Pregnancy & Maternity

Prenatal Care (Vorsorgeuntersuchungen)

Germany has one of the most comprehensive prenatal care systems in the world, and it's fully covered by both GKV and PKV. The moment you get a positive pregnancy test and visit your Frauenarzt/Frauenärztin (gynecologist), a structured program of appointments, tests, and screenings kicks in — all documented in your Mutterpass.

The Mutterpass

Your Mutterpass is the small booklet you'll receive at your first prenatal appointment. It's your pregnancy passport — carry it with you at all times. It records:

• All prenatal examination results
• Blood test outcomes (blood type, Rh factor, antibodies)
• Ultrasound measurements and findings
• Your weight, blood pressure, and urine results at each visit
• Baby's position, heart rate, and growth
• Any risk factors or complications
• Previous pregnancies and births

The Mutterpass is a legal document — every healthcare provider involved in your pregnancy and birth will reference it. If you lose it, your Frauenarzt can issue a replacement, but it's a hassle. Many women keep it in their handbag from the moment they receive it until well after delivery.

Standard Appointment Schedule

GKV covers approximately 10-12 prenatal appointments throughout pregnancy (more if complications arise). The typical schedule:

• Weeks 5-8: First appointment — pregnancy confirmation, medical history, initial blood work, Mutterpass issued
• Every 4 weeks until week 32: Regular checkups including weight, blood pressure, urine test (protein/sugar), fundal height, fetal heartbeat (from ~week 12)
• Every 2 weeks from week 32: More frequent monitoring as the due date approaches
• From week 36: Weekly appointments, including CTG (cardiotocography) to monitor contractions and baby's heart rate
• Past due date: Every 2 days with CTG and ultrasound monitoring

Blood Tests (Fully Covered)

A series of blood tests are standard and fully covered by GKV:

• Blood type & Rh factor: Determined at the first appointment. If you're Rh-negative and your partner is Rh-positive, you'll receive Anti-D prophylaxis (Rhesus-Prophylaxe) around week 28 to prevent complications — fully covered.
• Antibody screening (Antikörpersuchtest): Done twice — early pregnancy and around week 24-27
• Rubella immunity (Röteln): Checked at the first appointment. Rubella during pregnancy can cause serious birth defects.
• HIV test: Offered and recommended (voluntary, but strongly encouraged). Covered by GKV.
• Hepatitis B (HBsAg): Tested after week 32 to prevent transmission during birth
• Syphilis (Lues): Screened at the first appointment. The result is documented as "done" in the Mutterpass, but the actual result is not written in — only your doctor knows.
• Hemoglobin (Hb): Checked regularly to detect anemia, which is common in pregnancy
• Chlamydia screening: Urine test at the first appointment to detect this common STI that can cause preterm birth

Three Standard Ultrasounds

GKV covers exactly three ultrasound examinations during pregnancy:

• 1st ultrasound (weeks 9-12): Confirms pregnancy location (ruling out ectopic), determines gestational age and due date, checks for heartbeat, detects multiple pregnancies. This is usually a transvaginal ultrasound.
• 2nd ultrasound (weeks 19-22): The "big one" — the detailed anatomy scan (Feindiagnostik-Basisultraschall). Since 2013, you can choose between a basic screening or an extended basic screening (erweiterte Basis-Ultraschalluntersuchung) that checks organ development in more detail. This is when many parents learn the baby's sex.
• 3rd ultrasound (weeks 29-32): Checks baby's growth, position (breech or head-down), amniotic fluid volume, and placenta location.

Many gynecologists in Germany will do additional ultrasounds at routine appointments — a quick check of the heartbeat or growth — essentially for free as part of the consultation. This varies by practice, but it's very common. The three "official" ones are the thorough, documented examinations.

Glucose Tolerance Test (oGTT)

Between weeks 24-28, all pregnant women are offered a glucose screening for gestational diabetes (Schwangerschaftsdiabetes). GKV covers this in two steps:

1. Screening test (50g glucose challenge): You drink a sugar solution, and blood sugar is measured after one hour. If results are elevated...
2. Diagnostic test (75g oGTT): Fasting blood draw, drink glucose, then blood drawn at 1 and 2 hours. This confirms or rules out gestational diabetes.

