Gynaecologist and Mutterpass, finding a Hebamme, check-ups week by week and what your Krankenkasse pays.
A positive test raises lots of questions at once. Here is what to do in the first weeks, in a sensible order. Nothing here is urgent to the day, but the earlier you start, the easier the rest becomes.
Your first steps
Positive test → Gynaecologist → Hebamme → Krankenkasse → Employer
1. See a gynaecologist (Frauenarzt/Frauenärztin)
- When: book as soon as your test is positive; the first check-up should be as early as possible (familienplanung.de).
- Mutterpass: at one of the first visits you get this small booklet. It records every check-up and test; take it to every appointment and to the birth.
- Midwife too: a Hebamme can do most routine check-ups as well; you can combine both (Mutterschafts-Richtlinien, G-BA).
2. Look for a midwife (Hebamme) early
- Start early: midwives are scarce in many cities, so search in the first trimester.
- What she does: supports you in pregnancy and visits you at home after the birth. Statutory insurance pays (§ 24d SGB V).
- Where to search: the midwife list of the GKV-Spitzenverband and local midwife portals in your city.
No gynaecologist or midwife available?
In many cities practices are full. These official routes help.
Gynaecologist
- Appointment service: Call 116 117 (free, 24/7), use the 116117 app or book online. This appointment service of the doctors’ associations books a gynaecologist appointment for people with statutory insurance. For a gynaecologist you need no referral and no code (KBV).
- No choice: You cannot choose the practice, and it may be further from home (Verbraucherzentrale). Once you have a first appointment, ask the practice to keep you on as a patient.
- In English: The official doctor search on 116117.de lets you filter practices by foreign language, for example English (KBV).
Midwife
- Where to search: the midwife list of the statutory health insurers and Ammely, the free matching platform of the German Midwives’ Association. Ammely shows which midwives have free capacity and has an acute search for short-notice care.
- Still no midwife at the birth? Ask the birth clinic: some have navigators (Lotsinnen) who help you find aftercare. Your gynaecologist and your Kinderarzt can also take over check-ups for you and your baby (familienplanung.de).
3. Check your health insurance
Tell your Krankenkasse that you are pregnant. If you are not insured yet, sort this out now, as you will need cover for the birth and for your baby. What is covered is explained below.
4. Tell your employer early
By law you should tell your employer as soon as you know you are pregnant, with your due date (§ 15 MuSchG). There is no fixed deadline, but your protection only starts once your employer knows.
- Unsafe work stops. Your employer must check your job for risks and protect you right away. Some work is not allowed in pregnancy, for example regularly lifting more than 5 kg, contact with certain chemicals, viruses or radiation, and assembly-line work at a fixed pace (§ 11 MuSchG). This matters most if your job is physical or involves chemicals, patients or children.
- Your pay is safe. If the risk cannot be removed, your employer must adapt your work or move you to another job. As a last resort they stop you working, and you keep your full average pay (§ 13, § 18 MuSchG).
- Dismissal: you are protected from the start of pregnancy. If you are dismissed before you have told your employer, tell them within 2 weeks (§ 17 MuSchG).
- More in Mutterschutz – Maternity Protection.
5. Free counselling
Everyone has the right to free, confidential advice on all questions around pregnancy, including money, work, relationships and rights (§ 2 SchKG). Counselling centres can also help you apply to the federal foundation “Mutter und Kind” if money is tight. Find a counselling centre.
Feeling overwhelmed or unsure?
Pregnancy can bring worries about money, housing, your relationship, your job or your residence papers, even when the baby is very much wanted. You do not have to sort this out alone.
- Counselling centres: Pregnancy counselling centres give free and confidential advice, anonymous if you wish, on every question and whatever your situation (Familienportal).
- Hotline: Hilfetelefon „Schwangere in Not“: free, anonymous, 24/7, in 19 languages, 0800 40 40 020 (hilfetelefon-schwangere.de). They listen and connect you with a counselling centre near you.
6. Unmarried parents: paternity and custody before the birth
If the parents are not married, the father can acknowledge paternity already during pregnancy (§ 1594 BGB), and you can make a joint custody declaration (Sorgeerklärung, § 1626a BGB). Both are free at the Jugendamt and make the birth registration much easier.
7. Start thinking about the birth and money
Around the middle of pregnancy, look at where you want to give birth (Birth Options) and plan Elterngeld and Elternzeit (Elterngeld & Elternzeit). An overview of all benefits is in Family Benefits Overview.
Check-ups week by week
Pregnancy is counted in weeks from the first day of your last period (“SSW”). A full-term pregnancy lasts about 40 weeks.
- Weeks 1–13: Mutterpass, first blood tests
- Weeks 9–12: 1st ultrasound
- Weeks 19–22: 2nd ultrasound
- Weeks 24–28: glucose test for gestational diabetes
- Weeks 29–32: 3rd ultrasound
- Week 34: Mutterschutz starts (6 weeks before the due date)
- Week 40: due date
- 3–8 weeks after birth: your own check-up
Routine check-ups paid by statutory insurance; source: Mutterschafts-Richtlinien, G-BA.
Regular check-ups
Check-ups take place about every 4 weeks, and every 2 weeks in the last two months. They include weight, blood pressure, urine, the baby’s heartbeat and position. (Mutterschafts-Richtlinien)
Weeks 1–13: first trimester
- Confirm the pregnancy, get your Mutterpass and first blood tests (blood group, antibodies, rubella immunity, and more).
