Midwives without obstetrics in the future?

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Expensive professional liability: Many obstetricians give up work

An increasing number of midwives are giving up midwifery because the associated costs of professional liability represent an excessive financial burden, reports the news channel "ntv". Numerous midwives therefore give up the core area of ​​their profession and concentrate on services such as birth preparation courses or postnatal care.

The premiums for the professional liability of midwives who offer obstetrics currently amount to just under EUR 3,700 a year. According to "ntv", a further increase to 4,200 euros is planned from July. A financial burden that drives many midwives to stop offering obstetrics. The midwives have been protesting unsuccessfully for years against the massive rise in insurance costs.

Expensive professional liability for obstetricians Already in 2010, when the contribution of professional liability for midwives providing midwifery had risen from 2,370 euros to 3,689 euros, many decided to give up the core area of ​​their profession. With the planned increase to an annual contribution of over 4,200 euros, the trend will probably continue to increase, according to the assessment of the German Midwifery Association (DHV). Due to the enormous insurance costs, the income of midwives providing midwifery is reduced so that they are no longer willing to keep their offer. The obstetricians' income "has always been bad" and after "liability has made such an enormous increase, many have buckled," a midwife affected told "ntv".

Rising insurance costs Cause of premium increases The occupational burden on midwives is immense in relation to their income. They are available to pregnant women at any time during the weeks around the birth date. With the significantly increased costs for professional liability, the relationship between expenditure and income has shifted to such an extent that many are no longer willing to offer obstetrics - especially since the contributions for professional liability apparently continue to rise. According to Katrin Rüter from the German Insurance Association (GDV), the reason for the massive increase in premiums is the drastically increased insurance costs. In the past few years, insurers have increased their midwife professional liability insurance on average by almost 15 percent per year, Rüter explained. Although the midwives do not make more mistakes than before, the health insurance of injured children takes liability insurance for the midwives far more often, according to the expert. In addition, medical and nursing costs have risen continuously, which has resulted in a disproportionate increase in expenditure.

Difficult negotiations with the statutory health insurance funds In view of the explosion in costs for contributions to professional liability, the midwives are demanding state regulations that set a limit on further increases in contributions. The affected obstetrician Jitka Weber explained to "ntv" that a restriction was urgently needed, "so that this small professional group does not have to cover tens of millions with their insurance each year." Especially freelance obstetricians have had the massive increase in premiums for years Fight professional liability and are therefore limited to areas in which the contributions to liability are less high, such as birth preparation courses or postnatal care. In order to remedy this shortcoming, the German Midwifery Association is also calling for better benefits from statutory health insurance (GKV). However, the discussions with the National Association of Statutory Health Insurance Funds "shortly before the conclusion of the contract negotiations on midwifery fees, which had been going on for months", were interrupted by the relevant associations such as the German Midwifery Association, the Federation of Freelance Midwives in Germany and the network of birthing centers, because tactical games were played out on the part of the health insurance companies would be operated, according to the DHV press release at the weekend. "With each past week, the health insurance companies save while the midwives get too little money," emphasized Martina Klenk, President of the German Midwives Association.

Midwives hope for support from politicians In general, midwives hope for more support from politicians, because under the current situation the supply is suffering. “Since the end of January, nine hospitals have shut down the obstetrics department. On the other hand, more and more birthing centers are closing, ”said DHV spokeswoman Dr. Edith Wolber. The number of births being cared for shows which gaps in care would arise if all freelance obstetricians stopped working. Around 25 percent of births (678,000 newborns in 2010, according to the Federal Statistical Office) are accompanied by freelance midwives. However, according to the DHV, only a quarter of self-employed midwives already provide obstetrics. (fp)

Read also about midwives:
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