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From Elternzeit to midwives: An American’s view on having a baby in Germany

When The Local Germany Editor Rachel Stern had a baby, she found a new appreciation for the German healthcare system, especially compared to her home country of the US.

A parent holds the hand of a baby.
A parent holds the hand of a baby. Rachel Stern has been thinking about the differences between giving birth in Germany and the US. Photo: picture alliance/dpa | Fabian Strauch

“Only a year?” a German friend replied with genuine surprise when I told her how long I was on parental leave.

As we both walked with our two-month old daughters through a sunlit Berlin park, brimming with pram-pushing mums on a Monday afternoon, I mused that I would already be returning to work if I was in the US right now. 

Comparing social policies in Germany and the US may be like comparing apples and oranges (or a fruit to a five course meal). But doing so as a new parent has made me appreciate calling this country home more than any other time in my near-decade here. 

The lack of time off – and support structures – in the US too often turns new motherhood into an ordeal more stressful than it already is after the intense process of just giving birth followed by around the clock care of a new life. Yet Germany seems to treat this postpartum period as a sacred time, with insurance backed daily check-ins from midwives, free classes and resources galore, and (at least in my American perspective) ample time off. 

READ ALSO: Everything you need to know about parental leave in Germany

In Germany it’s possible to take up to 14 months of paid parental leave (Elternzeit), divided among both mothers and fathers, and up to three years of job-protected leave.

The Local's Rachel Stern with baby Amelie 10 days after she was born.
The Local’s Rachel Stern with baby Amelie 10 days after she was born. Photo: Jess Haverkamp

As day care (Kita) is free – or nearly so – in all 16 states from the age of one, it’s common that parents step away from the job for at least this amount of time.

Meanwhile in the US, the only developed country with no paid parental leave, many workers don’t even have access to unpaid time off. That’s led to a shocking statistic that one in four women go back to work within two weeks of giving birth, cited by the Biden administration in a call for better family leave policies.

This explains why I would frequently experience reverse culture shock when reading articles on American sites about how to stash away “maternity leave funds” – where friends and family chip in so that taking off even a few weeks is possible. 

Or how to bank up enough breast milk for returning to work full time, at the stage when most Germans would still be in Wochenbett – the six weeks following birth when women are entitled to free home care from a Hebamme (midwife).

Even after a complications-free birth my nurses urged me to stay in the hospital for as long as I needed and wanted – a sharp contrast to the US where many women try to check in just after midnight to maximise the two days insurance will (partially) pay for. Even with insurance, hospital birth bills in the US will come to between $5,000 and 14,500 depending on the type of delivery.

Birth and bureaucracy

But this being Germany, there can still be boisterous bureaucracy to claim all of the perks for parents. I grinned when reading American advice to ‘Interview paediatricians’ before choosing one, contrasting it with my own experience of contacting as many Kinderärzte nearby as possible in the hopes one wouldn’t say they’re already too full. 

This is not quite as intimidating, however, as the notorious search for a Kitaplatz, in which it’s typical to send out 50 or more applications as soon as you can fill in your child’s date of birth. Several parents around Germany have even sued for a spot, after the endless waiting lists never opened up.

READ ALSO: Kitas: Why are parents suing for a childcare spot in Germany?

To apply for these things in the first place you need a birth certificate, which depending on the local Standesamt (administrative office) can be a multi-week ordeal.

But there’s one piece of bureaucracy Germans don’t waste time on: at two weeks’ old, my daughter received her first official piece of post. Rather than sending congratulations, it was a tax ID number, listing her “move in date” to our Berlin address as her date of birth.

I’d still trade tedious paperwork over forking out a frivolous amount for childcare and medical expenses. And, above all, for living in a society that recognises time of work with a new baby – and healing from having one – isn’t a privatised luxury but a precious necessity in which even a year passes by quickly.

Member comments

  1. I’d like to point out that new parents in America have 12 weeks of protected “unpaid” leave FMLA, and many States offer 4-6 weeks of paid parental leave as well. Most companies provide paid parental leave as a benefit of employment and employees can combine it with vacation time to take home full paychecks while they are at home or stretch out leave. Many companies allow 1 year of leave (some of it paid) and many companies allow adjustable schedules when parents do come back to work. 1 in 4 women do indeed go back to work within 6-8 weeks, but 3 in 4 don’t and that should be focused on. There are pros and cons to each system. I’ve found it is harder to find really good paying full time work in say engineering in Germany or Austria if you are a female of child-bearing years. Why? They’d rather hire a man who won’t have a kid and be missing for what could be years. They can and do ask you if you are pregnant or planning on having children in interviews. This is not allowed in the US. I’ve found it easier to find employment equity in the US because of the non-government enforced parental leave system. It’s all in what you’re after I suppose.

  2. This is another perspective from someone from the US. I come from Louisiana which is a right to work state. I’ve worked in IT at a medical records company, a steel factory, insurance company and a small self owned business. None of them offered anything but the most basic unpaid maternity leave. When I saw here in Germany what the mothers and fathers have I couldn’t believe it.

    Watching what my friend had when she had her baby was unbelievable. She was off from 2 months before the baby was born until he was a year and a half old. A woman in her position would have never received that much paid time off at any of the companies I have been with.

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Who can get the monkeypox vaccine in Germany – and how?

The monkeypox virus continues to spread in Germany and the vaccines panel is recommending that three groups of people get a jab. Here's who can get one - and how.

Who can get the monkeypox vaccine in Germany - and how?

What’s the current monkeypox situation in Germany? 

The monkeypox virus is still spreading in Germany, with 2,982 confirmed cases of the disease recorded by the Robert Koch Institute (RKI) as of Tuesday.

