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HEALTH

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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HEALTH

Which of Germany’s hospitals are among the ‘world’s best’ in 2024?

A number of hospitals in Germany made it on a list of the world’s top ranked medical facilities this year. The Local takes a look at the nation’s top rated hospitals.

Which of Germany's hospitals are among the 'world's best' in 2024?

A total of 22 of Germany’s hospitals made it onto ‘the world’s best’ list, as reported by Newsweek with data provided by Statista. Additionally, Germany had 10 hospitals in the top 100, and six in the top 50.

Berlin’s world-renowned Charité Hospital was the only German clinic ranked in the top 10 worldwide, snagging the 6th spot. 

The top hospital was the the US state of Minnesota’s Mayo Clinic in Rochester, with second position going to the Cleveland Clinic in Ohio. Landing in third position was Toronto General, University Health Network in Canada. 

The 2024 list of best hospitals includes 250 hospitals, which ranked highest out of 2,400 hospitals from 30 countries that were evaluated. According to Newsweek, rankings were based on an online survey of 85,000 medical experts, public data from patient surveys, patient to doctor ratios, and other relevant metrics.

Germany has long held a positive reputation for the quality of its healthcare, so it’s not surprising that a number of its hospitals made the list. 

According to the World Health Organisation (WHO), Germany ranks among ‘the nations with the most responsive health systems’. 

A 2020 ‘Health system review’ published by PubMed, notes that the German health care system offers “good infrastructure with a dense network of ambulatory care physicians and hospitals”. 

However, the study also noted that, as of 2018, Germany had the highest per capita spending on its medical system in the EU, and that “there are signs that there is room for improvement in how the system allocates resources”.

Read Also: 10 key things you need to know about healthcare in Germany

Additionally, the nation is suffering from a shortage of doctors, nurses and medical personnel – an issue that medical clinics across the country cited last October when they closed in protest.

Of the 22 German hospitals that made it onto ‘the world’s best’ list, only two are found in former East German states – Universitätsklinikum Carl Gustav Carus Dresden ranked 99th, and Universitätsklinikum Leipzig ranked 238th.

This seems to suggest that the country’s ‘phantom’ border may still have an effect on the quality of healthcare facilities available in former Eastern versus former Western states, where the nation’s top facilities tend to be clustered in former Western regions.

Here are the six German hospitals that ranked among the world’s top 50:

Charité – Universitätsmedizin Berlin (6th)

Berlin’s Charité is one of the largest university hospitals in Europe. Home to the joint medical faculty of Freie Universität Berlin and Humboldt-Universität zu Berlin, more than half of the German Nobel Laureates in Medicine and Physiology came from here, including Emil von Behring, Robert Koch and Paul Ehrlich. 

Universitätsklinikum Heidelberg (15th)

Connected to Germany’s oldest university, the medical faculty of Heidelberg continues more than 630 years of tradition, while simultaneously funding and supporting innovative research, nationally and internationally. 

LMU Klinikum (26th)

Split between two Munich campuses, Campus Großhadern and Campus Innenstadt, the LMU clinic treats 500,000 patients each year. It’s comprised of 28 specialist clinics, 13 institutes and seven departments, as well as the 53 interdisciplinary centres.

Klinikum rechts der Isar der Technischen Universität München (27th)

The Technical University of Munich’s hospital in the heart of the city operates with the understanding that “knowledge creates healing”. Additionally, the hospital offers information in English on its website, noting that international patients are welcome at its “University Hospital rechts der Isar” (campus located on the right of the Isar river).

doctor in a hospital hallway

A senior physician and infectiologist seen at the University Hospital rechts der Isar of the Technical University of Munich. Photo: picture alliance/dpa/Klinikum rechts der Isar | Falk Heller

Medizinische Hochschule Hannover (39th)

Responding to the hospital’s ranking on the ‘World’s Best Hospitals’ list, President Professor Dr. Michael Manns said: “We would like to thank our dedicated employees who work as a team for the well-being of our patients.”

The research hospital also says on its website that it networks locally, regionally and globally to bring the best professionals to its patient care, clinical trials and teaching.

Universitätsklinikum Hamburg-Eppendorf (48th)

This Hamburg hospital employs 14,900 employees, and claims to be one of the most modern clinics in Europe. As part of its ‘Future Plan 2050’, the clinic has developed a long-term strategy with a focus on digitalisation and improving individualised precision medicine.

Read Also: What to know about Germany’s new digital healthcare law

Find Newsweek’s full ‘World’s Best Hospitals 2024’ list here.

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