Gestational diabetes affects about 6-7% of pregnancies in Germany. If diagnosed, treatment (dietary counseling, blood sugar monitoring, possibly insulin) is fully covered.

High-Risk Pregnancies (Risikoschwangerschaft)

If your pregnancy is classified as high-risk, additional screenings and more frequent appointments are covered. Risk factors include:

• Age over 35 (technically still flagged in the Mutterpass, though many doctors consider this outdated)
• Previous miscarriage, premature birth, or C-section
• Multiple pregnancy (twins, triplets)
• Pre-existing conditions (diabetes, hypertension, thyroid disorders, autoimmune diseases)
• Pregnancy complications (preeclampsia, placenta previa, gestational diabetes)
• Rh incompatibility with complications

Additional covered services for high-risk pregnancies include extra ultrasounds, Doppler ultrasound (checking blood flow in umbilical cord), more frequent CTG monitoring, cervical length measurement, and specialist consultations.

Hebamme (Midwife)

In Germany, every pregnant woman has a legal right to midwife care, and it is fully covered by GKV (and typically by PKV as well). Midwife care is not a luxury or an alternative — it's a core part of the German maternity system. In fact, a midwife is legally required to be present at every birth in Germany, whereas a doctor is not.

Types of Midwives

• Freiberufliche Hebamme (freelance midwife): Works independently, provides prenatal care, postpartum home visits, and breastfeeding support. This is the type you need to actively search for. She comes to your home after birth.
• Beleghebamme: A freelance midwife who has a contract with a specific hospital. She accompanies you during birth AND provides postpartum care — giving you continuity of care. Highly sought after and often booked very early. You may need to pay a small on-call fee (Rufbereitschaftspauschale, ~€200-500) that some GKVs partially reimburse.
• Klinikhebamme (hospital midwife): Employed by the hospital. She'll be assigned to you during labor based on shift schedules — you don't choose her. Fully covered. In busy hospitals, one Klinikhebamme may attend multiple births simultaneously.

What Your Hebamme Covers (All GKV-Paid)

• Prenatal support: Pregnancy counseling, help with complaints (nausea, back pain), monitoring — can be done alongside or as an alternative to some Frauenarzt appointments
• Birth preparation courses (Geburtsvorbereitungskurs): GKV covers the cost for the pregnant woman (partner pays ~€80-150 for their portion)
• Birth assistance: Present during labor and delivery — legally required
• Postpartum home visits (Wochenbettbetreuung):
  • First 10 days after birth: up to 2 visits per day (daily visits are standard)
  • Days 11 to 12 weeks: 16 additional visits as needed
  • These visits include: checking your recovery (uterus, stitches, bleeding), baby's health (weight, jaundice, umbilical cord, general development), breastfeeding support, emotional wellbeing screening
• Breastfeeding counseling (Stillberatung): Covered for the entire breastfeeding period — your Hebamme can visit for breastfeeding issues even months after birth
• Telephone consultations: Quick calls for advice between visits are covered too

Birth Options

Germany offers three main options for where to give birth, and all three are fully covered by GKV:

1. Hospital Birth (Klinikgeburt)

The most common choice — about 98% of births in Germany happen in hospitals.

• Kreißsaal (delivery room): Staffed 24/7 with midwives and obstetricians on call
• Kreißsaalführung (hospital tour): Most hospitals offer regular tours of the maternity ward and delivery rooms. Highly recommended — go between weeks 20-30. You can tour multiple hospitals before deciding. Register online as spots fill up.
• Birth plan (Geburtsplan): You can bring a written birth plan stating your preferences (pain relief, birthing positions, delayed cord clamping, skin-to-skin, etc.). Staff will try to accommodate but medical necessity takes priority.
• Epidural/PDA (Periduralanästhesie): Available on request in most hospitals, fully covered by GKV. Some smaller hospitals may have limited anesthesiologist availability at night.
• Emergency C-section capability: Every hospital with a maternity ward must be able to perform an emergency C-section within minutes (E-E-Zeit under 20 minutes is the standard).
• Neonatology: For high-risk pregnancies, choose a Perinatalzentrum Level 1 or 2, which has a neonatal intensive care unit (NICU) on-site.

