Missing midwives a serious problem - politics has to act
In the past few years, the midwifery associations have repeatedly pointed out the strain on their profession and the lack of junior staff. With the rising birth rates in Germany, pregnant women are finding a midwife less and less, now warn the professional association of pediatricians (BVKJ) and the professional association of gynecologists (BVF) in a joint press release.
Finding a midwife to care for the puerperium can present real difficulties for mothers. Because birth rates are increasing, while many midwives have stopped childbirth care and junior staff are in short supply. But "children have the right to a well-cared-for start in life" and therefore "politics must fight the shortage of midwives as quickly as possible", the BVKJ and BVF demanded.
Midwives are increasingly offering postpartum care
In view of the stressful shift work with increasing workloads, unattractive pay and increased liability premiums, many obstetricians have given up postnatal care and only offer preventive care, report the specialist associations. The situation is particularly precarious in large cities such as Düsseldorf, Hamburg or Berlin. "Birth clinics that reject pregnant women, women who have to share a single midwife during the birth: that is not possible," emphasizes BVF President Dr. Christian Albring.
Supervision by midwives in clinics and in the puerperium required
BVKJ President Dr. Thomas Fischbach adds that "first-time mothers in particular have many questions about the care and nutrition of their newborn". This advice is no longer provided in hospitals since they only get flat-rate payments for births and therefore send the mothers home earlier and earlier. Here, the midwife's care in the clinic and the puerperium is urgently required to provide young mothers with security in dealing with their children. This in turn makes work easier for doctors and saves the health system high follow-up costs. "Because well-informed mothers look after their children competently and help them grow up healthy," said BVF President Albring.
Previous measures without lasting success
"Mother and child have the right to a fully and competently supervised birth," emphasizes Dr. Albring. The Federal Minister of Health, Hermann Gröhe, had already promised to deal with the problem of midwives in April 2014, and a lot has actually happened since then. However, the measures such as the security surcharge, improvements in remuneration and liability insurance for midwives cannot resolve the problem of midwives missing in clinics and maternity care, according to the BVKJ and BVF.
There is even a shortage of birth preparations
For example, the “security surcharge” introduced in 2014 made it possible for midwives to get up to three-quarters of the insurance premium reimbursed, but in practice this proved to be not helpful due to the high level of bureaucratic work involved in keeping more midwives in obstetrics. Many midwives would shy away from this effort and would only offer birth preparation and rare postnatal care. And even when it comes to birth preparation, there is a lack. Women often find it difficult to find such care.
A critical point of criticism from the specialist associations is also that "to date, no solution has been found to the liability insurance problem of obstetricians and gynecologists who work as registered doctors". The high premiums represent a considerable burden here. The professional associations of pediatricians and gynecologists have therefore formulated the following demands "for the good of the children entrusted to us":
- A state fund that covers damaged children and mothers instead of midwives and gynecologists (instead of professional liability insurance, as in Scandinavia)
- Better remuneration for the midwives' work
- 1: 1 care during childbirth, instead of parallel care for up to three women during childbirth. Because well-cared-for women who give birth need less painkillers, fewer complications on the part of the child occur, and this means fewer operative deliveries
Politicians must quickly remedy this and vigorously combat the lack of midwives, the BVKJ and BVF concluded. (fp)