After the baby is born

In Germany, most women give birth in a hospital. They typically stay there for around three days, or longer if they had a Cesarean section (C-section). Nurses and midwives help the new mother with things like breastfeeding tips or how to bottle-feed. The baby can stay with the mother most of the time.

Doctors examine the child regularly. If the mother has had a C-section, a nurse or midwife will care for the wound. The mother’s partner can spend a lot of time in the hospital too and help to look after the baby.

Some women decide to take their baby home a few hours after giving birth (outpatient birth). It is possible to do that if there were no complications and mother and child are both well. Births at birthing centers are always outpatient births. It is important that women who give birth as an outpatient or at home have a midwife who checks on them and the child regularly at home.

In Germany, statutory health insurers cover the costs of help and support from a midwife until the baby is twelve weeks old. This support is vital for many mothers and their families. On the first few days after the birth or after the mother and child leave hospital, the midwife usually visits them at home daily. Once they’ve started to settle into a routine, she just comes as and when they need her.

The midwife provides advice on how to breastfeed or bottle-feed and look after the child. She looks after the baby’s umbilical cord and checks how the mother’s birth injuries are healing. These can be things like a perineal tear (between the vagina and rectum) or a C-section wound. She checks whether the child is healthy, whether it’s drinking properly, and what its poo looks like. She also gives tips on day-to-day life with the child and other forms of support available.

After the birth, the mother’s body gradually recovers and the changes the pregnancy caused to her body start to disappear. Immediately after giving birth, she begins to bleed from her vagina. This bleeding (lochia) lasts around six weeks and can be quite heavy, especially in the first ten days. The mother might also have afterpains – contractions that happen after the birth and feel like bad period pain. These contractions help the womb return to its normal size.

It takes some time for a new mother’s body to recover so healthcare providers recommend that mothers don’t do anything physically strenuous (like lifting or carrying heavy objects, or sports that put pressure on the pelvic floor) in the first few weeks after the birth. Light physical exercise is possible though. The midwife is a good person to ask about this. Around six to eight weeks after the birth, the mother can start postnatal exercise classes. These involve special exercises to strengthen the pelvic, back, and stomach muscles. These classes are free of charge for women who have statutory health insurance.

For some time after childbirth, a lot of women weigh more than they did before becoming pregnant. But right after giving birth isn't a good time to try to lose weight. It takes most women about half a year to get back to somewhere near their original weight.

A baby needs to be looked after around the clock. It has to be breastfed or given formula, have its diaper changed, be bathed, and soothed. Babies sleep a lot in the first few months but they also wake up a lot. It takes some time for them to develop a sense of day and night. How long differs greatly from child to child.

The mother’s milk gives the child everything it needs to grow. It can sometimes take a little while for mother and child to get the hang of breastfeeding. Midwifes and breastfeeding counselors can provide support by helping the mother find a good position for breastfeeding, for instance. They can also give advice on problems like swollen breasts (engorgement) or sore nipples.

If the mother can’t or doesn’t want to breastfeed, the alternative is to feed the baby formula. This contains all the nutrients the baby needs too. But breastfeeding and bottle-feeding aren’t just about food-they’re about being close to each other. That helps mother and child get to know each other better.

Apart from food and clean diapers, the main thing a newborn needs is to feel safe and secure. Cuddles, skin contact, being held, breastfed, or bathed – all these things make it easier for the baby to get used to its new life outside of the womb. They also help promote the special bond between the parents and the baby. As time goes by, the parents increasingly get to know their child better. That helps them understand the baby’s signals and react the right way.

This bonding usually starts right after the birth when the newborn is placed on the mother’s stomach or chest. The partner can welcome the baby to the world too. If the mother had a general anesthetic or the child had to have medical treatment, their first intensive skin-to-skin contact might not be possible until later on. But they can start the bonding process at a later stage.

Despite all the joy women may feel about their new baby, the hormonal changes following childbirth, the lack of sleep and adapting to their new life can take a real toll: There is a thin line between happiness and stress. Things can easily start to feel overwhelming if women don't get enough help. Some women get the “baby blues,” a short phase of severe mood swings and inexplicable sadness after giving birth. This usually only lasts a few days. If the sadness lasts longer than two weeks, it may be a sign of postnatal depression. Then help from outside is usually needed.

A number of standard medical check-ups (paid for by health insurers) are available in the first few weeks of a baby’s life: straight after the birth (U1), between the third and tenth day after the birth (U2), and in the fourth to fifth week after the birth (U3). During these check-ups, the healthcare provider listens to the baby’s heart and checks its reflexes and breathing. They measure and weigh the baby, and take blood for testing as well. The baby is also given vitamin K to prevent bleeding.

During the postnatal period, the mother’s partner is usually the person they turn to most. Other family members and close friends can provide important emotional and practical support during this phase too. Lots of parents are happy if someone else takes care of everyday chores like shopping, cooking, or cleaning. They’re also usually glad of help looking after their older children.

Doctors and midwives are on hand to help out with any problems or questions about the health of the mother and child, breastfeeding, and caring for the baby.

If the mother has health problems after giving birth, she can apply to her statutory health insurer for household help. Early prevention services (Frühe Hilfen) are also available free of charge for families with children up to the age of three. They are particularly aimed at parents who are feeling overwhelmed and want support. They’re also there for families that need special help because, for example, their baby is ill or has a disability.

More detailed information on the postnatal period can be obtained from the Federal Centre for Health Education (BZgA).

Germany’s Federal Centre for Nutrition (Bundeszentrum für Ernährung) also has a list of resources for babies’ first year on its “Gesund ins Leben” website.