Yes you choose your own midwife and your own hospital and your own frauenarzt which I find all very strange, nice, but I don't ever really know how to look for one and end up stuck with the first one I find. You don't need an uberweisung to see a Frauenarzt and they tend to do your smears and breast exams, as well as prescribe any hormonal contraception. I recommend looking for a FA that you like before you get pregnant because some of them have long waiting lists, and I find their offices a bit intimidating because most of them have the examination chair right there in the office. If you have any female friends locally, I would ask for their recommendations. And when you call, ask if you can be seen in a more neutral office? Some of them do have separate rooms.
I find German medical care in general is a bit "This is the correct course of action so we will proceed" rather than asking/discussing your treatment with you and they tend to be a bit baffled if you question things or try to refuse treatments so it's important to look around for one who is more willing to discuss things if that is important to you. I suppose that that is why you have the choice of different specialists. BUT, I also feel like pregnancy isn't treated like a big medical thing the way it is elsewhere.
It's true that there is no gas and air (you could ask about it, the medical name is entonox or half nitros oxide, half oxygen, I did hear that they trialled it in one of the hospitals where I am, but no idea if they still have it) but they have a lot of stuff like birthing pools, balls, those swing things, and if you did want stronger pain relief I hear they are very efficient about it, no horror stories like the UK when the midwife tells you you're not in advanced enough labour and then by the time you are, oh no, oops, sorry, it's too late.
I want to do an integration course after I pass my driving test and pay off the driving lessons. It feels like my next step. I'm not hugely happy in my job and speaking better German would open up loads more opportunities for me.