My understanding of Germany’s maternity system did not begin in a hospital or with a government brochure. It began inside my daughter’s home in Munich.

My grandson Salar had been born. Like any grandfather, I was watching the baby. But I also found myself watching the system around him.

A midwife came to the house after the birth.

She was not there simply to weigh a baby and leave. She checked how mother and child were doing. She discussed feeding and recovery. Questions that might have required another hospital visit elsewhere could be raised inside the home.

I come from Pakistan, where families often provide much of the support after childbirth themselves. Watching professional postnatal care enter the home made me curious.

Was this simply my daughter’s experience in Munich, or was I seeing something built into the German health system?

The answer turned out to be more interesting than I expected.

Midwives occupy a substantial place in German maternity care

A German midwife, or Hebamme, is not merely a birth attendant.

Midwives can support women during pregnancy, childbirth and the weeks after birth. During pregnancy, they can carry out many routine prenatal examinations. Ultrasound examinations remain the responsibility of doctors. Germany’s official family-planning portal explains the midwife’s prenatal role.

For an uncomplicated birth, midwives have substantial professional responsibility. Medical help is brought in when circumstances require it. This makes the simple description of German maternity care as either “midwife-led” or “doctor-led” misleading. The system is more integrated than that.

The distinction matters for foreigners accustomed to health systems in which pregnancy care is imagined almost entirely through the obstetrician. Germany gives the midwife a much larger role.

What surprised me happened after the hospital

The postpartum period was the part I remembered most clearly from Munich.

Germany calls this period the Wochenbett. It is the time when the mother’s body is recovering and the family is learning how to care for the newborn.

For women covered by statutory health insurance, midwife support can continue at home after birth. During the first ten days following birth, the statutory framework can provide for up to 20 midwife contacts. Further contacts are available during the baby’s first 12 weeks under the applicable rules and according to need.

That begins to explain what I had seen. The home visit was not an informal favour or a luxury arranged by an unusually attentive family. It belonged to a recognised part of German maternity care.

A postpartum midwife can monitor the mother’s physical recovery, including wound healing and uterine involution. She can help with breastfeeding and other feeding questions. She also observes the baby, including weight and umbilical care.

There is an important qualification, however. Germany provides continuity of midwifery care, but that does not guarantee continuity with the same individual midwife. The woman providing postpartum care may be different from the midwife present during the birth. The official postpartum guidance makes that distinction clear.

Finding a midwife can be the difficult part

A benefit written into a healthcare system is useful only if someone is available to provide it.

German official guidance encourages expectant mothers to begin searching for a midwife early because midwives can become fully booked. For an expat family, I would make this one of the first practical steps after pregnancy is established.

Do not wait until the final weeks.

The GKV-Spitzenverband provides a directory of freelance midwives whose services can be billed through statutory health insurance. Language can complicate the search. An international family may want a midwife who speaks English or another familiar language. In a large city such as Munich, possibilities may be greater than in a small town, but availability should never be assumed.

The practical lesson is simple: search early and ask specifically about postpartum care.

Who pays for the midwife?

This is another area where expat families should understand their insurance before the baby arrives.

Women covered by Germany’s statutory health insurance have an entitlement to specified midwife services during pregnancy, childbirth and the postpartum period. The statutory system defines which services can be billed and under what conditions. The GKV-Spitzenverband outlines the statutory framework.

Private insurance works differently. A privately insured woman should check her individual policy because reimbursement depends on the contract.

This distinction matters because foreigners sometimes hear that “midwives are free in Germany.” That wording is too casual. The more accurate statement is that Germany’s statutory health-insurance system covers defined midwifery services for eligible insured women.

Germany changed its midwife framework again in 2025 and 2026

There is another reason I wanted to revisit what I saw in Munich. Germany itself has been changing the rules governing midwife services.

A revised national Hebammenhilfevertrag, the contract governing midwifery services under statutory health insurance, took effect in stages from November 2025, with further provisions from April 2026. The changes affected remuneration, documentation and aspects of care during childbirth. The current contract and implementation information are published by the GKV-Spitzenverband.

That tells us something important. Germany’s midwife system should not be romanticised as a perfect model that requires no repair. The country is still negotiating how midwives are paid, how services are organised and how professional attention can be provided during childbirth.

The system impressed me precisely because I saw what it could do inside a family home. Its pressures should be part of the story too.

Germany’s family system does not stop at medical care

The more time I spend in Germany with my family, the more I notice how childbirth connects several institutions. Healthcare is one part. Income replacement is another.

Germany’s Elterngeld system can replace part of a parent’s lost income after birth, but its calculation depends heavily on employment status. A salaried researcher and a freelancer can face quite different assessment periods even when their incomes look similar. I examined that divide in Germany’s Elterngeld Has a Hidden Employment Divide.

Seen together, the two systems reveal something about the German welfare state. The midwife asks how mother and baby are recovering. The Elterngeld office asks how the parent earned money before the baby arrived. Both systems surround the same event, but they approach the family from different directions.

What expat families should do before the birth

For someone moving through a first pregnancy in Germany, I would concentrate on a few practical questions rather than trying to understand the entire health system at once.

Find out whether your insurance is statutory or private and what it covers. Start looking for a midwife early. Ask whether the midwife provides prenatal care, postpartum home visits or both.

If language matters, raise it during the first contact rather than assuming English will be available. Keep the obstetrician involved where medical examinations or complications require a doctor. And do not assume that the midwife attending the birth will necessarily be the person who comes to the house afterwards.

These are small questions before a baby arrives. They become much larger questions afterwards.

What stayed with me in Munich

I do not remember every detail of those first days after Salar was born.

I remember the house. I remember everyone adjusting to the presence of a new child. And I remember a healthcare professional coming through the door instead of expecting a recovering mother and newborn to make another journey out.

That small reversal stayed with me.

Germany’s maternity system has its shortages and arguments over funding. Families can struggle to find a midwife. The arrangements are more complicated than the simple picture I once had.

But the idea behind that home visit still strikes me as important.

After childbirth, care should not end at the hospital door.

Sometimes it should walk through the family’s door instead.

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This article provides general information about maternity care in Germany. Individual medical needs and insurance coverage vary. Families should confirm current arrangements with their health insurer, midwife, doctor or other appropriate healthcare professional.

About the author: Muhammad Munaeem Jamal writes about Germany, political economy, travel and family life across borders.