Healthy living Postnatal support for families

The birth of a child is a major life event that radically transforms daily life – especially in the case of a first baby. After the birth, the focus is on getting to know and caring for the new baby. A special bond develops gradually between the parents and the child. The baby needs its caregivers around the clock, especially in the very early days. This transition is challenging for most parents at first, and it can take some time for the family to find their feet with a new daily routine. It can be helpful to have friends and family members take care of everyday tasks such as grocery shopping. 

During the first 6 to 8 weeks after birth, a woman’s body recovers from the changes that occurred during pregnancy and childbirth. This time is referred to as the postpartum recovery period. Some women have limited physical movement due to birth-related injuries or following a cesarean section (C-section) and are need particular support. It is not uncommon for the birth of a child to be a life-changing experience for a woman that requires some time for her to process. Mood swings are not unusual after childbirth, as a woman’s hormone levels shift. Some women suffer from postpartum depression (also known as postnatal depression) following childbirth – a condition that requires medical treatment. All of these changes can impact on the daily life of the new family. 

A midwife is a key contact person following the birth. Midwives help and support the family. They also provide advice on any issues relating to the health of the mother and child and care of the newborn. 

A baby's first few months can sometimes be particularly challenging. In Germany, early prevention services provide many supports to families who are feeling pushed to their limits. These supports include a family midwife, who provides advice and assistance to those who find themselves in difficult life situations.

There are also many formalities to take care of in the weeks after the birth. It is helpful to find out about these during pregnancy, as some things can be prepared or completed even before the baby is born. 

The family portal provided by the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (Bundesministerium für Familie, Senioren, Frauen und Jugend) offers a useful checklist for before and after the birth of a baby.  

Midwives support women through pregnancy and birth, as well as during the postpartum recovery period and breastfeeding and all women are entitled to this support.

Parents may have many questions or feel unsure, in particular after the birth of their first child. Midwives support mothers and children during this period through home visits, which take place daily in the first few days after the birth and then as needed. During home visits, they check that the newborn is developing normally and provide parents with practical tips for caring for their child. They also check whether the mother is recovering from the physical changes her body has undergone during pregnancy and childbirth (physical recovery) and that any birth-related injuries are healing well. The midwife is also the go-to person for any questions relating to breastfeeding and infant nutrition as well as the health of the mother and child.

How long is support provided by a midwife?

Midwives generally support young families during the first 12 weeks after birth. For women with statutory health insurance, the health insurance fund covers the costs for up to 20 home visits during the first 10 weeks. After this, it covers the costs of up to 16 further visits or phone consultations within the first 12 weeks after the birth.

If difficulties arise with breastfeeding, the midwife can provide extended support for as long as breastfeeding continues. If the baby is bottle-fed using infant formula instead, the midwife can provide support up to the age of 9 months. Midwives provide support through phone consultations and home visits. Statutory health insurance funds cover the cost of 8 of these consultations. If families need continued support, this must be prescribed by a doctor in order to be covered by health insurance. 

Women with private health insurance should seek information before the birth from their health insurance fund regarding which costs will be covered.

Important: Women are also entitled to the support of a midwife following a miscarriage or still birth. Midwives can help parents through the process of saying goodbye and grieving and support women during postpartum recovery.  

Where can I find a midwife for support after the birth?

It makes sense to get to know the midwife during pregnancy, for example, in the context of prenatal care. Many midwives offer support both during pregnancy and after the birth. In any case, finding a midwife is something that should be done as soon as possible, as it can sometimes be difficult to find a midwife in the local area. You can also ask for information from your obstetrician-gynecologist or maternity hospital. Both can assist you in your search for a midwife.

The ammely platform operated by the German Midwifery Association (Deutscher Hebammenverband e.V.) allows you to search for midwives throughout Germany.  

Our article Preparing for birth provides further information about the process of finding a midwife. 

Some families feel pushed to their limit in the weeks and month after the birth of a baby. This time can be particularly challenging for single parents and socially disadvantaged families. If the baby has health issues or if the mother has postpartum depression, this may also cast a shadow over this time. 

