The rollout of a new midwifery support agreement, slated to take effect November 1st, is triggering alarm within Germany’s midwifery sector, with significant implications for birthing services and potentially, women’s healthcare access. The German Midwives Association (DHV) is warning that the agreement, designed to standardize remuneration and working conditions for freelance midwives nationwide, is poised to force numerous practitioners out of the profession, particularly those operating under the ‘Beleg’ system.
The new contract introduces a per-minute billing system, a significant departure from the previous model based on payment per birth. While seemingly neutral in design, the DHV highlights a critical disparity: midwives working within hospitals under the ‘Beleg’ arrangement – essentially providing freelance services to clinics – will only receive 80% of the newly established hourly rate. Given that this cohort hasn’t seen a wage increase in a decade, this reduction is projected to result in income losses of up to 30% for some.
The potential for widespread professional exodus is prompting serious concerns regarding the availability of maternity care. Currently, freelance midwives operating under the ‘Beleg’ system support over 20% of births in German clinics, a figure significantly higher in states like Bavaria where they effectively represent the dominant provider of birth support. The DHV argues that pushing these midwives to the brink of financial instability will inevitably lead to a critical shortage of services, disproportionately impacting women and families in affected regions.
Critics are already questioning the government’s approach, suggesting the rapid implementation of a system with such potentially detrimental consequences for a vital healthcare sector lacks foresight and proper consultation. The DHV’s warning underscores a deeper issue within Germany’s healthcare system – the precarious financial standing of freelance professionals and the vulnerability of specific medical specialties reliant on their services. The long-term impact of this new agreement risks not only a decline in the number of midwives but also potentially a deterioration in the overall quality and accessibility of maternity care across the country. This situation demands urgent review and a more sustainable framework for supporting midwives and ensuring adequate maternal healthcare.