2. Birth Center (Geburtshaus)

A Geburtshaus is a midwife-led birth center — no doctors, no operating rooms, but a homelike environment with birthing tubs, birth stools, and experienced midwives providing one-on-one care.

• Fully covered by GKV
• Only for low-risk pregnancies (no previous C-section, no complications, single baby in head-down position)
• Hospital transfer protocol in place for emergencies (typically located near a hospital)
• 1:1 midwife-to-patient ratio during labor (a major advantage over busy hospitals)
• You typically go home 4-24 hours after birth
• Growing in popularity — but limited availability. About 2% of German births.

3. Home Birth (Hausgeburt)

Yes, home births are legal and covered by GKV in Germany.

• A freelance midwife attends the birth at your home
• Only for low-risk pregnancies
• The midwife brings emergency equipment
• Hospital transfer plan is mandatory
• About 1-2% of births in Germany
• Finding a midwife who does home births is very difficult due to the shortage and high liability insurance costs for midwives

Hospital Stay After Birth

After delivery, you'll stay in the hospital for monitoring and recovery. Here's what to expect:

Length of Stay

• Vaginal birth: 2-3 days is typical (can be as short as 1 day if you prefer ambulante Geburt — going home within hours)
• Vaginal birth with complications: 3-5 days
• C-section (Kaiserschnitt): 4-5 days standard, up to 7 days if complications
• Premature birth: Baby stays in NICU as long as needed — parents can stay or visit. Fully covered.

What's Included

• Rooming-in: Standard in virtually all German hospitals — baby stays in your room 24/7. Nurseries where babies are taken away barely exist anymore.
• Midwife and nursing care: 24/7 support for breastfeeding, baby care, recovery monitoring
• Pediatrician examination: Newborn screening (U1 at birth, U2 before discharge), hearing test, blood spot screening (Neugeborenenscreening for metabolic diseases) — all covered
• Meals for the mother: Included
• Vitamin K administration: Given to the newborn to prevent bleeding disorders — covered

Familienzimmer (Family Room)

Many hospitals offer a Familienzimmer where the partner can stay overnight in the same room. This is not covered by GKV — it's a Wahlleistung (optional service). Expect to pay:

• €50-100 per night (varies by hospital)
• Includes a bed, meals for the partner, and use of facilities
• Highly recommended, especially after C-section when you need help
• Book in advance during your Kreißsaalführung — availability isn't guaranteed

Other Wahlleistungen (Paid Extras)

• Single room (Einzelzimmer): €50-150/night depending on the hospital
• Chief physician treatment (Chefarztbehandlung): Typically only relevant if you want a specific surgeon for a planned C-section
• These are standard hospital Wahlleistungen and may be covered if you have PKV or a Zusatzversicherung that includes them

Mutterschutz (Maternity Protection)

Mutterschutzgesetz (MuSchG) is the maternity protection law that applies to all employed women in Germany — regardless of citizenship, contract type, or how long you've been employed.

Protected Periods

• 6 weeks before the due date (Mutterschutzfrist): You may stop working. You can choose to continue working, but your employer cannot require it. You can revoke this decision at any time.
• 8 weeks after birth (absolute Schutzfrist): You are prohibited from working. No exceptions, even if you want to. This is absolute.
• 12 weeks after birth if: premature birth (Frühgeburt), multiple births (Mehrlingsgeburt), or if a disability is diagnosed within 8 weeks of birth
• If the baby is born early: The days "lost" before birth are added to the postnatal period. Example: if baby arrives 2 weeks early, you get 8 + 2 = 10 weeks after birth.

