Rural farm communities issue alarm over threats to natural childbirths
In a move that has raised concerns among healthcare professionals and women's advocacy groups, a new midwifery contract is set to take effect in Germany from November 1. This contract, which regulates the working conditions of approximately 190,000 freelance midwives, has been met with criticism due to its drastic cuts and potential impact on the midwife-on-call system.
The new contract, according to reports, will see midwives receiving only 80% of their usual remuneration for caring for a woman. There will be no surcharge for one-to-one care unless the midwife is continuously present for at least four hours around the birth. This has led to concerns that midwives may face significant income losses, with 100% of contract midwives expecting such losses, as revealed in a recent survey.
The survey, which polled 154 contract teams, paints a worrying picture, suggesting that the new contract may endanger the entire contract system. In fact, nearly 40% of hospitals with a contract system expect their obstetrics department to close due to the new contract. More than 80% of clinics where midwives work on a contract basis consider it likely that their contract midwives will resign or significantly reduce their activities due to the loss of income.
These potential resignations and reductions in activities could lead to noticeable supply gaps in obstetrics departments, even if entire departments do not close. This could particularly impact rural areas, where women may face less security, longer journeys, and reduced choice in childbirth due to potential midwife shortages.
The German Midwives Association and the German Federation of Rural Women have both criticised the regulation, warning that it will lead to significant income losses in practice. They have called for an immediate independent review of the economic consequences of the new contract and an urgent renegotiation of the contract components related to the on-call system.
Ursula Braunewell, the first vice-president of the dlv, has gone so far as to call for decisive action to maintain the midwife-on-call system. Petra Bentkämper, the dlv President, has warned of a potential collapse in the supply of midwives, especially in regions with precarious supply.
The demands for a review and renegotiation of the contract are not without support from the Federal Ministry of Health, although no specific organisation has been named in the search results as demanding this action. The Landwomen have also voiced their support for the demands of the German Midwives Association, expressing concern that the new contract poses a risk to the care of women, particularly in rural regions.
As the implementation of the new contract approaches, the future of midwifery services in Germany remains uncertain, with many calling for urgent action to address the concerns raised by healthcare professionals and women's advocacy groups.
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