- First ultrasound around weeks 9–12.
- Information about optional prenatal tests. A blood test for trisomies (NIPT) is only paid in individual cases after a doctor’s consultation (familienplanung.de).
- Start looking for a Hebamme (step 2 above).
Weeks 14–27: second trimester
- Second ultrasound around weeks 19–22.
- Gestational diabetes screening (glucose test) between weeks 24 and 28.
- Book a birth preparation course; insurance pays for it.
- Look at hospitals or a birth centre and register (Birth Options).
- Ask about recommended vaccinations in pregnancy, such as whooping cough and flu (STIKO, Robert Koch Institute).
Weeks 28–40: third trimester
- Third ultrasound around weeks 29–32.
- Your doctor or midwife issues the certificate of your due date. Use it to apply for Mutterschaftsgeld.
- Maternity leave begins 6 weeks before the due date (§ 3 MuSchG). See Mutterschutz.
- Prepare Elterngeld and Kindergeld papers so you can apply right after the birth (Elterngeld, Kindergeld).
- Choose a paediatrician (Pediatric Care) and pack your hospital bag.
After week 40
Many babies come a little later. After the due date you will be checked more often, and your doctor or hospital will discuss with you when an induction makes sense.
Call your doctor, the hospital or 112 straight away if you have bleeding, fluid leaking, regular contractions before week 37, a severe headache with blurred vision, or if your baby moves much less than usual.
After the birth: your own check-up
Book an appointment with your gynaecologist about 3 to 8 weeks after the birth, or earlier after a caesarean or complications. The doctor checks how your body is healing and you can talk about contraception, pelvic floor training and how you feel. (gesund.bund.de)
What your health insurance pays
If you have statutory health insurance (gesetzliche Krankenversicherung, GKV), pregnancy and birth care is covered by law. You do not pay extra for the services below.
What statutory insurance covers
- Medical care: all check-ups, ultrasounds and tests listed in the Mutterschafts-Richtlinien (§ 24d SGB V).
- Midwife care (Hebammenhilfe): during pregnancy, at the birth and after the birth, including home visits and breastfeeding advice.
- Birth preparation course: up to 14 hours with an approved midwife or physiotherapist; live online courses count too (AOK). The partner’s fee is usually not covered, but some insurers pay it as an extra, so ask yours. Many midwives and hospitals run courses in English; book early, because courses fill up.
- Postnatal course (Rückbildung): see Birth Options.
- Medicines and remedies needed because of the pregnancy, without the usual co-payment (§ 24e SGB V).
- The birth itself, in hospital, in a birth centre or at home (§ 24f SGB V).
- Home help (Haushaltshilfe) if you cannot run the household because of the pregnancy or birth (§ 24h SGB V).
- Mutterschaftsgeld during maternity leave if you are employed (§ 24i SGB V).
Mutterschaftsgeld in short
During maternity leave you keep roughly your full net pay through Mutterschaftsgeld and an employer top-up; who pays and how to apply is in Mutterschutz – Maternity Protection.
What is usually not covered
Some tests are offered as private extras (IGeL), for example certain extra ultrasounds or the toxoplasmosis test without a medical reason. Ask what is medically necessary before you pay. Some Krankenkassen pay extras voluntarily, so ask yours.
Private insurance
With private insurance, what is covered depends on your contract. Check early what is paid for the birth, midwife and newborn, and whether your baby can be insured with you.
Not insured?
Pregnancy counselling centres can help you find a way into insurance and to pay for care. Find a counselling centre.
Trying for a baby with treatment (IVF)
- Statutory insurance: pays 50% of IVF or ICSI for up to 3 attempts. Conditions: you are married, both are at least 25, the woman is under 40 and the man under 50, and the insurer approves the plan before treatment (§ 27a SGB V).
- Extra funding: In 12 federal states, the federal and state governments add funding, also for unmarried couples. Check with the online Förder-Check (Familienportal; informationsportal-kinderwunsch.de).
Sources
- Mutterschafts-Richtlinien, Federal Joint Committee (G-BA)
- § 24d SGB V, midwife care
- § 2 SchKG, right to pregnancy counselling
- § 1594 BGB and § 1626a BGB, paternity and custody
- familienplanung.de, Federal Institute for Public Health (BIÖG)
- § 3 MuSchG, protection periods
- § 15, § 11, § 13, § 17, § 18 MuSchG, telling your employer, unsafe work, dismissal, pay
- STIKO vaccination recommendations, Robert Koch Institute
- §§ 24c–24i SGB V, pregnancy and maternity benefits
- § 10 SGB V, family insurance
- Mutterschaftsleistungen, Familienportal of the Federal Family Ministry
- Wochenbett, gesund.bund.de (Federal Ministry of Health)
- Patientenservice 116117, Kassenärztliche Bundesvereinigung
- Ammely midwife search, German Midwives’ Association
- Aftercare midwife, familienplanung.de
- Geburtsvorbereitungskurs, AOK
- Pregnancy counselling, Familienportal
- Hilfetelefon Schwangere in Not, Federal Family Ministry
- § 27a SGB V, fertility treatment
- Funding for fertility treatment, Familienportal