Beschäftigungsverbot (Employment Ban)

Beyond the standard Mutterschutz periods, your doctor or employer can issue a Beschäftigungsverbot at any time during pregnancy if your work poses a risk:

• Ärztliches Beschäftigungsverbot: Your doctor determines you cannot work (e.g., risk of preterm labor, pregnancy complications). Can be partial (limited hours, no heavy lifting) or total.
• Betriebliches Beschäftigungsverbot: Your employer determines your workplace is unsafe (chemicals, heavy lifting, night shifts, standing for long periods) and cannot offer an alternative position.
• During any Beschäftigungsverbot, you receive full salary (Mutterschutzlohn) — paid by your employer, who can claim reimbursement from the U2 Umlage fund.

Mutterschaftsgeld (Maternity Pay)

During the Mutterschutz period (6 weeks before to 8/12 weeks after birth), you receive:

• From GKV: €13 per day (maximum) — apply directly to your Krankenkasse
• From your employer: the difference up to your full net salary (Arbeitgeberzuschuss). So effectively, you receive your full net salary during Mutterschutz.
• The employer is reimbursed through the U2-Umlage (a mandatory levy all employers pay — even those with only male employees). This means pregnancy costs employers nothing, removing any financial incentive for discrimination.

Job Protection

• Kündigungsschutz (protection from dismissal): You cannot be fired from the beginning of pregnancy until 4 months after birth. This protection is nearly absolute — only in extreme exceptional cases (company bankruptcy) can it be overridden, and only with approval from the Gewerbeaufsichtsamt.
• This applies even during your probation period (Probezeit)
• You must inform your employer of the pregnancy for the protection to apply (but you're not legally required to disclose pregnancy during a job interview)

IGeL Services in Pregnancy

IGeL (Individuelle Gesundheitsleistungen) are services your doctor offers that GKV does not cover. In pregnancy, you'll be offered several — some genuinely useful, others questionable. Here's an honest breakdown:

Commonly Offered IGeL in Pregnancy

Fertility Treatment (Kinderwunschbehandlung)

When natural conception doesn't work, German health insurance provides partial coverage for assisted reproduction — but with strict conditions.

What GKV Covers (50%)

GKV covers 50% of the cost for the following treatments:

• IUI (Intrauterine Insemination): Up to 8 cycles (insemination without hormonal stimulation) or 3 cycles (with hormonal stimulation)
• IVF (In Vitro Fertilization): Up to 3 cycles
• ICSI (Intracytoplasmic Sperm Injection): Up to 3 cycles

Eligibility Requirements

To qualify for GKV coverage, ALL of these must be true:

• Married couple: You must be legally married (eingetragene Lebenspartnerschaft alone was historically not sufficient, though this is evolving)
• Using own eggs and sperm: Donor eggs are not legal in Germany; donor sperm with IVF/ICSI has limited coverage
• Woman's age: 25-39 (treatment must begin before her 40th birthday)
• Man's age: 25-49 (treatment must begin before his 50th birthday)
• Both partners insured with GKV (if one is PKV, it gets complicated — each insurer covers their own member's share)
• Prior approval (Behandlungsplan) submitted to and approved by the Krankenkasse before treatment begins
• Non-smokers (you may be asked to confirm this)

Typical Out-of-Pocket Costs (Your 50%)

• IUI: ~€200-500 per cycle (your share)
• IVF: ~€1,500-2,000 per cycle (your share)
• ICSI: ~€1,800-2,500 per cycle (your share)
• Medications: Hormone stimulation drugs alone can cost €1,000-2,000 per cycle (50% covered)

Kassen That Cover More

Some Krankenkassen go beyond the 50% minimum, covering up to 75% or even 100%:

• BKK Mobil Oil: Up to 100% for the first 3 IVF/ICSI attempts
• DAK-Gesundheit: 100% for the first 3 attempts
• Techniker Krankenkasse (TK): 75% for the first 3 attempts
• AOK (varies by region): Some AOKs cover up to 75%
• IKK classic: 100% of the first 3 attempts
• BARMER: Up to 100% for the first 3 attempts in some Bundesländer

Always check with your specific Kasse — fertility benefits vary significantly and can change. If you're planning fertility treatment, it may be worth switching to a Kasse with better coverage (remember: switching is possible with 2 months notice if you've been with your current Kasse for at least 12 months).

