Rural assisted births face imminent peril, farmers caution
From November 1st, a new midwifery contract will apply, regulating the working conditions of around 190,000 self-employed midwives in Germany. However, concerns have been raised about the impact of the new contract on the midwife-on-call system, particularly in rural areas.
Ursula Braunewell, the first Vice President of the dlv (German Midwives Association), has called for decisive action to preserve the midwife-on-call system. She is joined by the dlv President Petra Bentkaemper, who warns that the midwife supply, particularly in rural regions, may collapse due to the new contract.
The new contract contains drastic cuts for contract midwives, resulting in significant income losses despite unchanged high responsibility. According to the German Midwives Association, this could lead to noticeable supply gaps, even if entire departments don't close. In fact, more than 80% of clinics where contract midwives work consider it likely that their contract midwives will resign or significantly reduce their activities due to the loss of income.
The demands are mediated by the Federal Ministry of Health, but the German Midwives Association is seeking clear signals and swift corrections to ensure reliable midwife services in the future. The organization is also demanding an independent economic assessment and immediate negotiations on contract components regarding the midwife call system in Germany.
The German Federation of Rural Women has also joined the chorus of voices expressing concerns. They warn that the supply of midwives, particularly in rural regions, is at risk due to the new contract. For women in rural areas, this means less security, longer journeys, and less choice in childbirth.
Under the new contract, a surcharge for one-to-one care will only be granted if the midwife is continuously present at least two hours before and two hours after the birth. Services for further births are only reimbursed at 30% when a midwife is caring for more than one birth at the same time. Services for every woman cared for by a midwife will only be billed at 80% of the usual remuneration, even in the case of parallel births.
Almost half of contract teams want to leave obstetrics within the next six months, and almost 40% of hospitals with a contract system expect their obstetrics department to close. This could lead to pregnant women having to accept longer journeys to give birth due to potential midwife shortages in rural areas.
The German Midwives Association criticizes that the regulation will lead to significant income losses in practice and endanger the entire contract system. They argue that this could have serious implications for the quality of care provided to pregnant women and newborns.
In conclusion, the new midwifery contract in Germany has sparked concerns about the impact on the midwife-on-call system, particularly in rural areas. The German Midwives Association and other organizations are calling for immediate action to address these concerns and ensure reliable midwife services in the future.
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