What Does the German Midwife Do?

Written by Johanna Tonn-Straavaldsen

One of the first things that many women* hear when they become pregnant in Germany is the question “Have you found a midwife yet?”

The search for a midwife has become a rite of passage with many women* starting their quest right after taking a pregnancy test. But for international women* who are new to the German system of care, the word midwife (Hebamme) might bring up a whole host of questions, starting with the most basic: What do midwives in Germany even do? 

At its core, the midwifery model of care (which the German model of perinatal care is based on) sees pregnancy and birth as normal physiological events and not medical emergencies. Midwives are experts in pregnancy, birth, and postpartum and have historically been the primary sources of prenatal care, birth support, and postpartum care. The role of doctors in care was typically limited to high risk pregnancies or instances in which a problem with the mother* or baby emerged.  

Things have changed a bit over time and OB-GYNs now play a bigger role in care than they did in the past, but midwives continue to play a key role. Because of this, it is so important for international women* to know about all that midwives in Germany offer and what to expect from their care. It is also important to know that midwives may be employed by a hospital, birth center, and/or work independently.  

So, now to that question: What do midwives in Germany even do? 

1. They provide prenatal care: While many people go to their OB-GYN (Fraunarzt/Frauenärztin) for prenatal care, midwives also provide prenatal or antenatal care either on their own or in conjunction with OB-GYNs. Midwives can do all that OB-GYNs can with the exception of ultrasounds. Many women* alternate care between their midwife and OB-GYN.  

   See our guide to care in pregnancy, birth and postpartum

2. They offer childbirth education and other courses: Midwives offer a wide variety of courses in pregnancy including childbirth education, prenatal fitness classes, infant care, and others. These may be offered through a hospital or through independent midwives. They also offer postpartum courses including postpartum recovery courses (Rückbildungskurse), postpartum fitness courses, infant first aid courses and more. 
   
   See our guide to perinatal groups and classes in Germany

3. They attend births: Whether in a hospital, birth center, or at home, midwives are the central caregivers in labor and birth. In fact, a midwife is legally required to be present at each birth in Germany, whereas a doctor is not.  

• Depending on the setting, a woman* or family may or may not have met the midwife who will provide care during labor prior to the birth. In general, midwives who work in birth centers or attend homebirths provide a broader spectrum of care and are well known to a woman* before labor begins whereas it is more likely that a woman* will meet a midwife for the first time when giving birth in a hospital setting.  

• Independent midwives (Beleghebammen) represent a hybrid option as these are midwives who have privileges at a hospital but are not directly employed by that hospital. These midwives have individual contracts with families and agree to attend their birth.  

Read about the difference between a midwife and a doula

4. They provide postpartum care of mothers* and babies: When people ask the question, ‘Have you found a midwife yet?’ this is what they are talking about. In Germany, midwives follow families closely in the days and weeks after birth and are the primary point of contact in this time. They make frequent house calls (every day or every other day in the first week) to monitor the mother*’s recovery, baby’s health, and address any questions or concerns. Due to a number of different issues, there tends to be a shortage of midwives in many communities and it is advisable to begin your search earlier rather than later. It can feel a bit silly searching for a midwife when you barely feel pregnant, but it cuts down on stress further down the line.  

It’s pretty clear that midwives play a key role in practically every aspect of perinatal care and are to be credited for all of the strengths of the German system care. While international women* may not be immediately familiar with midwives or their role in pregnancy, birth, and postpartum, it typically doesn’t take long to experience all of the benefits!