International moves can be complicated and unpredictable at the best of times. There is so much to organise, so much to figure out, and so many unknowns, even in a ‘straightforward’ move. Moving abroad while pregnant adds whole new layers of complexity!
I was five and a half months pregnant when we moved from Thailand to Germany – we didn’t exactly plan it that way, but life doesn’t always work to a perfect plan.
Even if you are in a familiar country, preparing to have a baby involves a lot of new and unfamiliar appointments and information. In a new country, especially when that country is Germany, the system can be very tricky to understand and navigate for the first time.
I found that there were lots of resources online about being pregnant in Germany and giving birth in Germany, but they typically assumed that you were already familiar with the German system.
So I thought it might be helpful if I wrote a guide specifically about moving to Germany while pregnant, based on my recent experience.
Overall, the experience of having a baby in Germany has been excellent – there are ample support systems, good services and high standards of care. But getting in and around the system was tricky initially, and there are significant differences in the German maternity care system which differ a lot versus, say the UK or Thailand.
So here are some useful things to know if you’re moving to Germany while pregnant!
Moving to Germany while pregnant: What You Must Do
1. Get proof of Health Insurance/ your insurance card
In order to access German Health Care, it is essential that you have your proof of Health Insurance. There are various public and private insurance providers, which admittedly I know little or nothing about! In my case, I had TK (Techniker Krankenkasse) insurance thanks to Mark’s job providing a family insurance plan.
On arrival in Germany, you will likely need to apply for your Health Insurance Card, which will be posted to your home address. While the request for your physical health card is processing, you can normally get a proof of health insurance PDF.
It is absolutely essential that you have your PDF or Health Insurance card when you visit the doctor (or any sort of medical appointment) – I learnt this the hard way when I was turned away by the doctor’s office receptionist.
Once you have your proof of Health Insurance/ Insurance Card, bring it to all doctor and hospital appointments.
As a side note, you might like to check out Mark’s helpful blog post of what to expect when moving to Germany. A number of my letters went missing due to my initial failure to put my name on our door buzzer/ letter box, including some from the health insurance provider.
2. Register with a gynaecologist (and get your Mutterpass)
The gynaecologist handles all of your prenatal care; it is very important that you find one and make an appointment as soon as possible.
The easiest way to find a gynaecologist it to search for one on Doctolib – a general booking system for medical services in Germany (the website is in German, so turn on the Google Translate plug in to translate the website as you navigate).
You will likely find that most gynaecologists are booked up months in advance, so it’s not the time to be fussy – choose one within a reasonable distance who speaks your preferred language and book an appointment (You can always move to a different gynaecologist after the baby is born).
I have noticed that typically male gynaecologists have more availability (perhaps because many women prefer being treated by fellow women?); my gynaecologist was male, extremely professional, and always ensured a female health assistant was present in the room for any physical examinations.
Gynaecologist appointments during pregnancy are numerous, be prepared for them to want to see you at least once a month with frequency increasing to every week in your final month of pregnancy.
The gynaecologist is responsible for providing and managing your most important pregnancy document – your Mutterpass.
This booklet logs the results from each of your appointments, as well as test results. It is likely that you will be asked to repeat all the standard pregnancy tests, even if you have results from another country. So if you’re moving to Germany while pregnant from abroad, bring your documents, but be prepared to repeat tests.
In my experience, the gynaecologist was only interested in my 20 week scan and NIFT results from Thailand, while all other paperwork was declined and I had to repeat blood & urine tests as well as scans.
Be prepared for your appointment to result in more appointments – as well as tests at the gynaecologist office, I had to visit a diabetes specialist in order to have a blood sugar test, and I was also sent to the hospital for further investigation when one of my results was abnormal. The process is very thorough.
Once you have your Mutterpass, bring it to all doctor and hospital appointments, along with your Insurance Card.
3. Register with your chosen hospital
In Germany, you get to choose which hospital you want to use to give birth. This can feel overwhelming if you have multiple choices, so focus on the practical elements – how near the hospital is to your home & if the hospital offers the type of birth you would like.
Once you have chosen your hospital, you need to register with the hospital via a Geburtsanmeldung appointment. Normally these appointments are booked via a phone call or online booking system (it varies between hospitals).
