Maternity facilities under threat of closure in Lower Saxony, alert issued by midwives
In Lower Saxony, a change is on the horizon for midwifery services, as a new contract is set to be implemented nationwide in November 2025. This contract, aimed at strengthening one-to-one care around childbirth, has raised concerns among freelance midwives who fear it may threaten their economic viability and lead to the closure of several delivery rooms in the state.
According to reports, more than 8,500 births in 2023 were accompanied by freelance midwives in Lower Saxony, with twelve delivery rooms in the region working exclusively with them. The new contract, it seems, will regulate remuneration for midwifery services in delivery rooms, a change that could significantly impact these professionals.
The new remuneration rules in the contract are expected to make freelance activities unprofitable for midwives, with potential income losses of up to 30% for multiple births. This concern has been echoed by freelance midwives working in clinics, who fear potential financial disadvantages.
CDU state parliamentarian Laura Hopmann has expressed support for the freelance midwives, stating that obstetric care is at its limit in many places and that waiting any longer is not an option. Health Minister Andreas Philippi, on the other hand, has emphasized the importance of freelance midwives but it is not yet clear whether financial disadvantages will result from the new contract.
The state government, however, has no direct influence over the contract, as it is not one of the contracting parties. The German Midwives Association states that the contract was decided on by an arbitration panel in April. A model of flat rates and time-dependent billing is planned for the new contract, which is intended to improve care in the midwifery field.
The state government has stated that it will closely monitor the economic effects of the new contract. A letter from midwives from eleven Lower Saxon clinics to Health Minister Andreas Philippi expresses these concerns and demands changes to the contract and political intervention. The German Press Agency obtained this letter, providing a glimpse into the anxieties of the midwives.
As the implementation of the new contract approaches, it is crucial to examine the exact contract terms, statements from local midwifery associations, and feedback from healthcare facilities in the region to assess its specific effects on freelance midwives and delivery rooms in Lower Saxony.
The forthcoming contract could potentially impact the financial stability of freelance midwives, with anticipation of income losses up to 30% for multiple births, as suggested by the new remuneration rules. Connecting this with the health and wellness sector, the comprehensive changes in remuneration for midwifery services in delivery rooms may negatively affect the well-being of freelance midwives, possibly leading to reduced availability of care in the sector.
