they remain in the education system).

Childcare allowance

Childcare allowance was discontinued nationally in 2015. 

Yet, some states, like Bavaria and Saxony, still offer regional equivalents for families who do not use public childcare:

• Learn more about childcare allowance in Bavaria
  
• Learn more about childcare allowance in Saxony

Before we move on…

Germany offers a strong legal framework and financial support for families, with clear protections during pregnancy and parental leave, generous childcare benefits, and flexible parental arrangements. These policies are designed to help families thrive, whether you’re planning to return to work soon, extend your time at home, or navigate your first year with a child.

But not every pregnancy continues to birth and for some, different decisions must be made. That’s why it’s also important to understand your options around abortion and pregnancy termination in Germany.

How does abortion work, and what pregnancy options do you have in Germany?

Abortion in Germany is legal under specific conditions, primarily within the first trimester. The process is structured to ensure informed decision-making while respecting personal autonomy.

The 3-step process for abortion:

1. Mandatory Counseling (Schwangerschaftskonfliktberatung): You must attend a session at a certified center (like Pro Familia). The counseling is nonjudgmental and confidential.
   
2. After counseling, you’ll receive a counseling certificate (Beratungsschein). It’s required to proceed.
   
3. After counseling, you must wait at least 3 full days before the procedure can occur.
   
4. You can then proceed with the procedure. It is performed by licensed OB-GYNs or clinics approved for pregnancy terminations. They are available as:
   
   • Medical abortion (pill method) up to 9 weeks after conception
     
   • Surgical abortion up to 12 weeks after conception

Abortion on request is legal up to 12 weeks post-conception (approximately 14 weeks after your last period). After this, abortion is only permitted under medical necessity, such as danger to the pregnant person’s physical or mental health, or in cases of severe fetal anomalies.

Learn more about abortion in Germany.

Does health insurance cover abortion?

It depends on why the abortion is performed. 

You must pay the medical cost (typically €300–€600) for personal reasons. However, public insurance covers pre-exams, counseling, and aftercare.

Statutory health insurance covers the entire procedure for medical reasons (e.g., health risks or severe fetal diagnosis).

If you can’t afford the cost, you may qualify for financial assistance through state-funded abortion cost coverage, available at your local Sozialamt (social services office). You’ll need to present proof of income and the counseling certificate.

Emergency contraception and the “morning-after pill”

In Germany, emergency contraception is available without a prescription. There are two main types:

1. Levonorgestrel (LNG): Effective up to 72 hours after unprotected sex
   
2. Ulipristal acetate (ellaOne): Effective up to 120 hours (5 days)

It’s sold in most pharmacies (Apotheken). Prices range from €15 to €35, and it’s Available to anyone 12 years and older without a prescription

Note that some university health centers and sexual health clinics offer the pill free of charge to minors or low-income individuals.

Anonymous birth and adoption alternatives

Germany provides options for continuing a pregnancy without long-term parental commitment, called a “confidential birth” (Vertrauliche Geburt)

It allows women to give birth anonymously in a hospital while protecting their identity from the child and public records. Medical staff will store personal data securely for 16 years, allowing the child to request access later.

It’s available nationwide and supported by a hotline reachable 24/7: 0800 40 40 020.

If you’re unsure where to start, certified counseling centers like Pro Familia can help you explore your options and next steps.