Open petition saves national budget for German midwifery

Over 1.5 million signatures against controversial plans of the Federal Ministry of Health: An online petition to protect midwives.

In Germany, a petition against the plans of the Federal Ministry of Health has caused a stir, with more than 1.5 million signatures. The petition was in response to the proposed changes to the hospital reform, which would have removed midwives from the nursing budget. The Federal Minister of Health, Karl Lauterbach, has since withdrawn the controversial plan, stating that midwives should be included in the nursing budget.

The main reason for the petition is the so-called GKV-Finanzstabilisierungsgesetz, which was passed in the German Bundestag on October 20th. This law includes provisions that stipulate that from 2025, only qualified nurses who are "employed in direct patient care on bed-holding units" will be considered in the nursing budget. The concern is that hospitals will no longer be able to finance additional nursing staff, including midwives and obstetric nurses.

The President of the German Midwives Association, Ulrike Geppert-Orthofer, has stated that the consequences for obstetrics would be "very, very severe" if this law is not changed. It is not just a matter of financing, but also the inevitable side effect that midwives would no longer be able to be trained.

Photo by Jörg Zägel on Wikipedia

The Federal Ministry of Health has stated that midwife services can still be included in the nursing budget until 2025 and that "obstetrics and pediatrics...should not be subject to the austerity dictate of the old hospital system". The Ministry is currently working on a hospital reform and the next steps for financing midwife services will be clarified in a legislative process.

The "Pflegepersonaluntergrenzen-Verordnung" (regulation on minimum staffing levels) stipulates the minimum number of staff required for a certain number of patients. Due to the shortage of nursing staff, hospitals often only meet the minimum staffing levels.

The ratio of nurses to midwives must not exceed 9:1 during the day or 5:1 at night. If this ratio changes in favor of in-house midwives, penalties will be imposed. This makes each additional in-house midwife disproportionately expensive and midwives face the threat of layoffs and hiring freezes.

This has led to a situation in German maternity clinics where a single midwife has to care for three or more births simultaneously, while a 1:1 ratio of midwives to births is considered ideal. The situation is dire and the law needs to be changed to protect the field of obstetrics and the health of mothers and newborns.