Pediatricians and gynecologists warn of acute midwifery shortage

Missing midwives a serious problem - politics must act
In recent years, the midwives associations have often pointed to the burden of their profession and the lack of junior staff. Pregnant women are currently less likely to find a midwife among the rising birth rates in Germany, and the Professional Association of Paediatricians (BVKJ) and the Professional Association of Obstetrics and Gynecologists (BVF) now issue a joint press release.

Finding a midwife for childbirth care may presently present mothers with real difficulties. Because the birth rates rise, while many midwives have stopped the childbirth care and junior staff are in short supply. But "children have a right to a well-cared start in life" and therefore the "policy must fight the midwife shortage as quickly as possible", so the claim of the BVKJ and the BVF.

Missing midwives are a major problem for pregnant women because they often find it difficult to find postpartum care or have to share a midwife with several women during delivery. (Image: Kzenon / fotolia.com)

Midwives are less and less likely to offer postpartum care
Many midwives have given up the puerperal care in the face of grueling shift services with more and more work, unattractive pay and increased liability premiums and offer only foresight, report the specialist associations. The situation in major cities such as Dusseldorf, Hamburg or Berlin is particularly precarious. "Maternity clinics that reject pregnant women, women who have to share a single midwife among many at birth: that's just not possible," stresses BVF President Dr. Ing. Christian Albring.

Care by midwives in clinics and in childbed required
The BVKJ president dr. Thomas Fischbach adds that "especially first-time mothers have many questions about the care and nutrition of their newborn". This advice is no longer done in hospitals, since they only get lump sums for births and therefore always send the mother home earlier. Here, the midwife care in clinic and childbed is urgently needed to give the young mothers security in dealing with their children. This, in turn, makes it easier for physicians to work and saves the healthcare system high follow-up costs. "Well-informed mothers provide competent care for their children and help them to grow up healthy," said BVB President Albring.

Previous measures without sustainable success
"Mother and child have the right to a fully and competently supervised childbirth", emphasizes Dr. med. Albring. Although the Federal Minister of Health Hermann Gröhe had already promised in April 2014, to take care of the problem of midwives, and indeed, a lot has happened since then. However, the measures such as the guarantee surcharge, improvements in the remuneration and the liability insurance of midwives do not address the problem of missing midwives in hospital and childbirth care sustainable, according to the notification of the BVKJ and the BVF.

Even birth preparation is lacking
For example, the "seizure surcharge" introduced in 2014 allows midwives to be reimbursed up to three-quarters of the insurance premium, but in practice it has proved unhelpful to keep more midwives in obstetrics because of the high bureaucratic burden. Many midwives would shy away from this effort and offer only birth preparation and, rarely, postpartum care. And even when preparing for birth, there is a shortage. Frequently, women would have difficulty finding such care.

Demands to the policy
A decisive point of criticism of the specialist associations is further that "until today no solution for the liability insurance problem of obstetric, gynecological obstetricians found" was. The high premiums represent a considerable burden here. The professional associations of pediatricians and gynecologists have therefore formulated "for the benefit of the children entrusted to us" the following requirements:

• A state fund that protects injured children and mothers from midwives and gynecologists (instead of professional liability insurance, as in Scandinavia)
• A better remuneration for work the midwives
• A 1: 1 care at birth, instead of parallel care of up to three women at birth. Because well-cared mothers need less painkillers, there are fewer complications on the part of the child and thus less operative deliveries are required

Politicians have to remedy this as quickly as possible and vigorously combat the midwife shortage, concludes the BVKJ and the BVF. (Fp)