Early prevention services offer support for difficult life situations like these. The services provided can support you in particular if:

• you often feel overwhelmed, helpless or exhausted due to caring for your child on a daily basis
• you feel that you may be unable to provide your child with an adequate level of care
• you feel that you are completely on your own in caring for your child
• your baby cries a lot and you don’t know what to do
• you and your partner argue frequently

The supports provided are free of charge and don’t require any special application process. Support can also be provided during the pregnancy. Early prevention services are primarily aimed at families that feel under pressure or overwhelmed. However, they are, in principle, available to all families with children up to the age of 3. Early prevention services seek to ensure that children can develop in a healthy way and in an environment that is free from violence.

In Germany, early prevention services are based on a network of various local systems and stakeholders. Services are coordinated at a regional level by individual youth welfare offices and may differ depending on the city or district. The early prevention network includes, for example, child and youth welfare professionals, family midwives, pediatric nurses specializing in family care and many other stakeholders. The services provided are generally funded by municipalities and by the Federal Foundation for Early Childhood Intervention (“Bundesstiftung Frühe Hilfen”) of the Federal Ministry for Education, Family Affairs, Senior Citizens, Women and Youth (BMFSFJ). 

Where can I find early prevention services in my local area?

You can ask your midwife or the staff at your gynecologist’s practice to provide you with more information about local early prevention services. 

You can search directly for early prevention services in your area on the website elternsein.info. 

As individual youth welfare offices are responsible for setting up early prevention services, you will also find contact details for your local point of contact for early prevention support on the website of your local youth welfare office (“Jugendamt”).

You can find the relevant youth welfare office on the website of the Federal Association of Youth Welfare Offices (Bundesarbeitsgemeinschaft Landesjugendämter). 

The early prevention services available are detailed below.

A family midwife is a midwife who has completed specialized professional training. She is qualified to support pregnant women and mothers in difficult situations either alongside or in place of a regular midwife. Services are free of charge. A family midwife provides support in the following cases, for example:

• feeling overwhelmed
• social isolation
• premature babies or disability
• addiction issues
• domestic violence
• very young or single mothers
• chronic illnesses or mental illnesses within the family

The role of a family midwife includes, for example, supporting the physical and mental health of the mother and child and promoting the development of a healthy bond. She checks that the child is developing normally and provides practical tips for infant care. Family midwives can also provide targeted support for everyday tasks, for example by accompanying you on visits to your doctor or appointments with authorities. They also advise parents on any issues relating to the health and development of the baby. Since family midwives are part of a wide network, they can refer you to further support services if needed.

How do I find a family midwife?

Support from family midwives is organized through the local points of contact for early prevention services. If you want the support of a family midwife, it is best to get in touch at an early stage of your pregnancy. This allows the family midwife to help ensure, from the outset, that your family gets the best possible start in life. 

You can, for example, consult your midwife or the staff at your gynecologist’s practice and ask for assistance in finding a family midwife. 

You can also search on the elternsein.info website for your point of contact for early prevention services in your area. 

A family pediatric nurse is a qualified healthcare and pediatric nursing specialist who has completed specialized further training. An alternative term is family healthcare and pediatric nurse.

Support from a family pediatric nurse is free of charge and is available, for example, to families with children who have additional support needs. These include:

• premature babies
• children with a chronic illness
• children who are difficult to settle or cry a lot

In principle, however, this service is available to all families who need support or advice regarding the daily care of their child. Family pediatric nurses visit families on a regular basis. They can also organize additional supports if necessary. Their services are available until the child is at least 1 year old. Some municipalities offer this support service up until the child’s third or even sixth birthday.

Since early prevention services are organized within regional networks, they may vary from place to place. Additional supports available from early prevention services may include, for example:

• family mentoring programs
• welcome visits and guidance services to inform new parents about local services
• parent-and-child courses, parent-and-child meet-ups or breastfeeding drop-ins providing a space in which families can meet and exchange experiences
• advice on further supports and points of contact, for example, regional crying clinics

You can search on the elternsein.info website operated by the National Centre on Early Prevention (Nationales Zentrum Frühe Hilfen) for crying clinics in your area.  

The elternsein.info website also offers detailed information about early prevention services, including information in simple language. 

What are family mentoring programs?

