Since German reunification, the number of hospitals that keep maternity wards has been cut in half. In 1991 there were 1,186 hospitals where children were born; by 2024 that figure had dropped to 578, a 51.3 % decline reported by the Federal Statistical Office (Destatis).
The fall in hospitals was accompanied by a steep reduction in specialist obstetrics and gynecology units. From 1,275 units in 1991 the number fell to 758 in 2024, a 40.5 % drop. This total also includes departments that never performed deliveries.
Bed capacity in obstetrics and gynecology fell sharply. The number of beds went from about 66,400 in 1991 to 24,100 in 2024, a 63.7 % decrease. Consequently, bed occupancy fell from 77.4 % in 1991 to 56.4 % in 2024, partly because patients are now discharged noticeably faster.
The decline has been nationwide, though it varies from state to state. How far a person lives from a maternity or obstetrics‑gynecology department also depends on how urban the area is. In major cities 95.1 % of women aged 16‑49 can reach a suitable hospital within 15 minutes by car. In medium-sized cities the figure is 73.4 %; in larger rural towns it drops to 44.7 %; and in small towns or rural communities only 29.9 % can get within the same time frame.