The virus, which causes small lesions on the skin alongside flu-like symptoms, is primarily transmitted through close physical and sexual contact. The vast majority of cases have so far been found in gay men, though five women have also had the virus in Germany to date. 

On Tuesday, the RKI reported that a four-year old girl in Baden-Württemberg had contracted monkeypox from two adults in her household but was asymptomatic. Before that, two teenage boys aged 15 and 17 were also found to have picked up an infection. 

READ ALSO: Monkeypox in Germany: Two teens ‘among new infections’

With the number of cases rising globally, the World Health Organisation (WHO) has declared the situation an “emergency of international scope” – the highest alert level possible.

This is a sign for members of the WHO like Germany to implement containment and preparation measures, such as rolling out vaccination campaigns. For its part, the Robert Koch Institute (RKI) is tracking the cases and has put out an information sheet about the best practices for avoiding the measures and what to do in the case of an infection.

What should people do if they contract the virus?

If people think they have a monkeypox infection, the first thing they should do is seek the advice of a healthcare practitioner such as a GP or sexual health advice clinic. However, the RKI advises people to phone the clinic beforehand to let them know they believe they may have the virus.

In confirmed cases of monkeypox, people should self-isolate at home until the lesions on their skin scab over and peel over, but for a minimum of 21 days. They should avoid physical contact and sharing items like hand towels or bed sheets with others and should wear condoms during sex for at least eight weeks.

Healthy people with no pre-existing conditions are generally fine to remain at home with someone who has contracted monkeypox, but those with weakened immune systems, pregnant women, elderly people and children under the age of 12 should move out for the duration of the isolation. 

READ ALSO: EXPLAINED: How Germany wants to contain the monkeypox

What monkeypox vaccines are available? 

The smallpox vaccine Imvanex, which has been available in the EU since 2013, was approved for use against the monkeypox virus on July 22nd, 2022. 

People are generally protected against monkeypox for at least two years after their first dose of Imvanex, but doctors recommend a second dose after a four-week interval in order to make this protection permanent. 

The vaccine is generally seen as a preventative measure but can also be used up as a so-called post-exposure measure to lower the risk of getting ill after contracting the virus. In this case, the vaccination is most effective up to four days after exposure. 

Who are monkeypox vaccinations recommended for? 

So far, the Standing Vaccines Commission (STIKO) has recommended that two primary groups of people get a monkeypox jab: men who have multiple male sexual partners and people who work in infectious disease laboratories. 

As mentioned, the vaccine can also be used to ward off illness or prevent a severe course shortly after someone has been exposed to the virus. 

READ ALSO: German vaccine panel recommends monkeypox jab for risk groups

Nurse laboratory monkeypox PCR

A nurse sorts monkeypox test samples in a lab. Photo: picture alliance/dpa/EUROPA PRESS | Carlos Luján

Is there enough vaccine to go around?

Not currently.

In May, the German Health Ministry preemptively ordered 240,000 doses of the vaccine – but so far just 40,000 of these have been delivered. 

This is far too little to cater for the estimated 130,000 people who fall into one of the target groups for a jab.

The remaining doses are due to be delivered in August and September, though some pressure groups are already calling for more to be ordered. 

On Friday, the German Aids Federation (DAH) called on the government to secure at least one million doses of the monkeypox vaccine in order to help stamp out the virus in Germany. 

“The goal must be to reduce the number of infections as quickly as possible and to get the epidemic permanently under control,” explained Ulf Kristal of the DAH board.

This can only be done if as many people in risk groups as possible are vaccinated, he added. 

How can people book a jab?  

At the moment, this varies quite a bit from state to state, with some issuing the jabs via the local health authorities and others supplying the doses to specialist HIV clinics and hospitals.

In Saxony-Anhalt, Bremen and Hesse, vaccinations are primarily organised through the local health authorities, so this should be your first point of contact to enquire about a jab if you live in these states. In Frankfurt am Main, however, a handful of specialised HIV clinics are also carrying out vaccinations, according the FAZ newspaper. 

In Saarland, too, appointments should be booked through the health authorities, though they are carried out at Saarbrücken University Clinic. In Hamburg, jabs are being administered solely at infectious disease clinics.

UKE university clinic Hamburg

The main entrance to the University Clinic in Hamburg, where monkeypox patients have been treated for the disease. Photo: picture alliance/dpa | Axel Heimken

Berlin offers the most diverse range of vaccinations and, with 8,000, has the largest number of vaccine doses available. Vaccinations are given in HIV specialist practices, counselling centres for sexual health as well as in several hospitals. A list of vaccination centres has been compiled by the German Association of Outpatient Doctors for HIV Treatment. Neighbouring Brandenburg organises vaccinations through the local health authorities as well as through GP’s practices.

In three federal states, only hospitals are responsible for monkeypox vaccinations. In Saxony, hospitals in Chemnitz, Leipzig and Dresden have been vaccinating since the end of June. In northern Schleswig-Holstein, outpatient clinics in Kiel and Lübeck are responsible. Neighbouring Mecklenburg-Western Pomerania is administering its doses exclusively through the University Medical Centre Rostock.

Several federal states have opted to roll out monkeypox vaccinations through both HIV clinics and hospitals. These include Bavaria, which has more than 3,500 vaccination doses available, as well as Rhineland-Palatinate, Lower Saxony and North Rhine-Westphalia, for which a list of all vaccination centres was recently published.

What else should people know? 

The monkeypox vaccine is perfectly safe, but people can experience a few side effects for a day or two afterwards, including soreness on the vaccination arm, fever and headaches. 

People with HIV should talk to a specialist before getting the vaccine, because the effectiveness may vary depending on your Helper T cell count. 

For more information on the clinics offering jabs, the German Aids Federation has published a helpful Q&A along with a list of clinics in each of the federal states, which can be found here (in German).