Family mentors provide regular support to young families in their daily lives, giving parents opportunities to take a short break. Family mentors may, for example, play with older siblings, help with household chores, take the baby for a walk or accompany the parents on visits to the doctor or appointments with authorities. They are ready to listen to any concerns, worries or fears that the parents may have. If necessary, they can help find additional supports for the family.

Family mentors are trained volunteers. They generally visit the family at home for 2 to 4 hours per week, mostly at prearranged times and for a period of up to one year. In some cases, they can be available for a longer period. The support they provide is free of charge. 

In the postpartum period, mothers must firstly recover from the physical changes in their bodies due to pregnancy and birth. During this time, it is helpful to have the support of family and friends in performing everyday tasks and household chores. But this kind of support is not always available. In such cases, a home help can assist with all tasks relating to household management. These include, for example, laundry, cleaning, shopping, and cooking. They can also help take care of the baby's older siblings.

When are the costs of a home help covered by insurance?

Health insurance funds will only approve a home help if there is nobody in the household who can carry out the household chores to the extent that is needed. This requires a doctor’s cert indicating that the mother is unable to manage household duties for medical reasons – for example, if her health is weakened after giving birth.

If you would like to apply for a home help, you should contact your health insurance fund as soon as possible. To make an application, you need a doctor’s cert stating that you are unable to manage household duties at present for medical reasons.

If your health insurance fund approves a home help for you after the birth of your baby, you are not required to contribute any co-payment. A home help can be prescribed for up to 26 weeks. After approving an application, the health insurance fund must organize home help. If the health insurance fund is unable to do this or there is a reason for it to refrain from doing so, people can also organize their own home help. The costs incurred can then be reimbursed by the health insurance fund.

For more information about home help entitlement and applications, refer to your consumer advice center. 

What is a maternal care provider?

In some larger cities in Germany, you can avail of the services of a “Mütterpflegerin”, who acts as a postpartum doula, i.e. maternal care provider, to offer additional support to mothers. Maternal care providers can help, for example, with household duties and with care of the infant and help the mother to put the advice of her midwife into practice. They may also take care of the baby’s older siblings and are ready to listen to any concerns or worries that the mother may have. They can also organize additional supports if necessary.

In contrast to a home help, a maternal care provider usually has special training in the areas of pregnancy, birth, postpartum recovery, breastfeeding and care of the infant. Maternal care providers are especially focused on the welfare of the mother. For example, they may give relaxing massages and teach mothers breathing and relaxation exercises.

The costs of a maternal care provider are not covered by health insurance. However, statutory health insurance funds may cover the costs of a maternal care provider who is providing home help under certain circumstances. In order for the costs to be covered, the same prerequisites that apply to a home help must be fulfilled and an application for home help must also be submitted to the health insurance fund. 

You can search for maternal care providers in your area on the website of the German professional association for maternal care provision (MDEV Mütterpflege Deutschland e.V.). 

Support is available free of charge throughout Germany at numerous antenatal clinics and family and parenting advice centers run by various organizations.

You can search for antenatal advice centers in your area on the familienplanung.de website of the Federal Institute for Public Health (Bundesinstitut für Öffentliche Gesundheit). 

The German association for youth and marriage guidance (Deutsche Arbeitsgemeinschaft für Jugend- und Eheberatung e.V.) also offers a comprehensive search for advice centers. When searching, you can filter by different areas of specialization, such as family counseling or antenatal counseling. 

For a list of resources available in relation to various topics of relevance to a child’s first year of life, see the website of the Healthy Start Network (Netzwerk Gesund ins Leben).

If you are experiencing mental health problems or find yourself in a crisis situation, you can phone the “Telefonseelsorge” helpline free of charge any time day or night.

Phone: 116 123
Counseling via e-mail and chat: online.telefonseelsorge.de 

If you feel overwhelmed or helpless due to caring for your child, you can also use the parents’ helpline operated by “Nummer gegen Kummer”. The advice is anonymous and free of charge.

Monday, Wednesday and Friday: 9 a.m. to 5 p.m.

Tuesday and Thursday: 9 a.m. to 7 p.m.

Phone: 0800 111 0 550