Kryokonservierung (Egg/Sperm/Embryo Freezing)

Since 2021, GKV covers Kryokonservierung (cryopreservation) when medically indicated — specifically for patients facing fertility-threatening treatments like chemotherapy. Social egg freezing (elective, without medical reason) is not covered and costs €3,000-5,000 plus ~€300-400/year for storage.

Single Women & Same-Sex Couples

Coverage for fertility treatment for single women and same-sex female couples is evolving:

• Historically, GKV only covered married heterosexual couples
• Since the "Ehe für alle" (marriage for all) law in 2017, married same-sex female couples have increasingly gained access, but coverage varies dramatically by Krankenkasse
• Some Bundesländer (notably Berlin) offer additional subsidies
• Donor sperm insemination (without IVF) for single women is legal but typically not covered by GKV
• In practice, many same-sex couples and single women end up paying fully out of pocket, especially for donor sperm costs (~€500-1,000 per attempt)

Miscarriage & Stillbirth

This is a difficult topic, but understanding your rights and coverage is important. German law distinguishes between two situations with significant legal differences:

Fehlgeburt (Miscarriage)

Legally defined as the loss of a pregnancy where the baby weighs under 500 grams and shows no signs of life after birth.

• All medical treatment is fully covered by GKV (emergency care, D&C/Ausschabung, follow-up appointments)
• Hospitalization if needed — fully covered with no co-payment
• Psychological support and counseling — covered
• No Mutterschutz after a Fehlgeburt — you can be sick-listed (Krankschreibung) by your doctor for recovery, which provides Lohnfortzahlung (continued salary for 6 weeks), but the special Mutterschutz protections do not apply
• Kündigungsschutz (protection from dismissal) continues until 4 months after the miscarriage if the pregnancy was past week 12
• No mandatory registration with the Standesamt, but parents can voluntarily register the child since 2013 (Sternenkinder ruling)

Totgeburt (Stillbirth)

Legally defined as the loss where the baby weighs 500 grams or more(regardless of gestational age).

• All medical care fully covered
• Full Mutterschutz applies: 8 weeks of postnatal protection (12 weeks for premature birth). You cannot be required to work during this time. You receive Mutterschaftsgeld.
• Kündigungsschutz applies for 4 months after the stillbirth
• Must be registered with the Standesamt (civil registry). A birth certificate and death certificate are issued.
• Hebamme postpartum care is available — for physical recovery and emotional support
• Burial rights: parents have the right to a burial (or can leave it to the hospital/municipality for a communal burial)

Postpartum Coverage

German health insurance continues to support new mothers well beyond the birth itself.

Rückbildungsgymnastik (Postnatal Recovery Exercises)

GKV covers up to 10 sessions of Rückbildungsgymnastik — specialized postnatal exercise classes focused on pelvic floor recovery and core rehabilitation.

• Must be completed within 9 months of birth (some Kassen extend to 12 months — check)
• Led by a midwife or physiotherapist
• Covers pelvic floor strengthening, diastasis recti recovery, posture correction, core stability
• Can be done in group classes or sometimes individually
• These courses are extremely popular and fill up fast — book by week 34-36 of pregnancy or immediately after birth
• Online Rückbildungskurse have been increasingly covered since the pandemic — check with your Kasse

Haushaltshilfe (Household Help)

If you cannot manage your household due to pregnancy or birth-related health issues, GKV can cover a Haushaltshilfe (household helper) who comes to your home to cook, clean, and care for other children.

