Friday, May 7, 2010
On May 5, International Day of the Midwife, the kids and I attended a protest in Berlin in support of German midwives. Midwifery care in Germany is currently threatened due to significant increases in the liability insurance premiums that midwives have to pay. According to the Deutscher Hebammen Verband (German Association of Midwives), the premiums over the years have gone up significantly and have tripled in the past three years:
- 1981 - 30.68 Euro
- 1992 - 178.95 Euro
- 2007 - 1,218.00 Euro
- 2009 - 2,370.48 Euro
- 2010 - 3,689.00 Euro
The increase in insurance premiums is not due to increased risk during births attended by a midwife. In fact, an there are fewer birth complications now than in the past. The increase in premiums comes from increasingly higher payouts being awarded by the courts in individual cases.
Midwives in Germany earn around 237 Euros for a birth in the hospital, 445 Euros for a birth in a birthing centre, and 537 Euros for a home birth. But this is not sufficient to cover ever-increasing insurance costs. As compensation for the increase in the liability premiums, the health insurance plans provide midwives with an additional 4.39 Euros per hospital birth and 14.19 Euros for a non-hospital birth. This is not nearly enough to cover the cost of the ever-rising insurance premiums and midwives end up working to pay the insurance, rather than working to live. The annual salary for midwives (before taxes and other required fees) is around 23,300 Euros. After all costs are taken away, a midwife earns around 7.50 Euros per hour.
As a result, birth centres are closing, midwives are being laid off, and some midwives are opting only to offer prenatal education and postnatal support, rather than helping moms deliver babies. This not only threatens midwifery as a career option, but also threatens the access of mothers to a midwife as their birth attendant. Currently, about 1/4 of German births are attended by a midwife (compared with between 2% and 5% in the Canadian provinces where public health care covers midwifery services ref: Canadian Institutes of Health Information). If the situation remains as is, those numbers will certainly drop. A drop in the number of midwife attended births in Germany, not only means fewer midwife attended births, but also greater pressure on other birth attendants (i.e. obstetricians).
In an attempt to find a solution to this problem, the German midwives have organized an e-petition and are collecting signatures in an attempt to force the Budestag (German Parliament) to discuss this situation.
For any of my readers in Germany who are interested in supporting the practice of midwifery or passing the information along to their friends in Germany, please see:
- Information on how to sign the E-Petition
- Facebook page for the Hebammenprotest
- Twitter account for the Hebammenprotest
Sources for information on German Midwife Protest:
- Hintergrundinformationen zur E-Petition des DHV - Deutscher Hebammen Verband
- Hebammen - In anderen Umständen - Suddeutsche Zeitung