This appointment typically takes place with a midwife at around week 34 of your pregnancy and covers practical elements such as your medical history, the type of birth you would like, what to expect at the hospital etc.
Once this appointment is complete, the next time you will return to the hospital will be when you are in labour.
- If you would like to request a caesarean section, you will likely need to have an extra appointment with the hospital. I’ve written more about this in the ‘What You Can Do’ section.
- You can also give birth in Geburtshaus, which are essentially midwife led units. Geburtshaus typically have a more cosy, unmedical feel, with the compromise that they cannot offer all medical interventions, and in the case of a complex birth, you may need to be transferred to the nearest hospital.
- In case of emergency, it is my understanding that a hospital cannot turn you away if you turn up in labour, even if you haven’t registered there.
Moving to Germany while pregnant: What You Can Do
1. Register with a GP (Hausarzt)
In Gemany, you typically make an appointment directly with a specialist in that area (e.g. for Women’s Health, you book an appointment with a gynaecologist). However, for general health complaints, you will need to visit a GP (aka Hausarzt).
You do not specifically need to have one as part of the pregnancy process, but it is helpful to have registered in case you experience any minor complaints during pregnancy.
The easiest way to find a Hausarzt & book an appointment is via Doctolib.
As a watch out – you may find that they are extremely reluctant to prescribe anything for pregnant or breastfeeding women and may suggest a herbal tea as an alternative remedy… (this has been my experience, which can be frustrating, especially if you are used to systems which prescribe medicine more liberally.
2. Arrange a Midwife (AKA Hebamme)
The midwife (AKA Hebamme) is responsible for at home support in the weeks immediately after you return from the hospital.
They check your physical and mental health, help with breastfeeding, weight the baby etc. Their cost is normally covered via your Health Insurance. They are optional, however in our experience, they are an extremely helpful resource & we recommend you try to find one.
In Berlin, you can contact Hebamme units directly, or you can also post on this facebook group with your delivery details & wait for a reply.
Demand for Hebamme massively outstrips supply, so unfortunately the chances of finding one when you are due to give birth in a few months is unlikely (typically women start looking as soon as they find out they are pregnant).
This was our experience, but we were fortunate that the hospital was able to find us one after I had given birth (I don’t know how common this is).
Having a Hebamme was extremely useful, especially as our baby was early. Ours came to our apartment every day for the first week and then very regularly for over a month, checking in on both mother and baby. Hebammen don’t cost anything as standard, they are covered by health insurance.
3. Request a caesarean section
In Germany, the hospital is not obliged to agree to elective caesarean requests, however in practice it does happen. We found it odd how anti- C-section the system is in Germany – in Thailand we would have had to fight not to have one, and in the UK it’s a much more free choice.
Certain hospitals are more likely to grant requests than others, so it is best to ask around to get recommendations (even if you don’t know anyone, try Facebook groups such as ‘International Families Berlin’ to crowd source information).
In order to request an elective caesarean, you need to inform the hospital when booking your Geburtsanmeldung appointment, and it is highly likely you will need to book a further appointment in order to discuss your caesarean request.
During this appointment, you will meet with a doctor who will ensure you are informed of all the risks of caesarean, as well as an anaesthetist in order to learn about the procedure.
In my experience, they will emphasise all the worst case scenarios, in part to ensure they are legally compliant. It is possible you will find these appointments unsettling, so stay strong if an elective caesarean is definitely what you want.
Assuming they agree to your request, you will need to sign a number of consent forms & they will provide you with the date of your procedure.
If you are unsuccessful, assuming you haven’t been turned down for a medical reason, you could try again with another hospital.
4. Attend a prenatal course
There are a number of English speaking prenatal courses available, both online and in person. These courses are typically covered by your Health Insurance.
They cover a number of useful topics from labour to caring for your baby. The in-person ones are also a great way to meet other parents in your area.
5. Book a postnatal Ruckbildung course
Ruckbildung is a postnatal workout class, focused on your core & pelvic floor recovery post pregnancy & birth. These courses can be online, or in person and are a great way to meet other mothers. These courses are typically covered by your Health Insurance.