• Available when: the mother cannot do housework due to pregnancy complications, hospital stay, or recovery, AND no other household member (partner) can take over
• Requires a doctor's prescription (Verordnung)
• GKV pays up to €10.25/hour (rates vary by Kasse) with a co-payment of €5-10/day from you
• Can also be approved for C-section recovery, multiple births, or if you have other young children at home
• Duration depends on medical necessity — typically days to weeks

Postpartum Depression Screening & Treatment

Postpartum depression (Wochenbettdepression) affects an estimated 10-15% of new mothers. In Germany:

• Your Hebamme is trained to screen for signs during postpartum visits
• Your Frauenarzt checks at the Nachsorge (postpartum follow-up) appointment around 6-8 weeks after birth
• Psychotherapy is fully covered by GKV — but waiting times for therapists can be 3-6 months
• For urgent cases: Psychotherapeutische Sprechstunde (initial consultation) must be available within 4 weeks, and Akutbehandlung (crisis sessions) within 2 weeks of referral
• Medication (antidepressants compatible with breastfeeding exist) is covered
• Inpatient mother-child psychiatric units (Mutter-Kind-Einrichtungen) exist for severe cases — fully covered

Nachsorge Appointments

• Postpartum checkup (6-8 weeks after birth): With your Frauenarzt — checks uterine recovery, stitches/scars, contraception counseling, emotional wellbeing. Fully covered.
• Baby's U-examinations: The famous German U-series (U1 through U9) begins at birth and continues to age 5. U1-U6 happen in the first year. All covered.
• Breastfeeding support: Your Hebamme is available for breastfeeding issues throughout the entire breastfeeding period — covered.

PKV and Pregnancy

Private health insurance and pregnancy is a different beast. Here's what you need to know:

Coverage

• Prenatal care: Generally comprehensive — same or better than GKV. Most PKV tariffs cover all standard prenatal appointments, blood work, and ultrasounds without the 3-ultrasound limit.
• Birth: Hospital birth fully covered. Home birth and Geburtshaus also usually covered but check your specific tariff.
• Hospital stay: Typically single room (Einzelzimmer) and chief physician treatment (Chefarztbehandlung) included in most tariffs — this is standard PKV, not a maternity perk.
• Midwife care: Covered similarly to GKV (prenatal, birth, postpartum). Some tariffs may have limits — verify yours.
• Complications: Fully covered without special approval needed

The Wartezeit (Waiting Period) Trap

Many PKV tariffs include a Wartezeit of 8 months for maternity-related benefits. This means:

• If you become pregnant within the first 8 months of your PKV contract, maternity costs may not be covered
• This applies to the birth and prenatal care, not to pregnancy complications classified as illness
• Some tariffs waive the Wartezeit (besondere Wartezeit) — negotiate this before signing
• If switching from GKV to PKV, pregnancy planned within 8 months is a critical consideration

Krankentagegeld During Mutterschutz (Self-Employed)

If you're self-employed with PKV:

• You receive Krankentagegeld (daily sickness allowance) during the Mutterschutz period if your tariff includes it and covers maternity
• The amount depends on your insured daily rate (you choose this when signing the contract)
• No employer tops anything up — the Krankentagegeld is all you get
• Some tariffs explicitly exclude maternity from Krankentagegeld — read the fine print before pregnancy

Baby's Insurance

• If both parents are in PKV, the baby must be privately insured (can be added to either parent's policy within 2 months of birth — Kindernachversicherung with no health check or waiting period)
• If one parent is in GKV and the other in PKV, the baby goes to the parent with higher income. If the PKV parent earns more, the baby must go into PKV. If the GKV parent earns more, you can choose GKV (beitragsfrei as a Familienversicherung).
• PKV children's tariffs typically cost €100-200/month — a significant ongoing cost to factor into family planning

Elterngeld & Elternzeit: Insurance Implications

Elterngeld (parental allowance) and Elternzeit (parental leave) are primarily social benefits, not health insurance topics. But they have critical implications for your insurance:

GKV During Elternzeit

• Pflichtversichert (mandatorily insured) members: You pay €0 in GKV contributions during Elternzeit while receiving Elterngeld. Your insurance continues fully. This is one of the biggest financial perks of GKV.
• Freiwillig versichert members: You still owe contributions during Elternzeit, calculated on your actual income. The minimum contribution (~€210/month for health + Pflege) applies if your only income is Elterngeld (Elterngeld itself is not counted as income for GKV purposes).
• Familienversicherung possibility: If your income drops low enough during Elternzeit and your spouse is in GKV, you may qualify for beitragsfrei Familienversicherung (free family co-insurance). This requires earning under €505/month (2024 threshold, adjusted annually).

