"Looks bleak" - Tölz midwife on Lauterbach's plans and the situation of her profession

Created: 11/21/2022, 06:30

By: Felicitas Bogner

The midwife and mother of two Birgit Krey has already brought more than 300 babies into the world and accompanied numerous mothers before and after their pregnancy.

© arndt pröhl

After the excitement about Karl Lauterbach's hospital reform: Brigit Krey from Bad Tölz speaks in an interview about the situation of midwives and the lack of staff.

Bad Tölz

- Midwives should now remain in the care budget, Health Minister Karl Lauterbach (SPD) rowed back after sharp criticism of his hospital reform.

For the midwives in the district - whether self-employed or employed in clinics - there is currently little reason to be happy.

There is a drastic midwife emergency.

In the interview, the midwife Birgit Krey (48) openly addresses the problems.

She herself worked in the delivery room at the Großhadern Clinic for four years and has been self-employed with a practice in Tölzer Marktstraße for 21 years.

For Krey, the low regard for her profession and the earnings are difficult to bear.

Ms. Krey, after the first presentation of Lauterbach's plans for his hospital reform, midwives had to fear that from 2025 they would be out of the care budget.

What would that entail?

That would have had fatal consequences for colleagues and patients.

If that had happened, the positions of midwives in the clinics would have been eliminated – except for those in the delivery room, because they bill the health insurance companies.

This would then affect, for example, pregnant women's outpatient clinics or postpartum wards.

If these posts were gone, the question would also arise as to who would lead the midwifery students on the postpartum ward in their practice units.

Moreover, this idea shows a frightening disdain for our knowledge.

Midwife on Lauterbach's first plans for hospital reform: "Frightening contempt for our knowledge"

After the wave of criticism, Karl Lauterbach made a change in his views.

However, many midwives remain frustrated.

There has been a shortage of midwives for years.

That had been foreseen for a long time.

Why?

The job is not lucrative.

You can see that in the catalog of fees of the statutory health insurance companies.

I openly show that to everyone, so that the women can see that certain circumstances are not my fault and that my work is not paid like that.

What do you mean?

also read

Benediktbeurer municipal council reacts to the mayor's letter on the subject of refugees

"At some point it's enough": butcher's shop closes after 64 years of family ownership

For example, I get 38.46 euros for a postpartum visit.

It doesn't matter how long I'm at the woman's house.

A telephone consultation after childbirth is remunerated with 7.02 euros.

I can only settle accounts with the mother.

All examinations that I carry out on the baby, such as checking the weight, will not be charged.

With this in mind, it is important to understand that a midwife cannot spend two hours on a home visit or answer questions over the phone for an hour.

And that's why I can no longer accept patients who live more than 12 kilometers away.

That's very little...

The last salary adjustment was in 2017 and we know how the prices have developed.

You have to consider how high the liability insurance premiums are that we pay ourselves.

Depending on the contract and whether you work in the clinic or independently, this can mean up to 11,000 euros a year.

EUR 7.02 for telephone advice

Are there other reasons for the shortage of midwives?

I think the financial aspect is the main reason.

Added to this is the low level of appreciation and the high workload in the hospital.

On average, a midwife looks after three women at the same time.

What happens when two women are in labor at the same time?

That's just not feasible.

As a self-employed midwife you have to be very flexible.

A pregnancy lasts 40 weeks.

Only four percent of all babies come at term.

Spontaneous vacation is not possible.

I have assured the women that I will be there for them as soon as they give birth.

Holidays must be scheduled at least nine months in advance.

In Germany, women have the right to midwife care.

What is the reality?

Grim.

It is difficult to find a midwife who has the capacities.

If I have a free spot, I get to know each other.

That's important given the intimacy that comes with the job.

I also present my work and priorities.

There are midwives who focus on obstetrics – in-hospital or out-of-hospital.

For example, I don't offer that at all.

When should a woman start looking for a midwife?

Preferably as soon as she knows she's pregnant.

And then you get a place?

Unfortunately, there is currently no guarantee for this.

How many inquiries do you get per month?

As an example: I received 26 inquiries for the last two weeks of August.

And that of women between Penzberg and Wolfratshausen who were desperately looking.

How many women can you take care of at the same time?

Six.

Women are released from the clinic earlier after childbirth

Are you at the limit of your workload limit?

Yes, and Corona has exacerbated that, since many women wanted to leave the clinic quickly due to the restrictions.

I was very challenged for the postpartum care.

Many were home after four hours.

Is this going back?

There is an increase in births.

It strikes me that the capacities of the clinics are fully utilised.

Women are generally sent home quickly now.

Before Corona, it was usually the case that you were in the clinic for three days with a spontaneous birth and longer with a caesarean section.

Is that problematic?

Hard to say in general.

The woman should decide when she feels safe to go home with the baby.

I had a patient who wanted to stay in the clinic for three days but was sent home on the second day.

If a woman is quickly dismissed, it does not mean that everything is fine.

Newborn jaundice or infections are issues to watch out for.

Midwives have a great responsibility.

A midwife from Kochel was the first woman in the village to own a moped

What made you decide to take up the profession?

My grandmother's cousin was a midwife and told me a lot.

Working in a healthy state with something so natural fascinated me.

And that it's a woman's job.

At the time, the midwife in Kochel was the first woman in the village to get a moped, which I thought was great.

Does the job still fulfill you?

It's a great feeling to see what I can achieve with my work.

For example, when the family has a good start in the new phase of life.

I receive many grateful letters from young families, which encourages and moves me.

Despite all the circumstances, I am still passionate about it.

But not with all the consequences.

Have you ever thought about quitting?

I understand everyone who no longer wants to do it or is no longer financially able.

I used to fight and demonstrate a lot.

Nothing has changed.

At some point you get tired.

The interview was conducted by Felicitas Bogner

You can find more current news from the region around Bad Tölz at Merkur.de/Bad Tölz.