HEDI - Check-Ups During Pregnancy

To ensure that you and your developing baby are well looked after during pregnancy, you are entitled to regular check-ups. The costs for this are covered by your health insurance. You should definitely make use of these check-ups to avoid any unnecessary risks for you and your baby. The results of all your check-ups and screenings will be recorded in your maternity record (Mutterpass), which you will receive at one of the first examinations.

Who does the check-ups?

Most check-ups can be carried out by either midwives or gynaecologists. So you don't necessarily have to visit your gynaecologist's office for every exam. Many women seek care from a gynaecologist and a midwife at the same time. In some gynaecological practices, midwives are even part of the team or work together with the practice. The only exceptions are the ultrasound examinations at the beginning, middle and end of pregnancy, which must be performed by a doctor. If you have a high-risk pregnancy, medical attention is recommended.

Medical history and consultation at the first check-up

If you think you are expecting a baby, contact your doctor or a midwife. After pregnancy is confirmed, prenatal care begins with an in-depth medical history interview. For example, the person conducting your check-up will ask about any illnesses that you currently have or have had in the past. They will also talk to you about hereditary diseases in your family or in the father’s family. They will also ask you about any previous pregnancies. During a counselling session, you will also receive information about important topics, such as how you should eat, what regulations apply to your work and what you need to bear in mind if you need to take medication during pregnancy. At your first check-up you will also have detailed blood work done. You can read the test results on pages 2 and 3 of your maternity record (Mutterpass).

This is done at every appointment

Some blood values need to be checked by your midwife or doctor at every examination. Your blood pressure, weight, and urine are always checked, as is the distance between your pubic bone and the upper edge of the uterus, which indicates the state of your uterus. If the pregnancy is further along, your doctor or midwife will listen to the baby's heart. Its position must also be checked regularly. You will also have blood taken for some tests.

Ultrasound examinations

Three ultrasound examinations are done as part of preventive care; these are also sometimes called ‘sonography’. They take place around the 10th, 20th and 30th weeks of pregnancy. Health insurance will pay for further screenings under special conditions, for example if your doctor has found any abnormalities. It is generally possible to determine the fetus’s sex starting at the 14th or 15th week of pregnancy and you may be informed of the sex around the end of the 14th week. Let the person doing the examination know if you'd rather be surprised.

How many check-ups am I entitled to?

During the course of your pregnancy, your midwife or doctor will give you ten to twelve check-ups. At first they take place every four weeks, and then starting approximately with the 32nd week of pregnancy they take place every fourteen days; from the 40th week of pregnancy onwards you should have a check-up every two to three days. If you're expecting multiples, you're entitled to additional testing.

Who pays for check-ups?

Your health insurance covers the costs of all examinations to which you are entitled by law. They are set out in the official German maternity guidelines (Mutterschaftsrichtlinien). If your pregnancy has been classified as a high-risk pregnancy, your health insurance will pay for further measures. There are also some examinations that are not covered by every insurance company in Germany. These include, for example, first trimester screenings or a toxoplasmosis test. These are considered supplementary screenings. You must pay out of pocket if you want these or other health services considered to be supplementary; such services are shortened to ‘IGel services’ (IGel-Leistungen), meaning ‘individual health services’. Ask your doctor or midwife to tell you exactly what these services are. Then you can make a well-informed decision about what additional tests should be done.

If you don't have health insurance

If you receive social assistance (Sozialhilfe) under the Federal Social Assistance Act (Bundessozialhilfegesetz), you can count on assistance from the Social Welfare Office (Sozialamt). Maybe you don't have a regular residence status and you are pregnant. Then you can turn to various counselling centres, for example the Early Help Network (Netzwerk der Frühen Hilfen).