6. Find your local Familienzentrum
Look no further for classes and activities with your new baby! Familientzentrum are essentially community centres for parents with young children. Depending on your area, and the activity class they may be English speaker friendly.
Helpful Extras on Pregnancy and Birth in Germany
When moving from Bangkok to Berlin, I noticed that was is considered a ‘normal’ or ‘recommended’ birth or childcare practice can dramatically vary by country (or maybe even city). Personally, I think that the mother’s preference is most important so if you disagree with the German perspective on the below, be confident and speak up to get what you want.
The German perspective is that vaginal birth, with minimal intervention is best. You may even find that your prenatal course will suggest that you try to avoid pain management such as epidurals. If you do want to have an elective caesarean, you will find that some medical professionals and midwives will try to persuade you not to based on their opinion rather than medical reason, emphasising that vaginal birth is ‘best’.
In my case, I successfully booked an elective caesarean, but I went into labour a month early, and the baby came so quickly that I ended up having a vaginal birth anyway. Happily, both myself and the baby were fine (mentally as well as physically), but I did find it very strange that a few medical professionals congratulated me on having ‘avoided’ a caesarean birth, and my experience was ‘much better for me and the baby’.
As I mentioned above, Thailand was the polar opposite, and the UK is much more ambivalent.
Germany is pro-breastfeeding, and encourages you to breastfeed your child. The hospital midwives will assist you in finding a technique that works, and may also have a lactation specialist to further help. It is common to be given a milk pump to use in the hospital and also receive a prescription to pick one up from your local pharmacy.
Once home, if you have a Hebamme, they will also help you further your breastfeeding technique.
The tricky part comes if you do not want to breastfeed, or find it difficult. You may find that you are encouraged to keep trying, without any consideration to impact on your mental health.
Personally, I had a difficult start, with a baby who was very sleepy and wasn’t strong enough to breastfeed directly.
After being told repeatedly in the hospital that my baby was hungry and I needed to try and keep her awake to feed (easier said than done), my requests for formula not followed up, and some success with pumping, I was ultimately sent home with a warning that if my baby continued to lose weight, I would have to return to the hospital.
Immediately on arrival home, I fed my baby formula and everyone was happier. Thanks to our very helpful and supportive Hebamme, I was able to find the best option for me, bringing my milk in via pump & then bottle feeding it to my baby.
Speaking to other women from my prenatal group, not all Hebamme are as supportive of formula and finding creative workarounds. Whatever happens to you, it doesn’t matter how you feed your baby, so long as you feed them, and you need to look after yourself physically and mentally in order to be able to look after your baby.
Access to English speaking medical professionals
For your prenatal care, it is very easy to find medical professionals who speak your preferred language via Doctolib.
It is common that the receptionist doesn’t, or prefers not to speak a language other than German, which is fair since we’re on Germany! If your German is still basic, I recommend learning one simple phrase ”Ich bin ….., ich habe einen Termine’ (I am…., I have an appointment).
Admittedly, Berlin has a lot of fluent English speakers, so it might not be as easy in other cities or rural areas.
At the hospital, in my experience, every Berlin doctor & midwife on the labour ward speaks English (I also heard French and Russian). It is very helpful to have a shared language during the labour itself, so if your hospital doesn’t have English speakers, you may want to learn some key birth phases.
My experience on the maternity ward post birth was quite different, about 50% of the midwives spoke English, while the rest would understand by reply in German.
As a result, I found my time on the maternity ward a lonely and confusing time, although I am grateful and astonished by the number of medical professionals who speak fluent English, despite it not being required for their job.
Registering your child’s birth
Once your child is born, there is a 7 day window where you can register their birth & name at the hospital office.
You will need to plan ahead as typically the hospital office is only open during weekday business hours, and you will need to provide various documents such as birth certificates & marriage certificate.
I believe it is possible to register their birth after this date, but it’ll require going to a central government office, and it’s a trip best avoided when you are recovering from birth and getting to grips with your newborn.
I hope that you find this guide, and sharing of my experiences helpful. While there has been some stress, confusion and tears, I wholeheartedly believe that Germany is an amazing country to have and raise children in.