Schleswig-Holstein Midwifery Crisis: New Rules Threaten Care for Expectant Mothers
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A controversial new contract for midwives in Schleswig-Holstein is sparking fears of reduced care for pregnant women and potential closures of vital maternity services.
The steady knock on the examination room door at the Ameos Clinic Eutin signals more than just a routine check-up. For Jasmin Prinz, 30 weeks pregnant with her second child, it’s a reminder of the increasingly long journey she and her husband must take to access prenatal care. “We come from Preetz,” she explains, “The obstetrics service ther was closed – we now drive almost an hour to Eutin.” her experience is becoming increasingly common as delivery rooms across the region close, placing a strain on remaining facilities and raising concerns about the future of maternity care – a model now threatened by upcoming regulatory changes. According to the Schleswig-Holstein Midwives Association, the new midwifery assistance contract, set to take effect in November, could jeopardize this system.
The Service midwife Model: A Regional Approach
The service midwife model,currently available in Eutin,Bad Segeberg,and Kiel,provides care for approximately 3,500 births annually. These midwives operate independently, taking on regular shifts at clinics, assuming thier own risk and insurance, and offering a unique blend of personalized care and hospital resources.
What Changes with the New Contract?
The new midwifery assistance contract aims to regulate how midwives are reimbursed for their work. Jens Ofiera, a spokesman for the National Association of statutory Health Insurance funds (GKV), stated that the goal is to improve the quality of obstetric care. The contract proposes increased payment for midwives providing one-on-one care – dedicating themselves exclusively to a single patient for at least two hours before and after birth. Remuneration will be lower for midwives attending to multiple women simultaneously.
The Reality on the Ground
“This is far from reality,” asserts Anke Bertram, chairwoman of the Schleswig-Holstein Midwives Association. In practice,she explains,staff midwives often manage two patients concurrently. “If the doorbell rings at the delivery room door after 3 hours and 58 minutes, then of course you have to go there, but then you can no longer charge the surcharge.”
Midwife Miriam Mareike Kamppari, with 17 years of experience, echoes these concerns. “We expect up to 25 to 30 percent less income,” she says, adding that layoffs have already begun in Schleswig-Holstein.Two midwives at the Eutin clinic have already resigned in anticipation of the new regulations.
Consequences for Pregnant Women
“The distances are getting longer, the uncertainty is growing,” Bertram warns. The fear of not reaching a clinic in time is driving some women to opt for Cesarean sections, leading to a noticeable increase in the rate, particularly along the west coast.
A recent survey by NDR SH revealed that more than half of maternity hospitals in the region rate their economic situation as “mediocre” or “poor.” .
Health Insurance Companies See Advantages
The National Association of Statutory Health Insurance Funds views the reform positively, emphasizing the improved compensation for one-on-one care. They anticipate additional costs exceeding 100 million euros for obstetric care, translating to increased funding for enhanced services. “The new regulations should now be implemented,” ofiera stated,adding that a working group will be established to address any emerging challenges.
expectant mothers like Jasmine Prinz remain apprehensive. “People do think about it,” she says, “I think midwives earn more – not less.”
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The situation underscores a critical juncture for maternity care in Schleswig-Holstein,raising questions about access,quality,and the future of a vital profession.