PKV During Elternzeit

• Premiums continue unchanged. PKV has no concept of reduced or waived contributions during parental leave.
• If you were employed and your employer paid 50% of your premium, that employer contribution typically stops during Elternzeit (unless your employer voluntarily continues it).
• This means your monthly PKV cost can effectively double during Elternzeit — from ~€250 (your share) to ~€500+ (full premium).
• If taking Elternzeit causes financial hardship, switching from PKV to GKV is generally not possible just because of Elternzeit (you would need a qualifying event like employment below the JAEG threshold).

Pregnancy Checklist Timeline

A week-by-week guide to what you should do and when, from a health insurance perspective:

First Trimester (Weeks 1-12)

• Positive test (week 4-5): Book appointment with your Frauenarzt. Start searching for a Hebamme immediately.
• Week 6-8: First prenatal appointment. Mutterpass issued. Begin contacting Hebammen (call/email at least 15-20). Register on ammely.de.
• Week 8-10: Inform your employer (recommended for Mutterschutz protections, though not legally required until later). Check if your workplace triggers a Beschäftigungsverbot.
• Week 9-12: First ultrasound. Consider first-trimester screening/NIPT (IGeL or GKV-covered depending on indication).
• Week 10-12: Secure your Hebamme. If you haven't found one yet, expand your search radius and consider group midwife practices (Hebammenpraxen).

Second Trimester (Weeks 13-27)

• Week 13-16: Book a Geburtsvorbereitungskurs (birth preparation course) — popular ones fill up months in advance.
• Week 16-20: Research hospitals. Attend Kreißsaalführungen (delivery room tours).
• Week 19-22: Second ultrasound (anatomy scan). Choose between basic and extended screening.
• Week 20-24: Register at your chosen hospital (Anmeldung zur Geburt). Some hospitals require this, others don't, but it's always recommended.
• Week 24-28: Glucose tolerance test. Consider signing up for Rückbildungsgymnastik (yes, already — courses fill up).

Third Trimester (Weeks 28-40+)

• Week 29-32: Third ultrasound. Appointments now every 2 weeks.
• Week 32: Pack your hospital bag (Kliniktasche). Include Mutterpass, insurance card (Versichertenkarte), birth plan.
• Week 34: Apply for Mutterschaftsgeld at your Krankenkasse (you need a doctor's certificate with the expected due date). GKV members: apply to your Kasse. PKV/not insured: apply to Bundesamt für Soziale Sicherung.
• Week 34: Begin Mutterschutz (6 weeks before due date). Inform employer with the medical certificate (Zeugnis über den mutmaßlichen Entbindungstermin).
• Week 35-37: Consider Strep B test (IGeL). Weekly appointments begin at week 36.
• Week 36-37: Pre-register at hospital if not done yet. Confirm Hebamme's on-call plan.

After Birth

• Day 1-3: U1 and U2 examinations at hospital. Newborn hearing screening. Metabolic blood spot test (day 2-3).
• Within 1 week: Register the birth at the Standesamt. Get the Geburtsurkunde (birth certificate).
• Within 2 weeks: Register the baby with your Krankenkasse (GKV: Familienversicherung application) or PKV (Kindernachversicherung within 2 months).
• Within 3 months: Apply for Elterngeld at the Elterngeldstelle. Apply for Kindergeld at the Familienkasse.
• Week 3-4: U3 examination at the pediatrician (Kinderarzt). Find a pediatrician in advance — they're also in high demand.
• Week 6-8: Your postpartum gynecologist checkup (Nachsorgeuntersuchung).
• Within 9 months: Complete Rückbildungsgymnastik (10 sessions).