What You Need to Know About an Out-of-hospital Birth in Berlin?

01 September 2022 | Before Your Baby is Born | By Lisa H

If you’re considering an out-of-hospital birth in Berlin, you may be wondering what guidelines and processes to follow to explore this option.

First off, there are two option for an out-of-hospital birth:

  1. Traveling to a birthing center (Geburtshaus in German)

  2. Planning a home birth (Hausgeburt in German) at your house/apartment

Who is an out-of-hospital birth for?

Anyone with an uncomplicated pregnancy expecting only one child can consider an out-of-hospital birth.

Note however 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 midwife and/or OBGYN if you have any concerns.

Why choose an out-of-hospital birth?

Choosing a place to give birth is a very individual decision. In the end, it comes down to where you feel safe and well taken care of, both when it comes to the medical assistance and the atmosphere.

In our blog post “How to choose where to give birth”, we look at the pros and cons of an out-of-hospital birth (as well as a hospital birth).

If you’re interested in an out-of-hospital birth, you could read the first part of Marie Mongan’s book “Hypnobirthing” which talks about a woman’s needs in labour and what makes her feel safe and sound. Again, this is an individual decision and a home birth or birthing center is not for everyone.

If you are considering it, here are some of the positive aspects to highlight for an out-of-hospital birth:

  • Your midwife (who takes care of you during your pregnancy) will be on-call 24/7 for the last few weeks of your pregnancy

  • You can call them when you think labor may have started to discuss next steps

  • You will have 1-on-1 care with your personal midwife, who you will have developed a close relationship with, during labor (usually, a second midwife joins to assist)

  • The environment will be calm, cozy and home(-like)

  • There will be no interventions such as a drip or CTG cables, you can move around freely

  • No transfer to the birthing place during labor with a home birth

  • Immediate bonding with the family (partner, siblings) at home

What are the cons of an out-of-hospital birth?

There’s a few things you need to be aware of if you’re considering giving birth at home or at the birthing center:

  • There is no option for an epidural or other chemical pain medication

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

  • If complications arise, you will need to transfer to a hospital and will be taken care of by the midwives on staff at the hospital (in most instances, your “personal” midwife will not be able to come)

  • If not already home, you will go home about 3 hours after the baby is born at the birthing center. This may seem scary but your midwife will come check on you at home frequently (up to twice a day in the first days) and you may actually be better taken care of at home than at the hospital where sometimes the maternal ward is not very well staffed.

  • Registration of birth needs to be done by you within 7 days of the birth (find out what you need to do for this at the Standesamt of your district)

  • The U2 baby checkup 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 (not all pediatrician’s do the U2 since a lot of families have it done at the hospital). Check if perhaps they can visit you at home for the checkup.

  • You will need to schedule an appointment for the newborn hearing screening at an ENT office. You will get a referral paper at the U2.

  • If your midwife does not offer the newborn screening, this needs to be done within 36 to 72 hours of the birth at the pediatrician’s office (this is a voluntary blood test to check for certain metabolic diseases and hormonal disorders that is paid for by your health insurance).

Home birth versus birthing center?

Objectively, the two are the same so it will depend on your personal preference. Here’s some questions to help with the decision making:

  • Will you feel more comfortable at home or at a birthing center?

  • Do you mind the transfer to the birthing center during labor and after you gave birth?

  • What is the distances to the nearest hospital should you need to be transferred?

  • What are the “amenities” at home and at the birthing center (eg a bath tub)?

  • Do you mind purchasing a few additional throw away items (sheets, towels, water proof pads, etc.) for a home birth? (The midwife will provide a list beforehand and will generally help with the biggest items to clean up after)

What are the risks and how can I learn more?

If you’d like to consider an out-of-hospital birth, make sure you are aware of the risks associated with it. Attend an information session at the birthing center or meet with a home birth midwife to learn more and have your questions answered. If afterwards you are still considering this option, you will have an appointment with your midwife where they talk in more detail about the risks.

If you decide to go for it, you will also have an appointment closer to your due date to talk about what to do if the midwife does not get there in time, if there are complications during labor, etc. It is important (for both partners) to be aware and comfortable with these factors before making a decision.

Questions to ask

Here’s some of the questions you might like to ask your midwife when deciding if this is the right option for you:

  • Number of years of experience, number of births attended

  • Why did they decide to offer out-of-hospital births? What is their birthing philosophy?

  • What are the steps when labor begins?

  • What percentage of women are transferred to the hospital and what is the main reason for this?

  • What other complications have they seen arise?

  • Will a second midwife join? If so, can you meet them in advance?

  • Will they be able to also do the post-natal care?*

  • Do they offer (or can they recommend) a birth preparation course?

  • Any specific questions you have about your personal situation, your pregnancy or any fears and doubts that might plague you.

*Sometimes, midwives working at a birthing center or doing home births don’t have capacity to do the post-natal care, so it is a good idea to start looking for a separate midwife to cover this period while you explore your options.

How to register for an out-of-hospital birth?

📍 First off, you should decide if you want to explore this option as quickly as you can, as spots at the birthing centers and with home birth midwives fill up quickly in Berlin!

If you’d like to learn more, check with your closest birthing center(s) about upcoming information sessions (most are currently paused due to Covid and alternative ways to learn more are listed below).

For a home birth, you can select this option in the midwife search platforms ammely and Berliner Hebammenvermittlung (see links in our article of midwives).

Here’s a list of birthing centers that were open as of June 2022 (unfortunately, a couple had to close in recent years):

Happy birthing!

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