Bavarian midwives call for help - many give up in frustration

Created: 05/11/2022, 08:04

By: Katrin Woitsch

Care under time pressure: Many midwives in Bavaria work at the limit.

More and more give up.

© Seidel/DPA

The number of births in Bavaria is increasing.

But there are fewer and fewer midwives.

Many give up their jobs because of the enormous workload.

Ansbach - Kathrin Bauer loves her job more than anything.

And yet she has a moment every month where she considers giving it up.

Because the working conditions are so tough, the responsibility so great - and the pay for it is not appropriate.

She has been a midwife for 15 years and has waited a long time for an apprenticeship.

The working conditions were never good, she says.

But because more and more midwives are giving up, the others are working more and more to the limit.

Midwife has to look after four women at the same time: "Always a bad feeling"

It happens that Bauer has to look after four women at the same time when she is on duty in the clinic in Ansbach.

Actually, two would be too many if there are complications or intensive care is required, she says.

"It's a lot of responsibility and it's always a bad feeling." In addition, she doesn't even make any money rushing from delivery room to delivery room.

Because she can only count two women.

The Bavarian Association of Midwives requires one-to-one care.

And a reform of the compensation system.

Time is the most important factor in a birth, explains Chairwoman Mechthild Hofner.

However, time is not a factor in the calculation.

Even if a birth lasts 14 hours, midwives can only charge a lump sum.

"The remuneration system is only geared towards active interventions," she explains.

This is another reason why many midwives give up.

The responsibility is great, the pay is low.

The midwives' association recently launched a survey among its members.

577 midwives took part.

74 percent of them stated that they would be willing to work more in the delivery room if the working conditions there changed.

Midwife and obstetrician: training, occupation and tasks

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There is a bonus of 1000 euros for freelance midwives

The problems are not new.

A few years ago, the Free State therefore decided on support measures to ensure childbirth care in Bavaria.

There is a bonus of 1000 euros for freelance midwives, as well as a settlement bonus of 5000 euros. There are coordination offices in the municipalities that help to bundle the services.

And the training has become academic.

165 midwives are currently being trained at universities, and the number of places is growing steadily.

Hofner agrees.

"The requirements have increased," she says.

Without all these support measures, birth support in Bavaria would be in a much worse position, she emphasizes.

The burden has increased during the pandemic, there are many staff shortages, including facility-related vaccination requirements,

The funding measures are not enough to keep midwives or bring them back, she emphasizes and gives an example: a midwife can bill 38.46 euros for a postpartum visit.

Plus 81 cents per kilometer driven.

"With the current fuel prices, it's no longer worth it - especially not in rural areas with long journeys." Especially since it's only a matter of gross income.

Midwife Kathrin Bauer is also annoyed about it.

The health insurance companies allow 20 to 30 minutes for a postpartum visit - "that's completely unrealistic," she says.

For years she has been doing her job with time pressure on her neck.

And more and more often she asks herself why she is doing this to herself.

"If women weren't so grateful and births such a wonderful experience, I probably would have given up long ago."