Individual Health Services (IGeL-Leistungen)

During pregnancy you are entitled to ten to twelve check-ups and consultations. Your health insurance will have to cover the cost of this. So you already have good care for you and your baby. In addition, you can have other tests and examinations done that your health insurance does not have to pay for. They are called individual health services and shorted to ‘IGeL’ in German. In most cases, you'll have to pay for them yourself. But there are exceptions. Therefore, it is best to ask your insurance company if you would like to use any IGeL services.

The question of which additional services make sense and which do not is not so easy to answer. Therefore, your doctor should take the time to inform you in detail about the advantages and disadvantages of the individual offers. The consultation should address your personal situation and show you why a particular additional benefit may or may not make sense in your pregnancy. After the consultation, you always have the option of taking your time to think things over first and then make use of the service at a later date. It is also important to know that the costs for the same IGeL service can differ from one medical practice to another.

The online IGel-Monitor provides information about the benefits of individual IGeL and is a good decision-making aid. Behind this is a team of experts who collect and evaluate the current knowledge about individual additional services. They make the results available in standard German and the simplified language known as ‘easy German’, as well as in German sign language at www.igel-monitor.de. All insured persons should thus have the possibility to inform themselves well before they decide for or against an IGeL. Below you will find descriptions of the additional services that gynaecologists most often recommend to pregnant people.

The toxoplasmosis test is a blood test that shows if you have antibodies to a pathogen called Toxoplasma gondii. It can cause the disease toxoplasmosis. It mainly affects cats. For humans, the pathogen is usually harmless. Many people don’t even notice if they have a toxoplasmosis infection and then become immune. However, if you are infected for the first time during pregnancy, it can cause damage to the health of the fetus or even lead to a miscarriage. A toxoplasmosis test provides clarity. If the result is positive, you can rest easy. If the test is negative, you should protect yourself from infection. It is important, for example, that you pay great attention to hygiene when coming into contact with cats and only eat well-cooked meat and well-washed fruit, vegetables and salad. If there is a reasonable suspicion of infection with toxoplasmosis, statutory health insurance will pay for the test.

Ringworm is a harmless childhood disease. However, if you become infected with it during pregnancy, it can have serious consequences for the pregnancy. A blood test can show if you have antibodies to the virus. If that's the case, you have nothing to worry about. If you don't have antibodies, an infection can lead to anaemia in the fetus and thus to heart damage, among other things. It also increases the risk of premature birth or miscarriage. Doctors can then monitor the pregnancy at regular short intervals via ultrasound in order to counteract the first signs of anaemia, for example with blood transfusions via the umbilical cord. It is best to have the test done before or at the beginning of a pregnancy.

The cytomegalovirus test is a blood test that shows if you have antibodies to cytomegaloviruses. If the test is positive, everything is fine. This shows that you have already been infected with the pathogen. If the test result is negative, you should be especially careful not to become infected. If you contract the disease for the first time during pregnancy, the fetus may become ill. Cytomegaloviruses are transmitted through bodily fluids, especially from young children, but also through breastmilk and the placenta. To protect yourself and the pregnancy, you should avoid contact with saliva or urine, especially from young children, from the beginning of pregnancy and wash your hands regularly. Also, don't share dishes and cutlery with toddlers, disinfect toilets and sinks regularly, and be careful when changing diapers, feeding, and blowing noses. The test is particularly useful if, for example, you have a lot of contact with young children in your job. In this case, the employer usually pays for the test.

The group B strep test is done in the last trimester of pregnancy. To do this, your doctor will take a swab from your vagina and examine it to see if it contains group B streptococci. These are actually harmless bacteria that are found on the skin and often in the intestinal tract. In some people, they also occur in the vagina. B streptococci are dangerous only when they occur in pregnant people shortly before birth. Then the baby can be infected through the birth canal during delivery. Possible consequences for the newborn are blood poisoning, pneumonia or meningitis. If the B streptococcus test is positive, doctors can provide an antibiotic at birth as a precaution. This can prevent infection of the baby.

During pregnancy, doctors can also look for indications of fetal diseases or chromosomal disorders. This is called prenatal diagnostics. Most of these are called ‘IGeL services’ (IGel-Leistungen) in Germany, (meaning ‘individual health services’) for which a fee is charged. However, there are also three basic ultrasound examinations that are free of charge for pregnant people with statutory health insurance. You can read more about this in the text on prenatal diagnostics.