How to Choose Where to Give Birth in Germany?

Note that spots for an out-of-hospital birth go very quickly, so if this is an option you are considering, contact the birthing center(s) and/or home birth midwives as soon as you can!

Similarly, hospitals have certain periods where you can pre-register, so check with the hospital you’re targeting to see when you need to contact them.

Things to consider when choosing where to give birth

Overall, there are two main criteria when deciding for a hospital or out-of-hospital birth (ausserklinische Geburt in German):

One is your requirements for a feeling of safety and the other is atmosphere. So think about what type of environment and care you want for your birthing experience and what type of role medical assistance plays for you.

This decision is a super important one as you want to make sure you feel comfortable, safe and secure in the surroundings you chose so you can fully embrace your birthing experience. (I enjoyed reading the first part of Marie Mongan’s book “Hypnobirthing”, which reflects on a woman’s need to feel safe and secure in her choice of birthing environment.)

All options are covered by health insurance in Germany although there will be an on-call fee if you opt for an attending midwife, a home birth or birthing center birth.

Comparing a hospital birth with an out-of-hospital birth

Here are some pros and cons for each option:

Hospital birth

• You will be taken care of by the midwife (or multiple different ones) on staff that day (no 1-on-1 care unless you have a Beleghebamme)*

• An OBGYN and/or pediatrician is available to assist if needed

• Neo-natal units available at some hospitals if needed

• An epidural and other drugs are available

• You can stay for 2-3 days after delivery (longer with a C-section)

• The baby's U2 checkup is possible at the hospital

• Registration of birth is possible at some hospitals

• Private and family rooms are not always available, so resting and family bonding may be harder than at home

*According to the Berliner Hebmmenverband, it is common on big German cities that 85% of midwives working in a hospital take care of more than 3 women in labour in parallel during their shift.

Out-of-hospital birth (home birth or birthing center)

• Your midwife will be on-call 24/7 for the last few weeks of your pregnancy

• You will have 1-on-1 care with your personal midwife

• (Usually a second midwife joins to assist)

• The environment will be home(-like)

• No transfer during labor with a home birth

• There will be no interventions such as a drip or CTG cables

• There is no option for an epidural or other drugs

• There will not be a doctor on-site, nor a neonatal unit

• If complications arise, you will need to be transferred to a hospital

• Birthing center: you will go home about 3 hours after the baby is born*

• (Almost) immediate bonding with the family (partner, siblings)

• Registration of birth needs to be done with the local Standesamt within 7 days

• U2 needs to be done at a pediatrician’s within 10 days so you need to make sure you have a pediatrician lined up for this

*Note that this is also an option at the hospital (ambulante Geburt). In this case, your midwife will visit you shortly after arriving home and then frequently (up to twice a day) for the first few days.

Note that certain health conditions may prevent a birth at home or at a birthing center, for example:

• Pregnancy with multiples (twins, triplets…)

• Baby in breech position

• Premature births

• Obesity (BMI higher than 35 pre-pregnancy)

• (Pregnancy) diabetes with insulin treatment

• Low iron levels

• Delivery after week 42+0

Check with your OBGYN and midwife about any health concerns.

If you’re going for a hospital birth, here are some criteria for choosing the right one for you:

• Distance from home

• A neonatal unit, if this may be needed or will make you feel safe

• Other special requirements, such as for pregnancy diabetes or breech position

• Quality of care during the delivery

• Quality of care on the “Wöchnerinnenstation” (maternity ward)

Also pay attention to any registration deadlines at your chosen hospital.

For a detailed overview of options near you, check out the following articles:

• How to Choose Where to Give Birth in Berlin?

• Which Hospital to Choose for Birth in Berlin?

• List of Birthing Centers in Berlin

• Where to Give Birth in Düsseldorf

• Where to Give Birth in Cologne

• Where to Give Birth in Frankfurt

• Where to Give Birth in Munich [coming soon]

• Where to Give Birth in Hamburg [coming soon]