For many expectant moms, the choice is clear: they want to give birth in a clinic.
Which clinic that will be can be decided calmly over the course of pregnancy. However, some women have the desire to give birth not in a clinic, but in their own four walls. Because in Germany there are relatively few midwives who attend home births, you should start looking for your home birth midwife as soon as you hold that positive pregnancy test in your hand. Depending on the region, this might mean even before your first doctor’s appointment.
Now, you may not be exactly sure what a home birth really means for you and your baby. Let’s shed some light on it.
Start looking early for a midwife who will accompany you during your home birth.
How does a home birth actually work?
In a home birth, a healthy pregnant woman expecting a healthy child is attended by her midwife, whom she already knows from prenatal care. The birth takes place in your home – you don’t have to decide when to leave for the clinic or worry about being sent home again. You stay in close contact with your home birth midwife, and as soon as you need support, she comes to you with everything necessary.
Once she arrives, she will first observe you a bit:
- How are you doing during contractions?
- Do you need support for the right position or breathing?
- Can you relax well between contractions?
After that, she will examine you and your baby. She may ask whether she can check your cervix and the amniotic sac to better assess what stage of labor you are in. She will also listen to your baby’s heartbeat after contractions to ensure that the baby is coping well.
Now it’s time
When you and your midwife expect the baby to be born soon, she will set up all the equipment she might need for the birth. After some time, the moment arrives: your baby is born – calmly, safely, and in familiar surroundings.
- In your bathtub,
- in your living room,
- or in your bedroom.
Wherever you feel most comfortable.
Afterward, your midwife will examine you and your newborn, ensure your baby has breastfed for the first time, document everything, tidy up, and then quietly leave after 2–4 hours until her first postpartum home visit.
Sounds good? It is!
But what if something doesn’t go smoothly during pregnancy, birth, or right afterward?
To ensure both mother and baby are well in the end, there are many safety nets. After first contacting your midwife, you will have an initial meeting. She will ask you many questions about your health and pregnancy so far and explain how she works.
- Does she have a colleague who can support during the critical phase of birth?
- She will also explain in which cases a home birth cannot be planned from the start.
There is even a criteria list from the health insurance companies to avoid risky situations.
For example:
- Expecting twins?
- Problems with blood clotting?
In such cases, you are better cared for in a clinic. (You’ll find a link to the “exclusion criteria of statutory health insurance” at the end of the article.)
Prenatal check-ups are important
Sometimes, a situation that rules out a home birth only arises during pregnancy. Your midwife will recognize this during check-ups and advise you on the safest place to give birth. This preparation helps prevent emergencies during labor.
Sometimes, unforeseen complications arise during labor. But your midwife always has techniques and emergency medications with her to act immediately – either to resolve the situation or stabilize it until you can be transferred to a clinic. To avoid emergency transfers, your midwife will continuously monitor you and your baby’s well-being and, at the slightest doubt, discuss with you how to proceed.
Often, the reason to transfer to a clinic isn’t even an emergency, but simply because many first-time mothers imagined contractions differently and, after experiencing a few, decide they’d like stronger pain relief. Changing your mind is perfectly okay – planning a home birth does not bind you to any obligation, neither to yourself nor to your midwife.
Whether home is the ideal place to give birth is a personal decision for each woman and family. The discussions about it can get quite emotional. To assess safety, all births in Germany are recorded statistically, and the data show: healthy women without risks are well cared for by our well-trained home birth midwives.
Tips if you feel home is the perfect place to give birth
1. Finding a midwife
At the latest, once you have your maternity record booklet (Mutterpass), you should contact a home birth midwife. All health-insurance-registered midwives (“Kassenhebammen”) can be found in this list. You may need to broaden your search radius – if there isn’t one in your town, try entering 50 km into the search.
2. Registering with a clinic
Even if you plan a home birth, I recommend registering with the nearest clinic. If a transfer becomes necessary, your data, blood type, and pregnancy stage are already known, saving valuable time.
3. Costs
The costs for the birth, labor support, and first baby check-up are covered directly by health insurance. However, midwives are on call for you day and night for up to 5 weeks. For this “on-call availability,” depending on the region and midwife, a fee between €500 and €1,000 is charged. While that may sound like a lot, remember: your midwife greatly restricts her personal life for you – no nights out, no spontaneous getaways. Some insurers reimburse part of this fee upon request, so it’s worth asking.
4. Bureaucracy
As with clinic births, every child born in Germany must be registered with the registry office (Standesamt). You’ll receive a form from your town and complete it with your midwife, who certifies the birth. This is also where you officially register your baby’s name. Don’t worry if you haven’t decided beforehand – you have one week after the birth.
5. Last preparations
As your due date approaches, you can prepare everything for the birth, the first days, and in case of a clinic transfer:
- Bag with important papers: maternity record, insurance card, medical documents, phone + charger
- Hospital bag: toiletries, medications, comfortable clothes, towels, baby’s going-home outfit
- Birth supplies box: towels, dextrose, snacks & drinks, large underwear, maternity pads, fitted sheet + plastic cover, disposable pads, birthing pool or inflatable tub, baby blanket, hat, muslin cloth, camera
