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A midwife looks after pregnant women in Corona times
Photo: Caroline Seidel / picture alliance / dpa
One word was missing.
Regardless of whether it was about corona regulations on systemic relevance, test or vaccination regulations.
Nowhere did this word appear: midwives.
As if the Federal Ministry of Health and the state governments had forgotten them.
Forget that they give birth to almost 800,000 children a year.
That they cannot keep a distance from their mothers in the process.
That you can't postpone births.
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Head of the midwifery association, Geppert-Orthofer
Photo: Hans-Christian Plambeck / German Midwives Association
So the President of the Midwives Association, Ulrike Geppert-Orthofer, wrote a letter to the Minister of Health: Midwives should also be included as systemically relevant for the emergency care of their children.
Two weeks later she wrote the next.
When purchasing protective equipment, please also consider the midwives.
The association sent out many such letters during the year.
The answer was always the same: Of course, midwives were included.
But to be included, says Geppert-Orthofer, does not do much if a midwife is not allowed to give her child to emergency care because it is not explicitly considered to be "systemically relevant".
Or when a midwife has to visit pregnant women at home, but no protective equipment is available.
After a year of pandemic, Geppert-Orthofer draws a sad conclusion.
"Obstetrics," she told SPIEGEL, "is still not a matter of course in the definition of health." In society, the importance of childbirth is still not recognized.
Low pay, high workload
In fact, the Federal Ministry of Health had decided to improve the work of midwives.
As with the nursing staff, the shortage of personnel has long been known.
According to the Federal Statistical Office, around 40 percent of maternity wards in Germany have been closed since 1991.
The reason: Obstetrics is expensive and it is often not profitable for the clinics.
In a study for the Federal Ministry of Health in 2019, experts recorded that most clinics had difficulties filling open midwifery positions.
Two thirds of the clinics attributed this to insufficient remuneration and excessive workload.
On average, at the time of the survey, a midwife was working shifts looking after three women in the delivery room at the same time.
Other countries such as Great Britain guarantee 1: 1 support.
In the last legislature the attention to the problem has grown.
Many parties are calling for improvements: the SPD has included midwife care in the draft of its election program.
The Greens and Leftists have long been calling for 1: 1 care for pregnant women and improvements in remuneration.
Childbirth health has been added to the list of national health goals.
And the World Health Organization had declared 2020 the year of the nurses and midwives.
But during the pandemic, the midwives probably didn't notice these goals.
Once a week, Geppert-Orthofer meets digitally with other midwives for the crisis team.
Then everyone from their state reports how the situation is.
So far, they have teamed up 60 times and organized over 40 joint campaigns.
You have received numerous letters from colleagues.
There was the midwife who, within three weeks, helped give birth to four women who subsequently tested positive for the coronavirus and hoped for a vaccination.
The midwife who worries about working because her own child belongs to the high risk group.
And finally, the obstetrician from Bremen, who looks after refugees and who has so far taken care of most of the pregnant women infected with Covid-19 in Germany.
They are slowly getting enough.
Mothers who give birth cannot wear FFP2 masks
In the first wave, she got over dealing with her professional group.
"We don't decide about the life or death of a corona patient," says Geppert-Orthofer.
You saw the overload of the health system and wanted to let the nurses come first.
The midwife assumed that her profession would be considered in the second wave.
But even when it came to vaccination and testing, the midwives were nowhere to be found in the regulations.
Sometimes, she says, she thinks that politicians just don't know what a midwife does:
that aerosols are increasingly emitted during childbirth and that the midwife should therefore be protected
that it is not possible, for example, to wear an FFP2 mask as a woman giving birth because it is difficult to breathe
that a video camera cannot be used to judge whether a baby may have turned an unhealthy yellow color and therefore cannot do everything digitally
that mothers are still not always allowed to be accompanied to birth by their partner and that this is an event in which women need support
that parents felt alone when after the birth no one could come to their home to support them
She hoped that this would change with the pandemic, says Geppert-Orthofer, in which it became increasingly clear to what extent women are still not on an equal footing with men.
But the effect now seems to have fizzled out.
Systemically relevant in one federal state only
The federal states still regulate the supply very differently: Berlin has provided midwives with protective clothing from the start.
Midwives were vaccinated in Bremen.
But only one federal state has now classified midwives as systemically relevant: North Rhine-Westphalia.
Most recently, Geppert-Orthofer and her colleagues achieved a small success.
When it comes to prioritizing vaccinations, midwives are now in the second category.
And midwives are now appearing in the national test regulation.
Geppert-Orthofer believes it will take some time before this information actually reaches the test and vaccination centers.
Obstetricians would still be sent away for vaccinations or would have to insist on the free test once a week.
And: As almost the only medical profession, they are not allowed to carry out the tests themselves: They are not certified for professional testing.
"It's a scandal," says Geppert-Orthofer.
“There are too few of us anyway.
And now should we spend our time waiting in test centers? "
In this case, the midwives are obviously not included as a medical profession.
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