Midwives protest
May 26, 2010
Independent midwives in Germany are hoping that Wednesday's meeting with Health Minister Phillip Roesler will help bring about a solution to an ongoing dispute between midwives and insurance companies.
The midwives' union DHV (Deutscher Hebammen Verband) is presenting the minister with an online petition of support, which so far over 91,100 people have signed.
The campaign has been prompted by the staggering rise of liability insurance for independent midwives. The premium was 1,218 euros ($1,495) a year in 2007, and has risen by over 203 percent to 3,689 euros as of July 2010.
Paying the insurance
Andrea Wehling, has been working as an independent midwife in Cologne for 26 years. She says the higher cost of insurance is making life "impossible".
Under the German system, a pregnant woman can choose to have her baby in a hospital, at a special birthing house, or at home. An independent midwife is paid 448 euros ($550) for a home delivery, and around half that amount for a delivery in a hospital.
"You have to make minimum 10 deliveries at home to get the amount to pay your insurance," Wehling told Deutsche Welle. "It's impossible. Especially for midwives who live in an area with a low rate of home deliveries."
Around 10 to 15 percent of midwives working in Germany are independent, and so have to cover their own liability insurance. Those working in hospitals have the insurance premium covered by the hospital.
Damages soar
The private insurance companies who provide the midwives with liability cover say the price has had to increase as they are paying out more and more in damages.
Although the number of cases is not changing drastically, individual compensation amounts have increased.
The companies claim the amount they are charging simply covers the higher damages they are forced to pay out after complications in deliveries.
One of the largest providers of insurance for midwives is the Bavarian insurance company VKB. Spokesperson Claudia Scheerer told Deutsche Welle that care and treatment costs as well as paying out higher damages were the cause.
"In the last year in particular we have seen higher payments awarded for pain and suffering caused," Scheerer said.
"It is important that there is compensation for occupational hazards. It is a problem with society, and can not be solved at the expense of the insurer," she added.
Demanding more pay for deliveries
According to statistics from the DHV, 160,000 babies born each year are delivered by independent midwives - around a quarter of the total.
For the DHV, and for midwife Andrea Wehling, the solution is clear – higher pay.
"I love this work, but the fight to get enough money for the good work we do has been going on my whole life," said Wehling. "It is very satisfying work, but financially it is not so satisfying," she adds.
Andrea Wehling says she is proud of the German system and the way it allows women to choose where to give birth.
However, according to a statement by the DHV, "this freedom of choice is now at risk."
Other problems
It is not just the problem of paying for insurance that has made midwives throughout Germany so disgruntled.
Midwife Lisa von Reiche told Deutsche Welle the wages for student midwives, at seven euros fifty an hour, were "scandalous".
"The fees for midwives' services must be appropriate," she said. "The current student midwife wage does not reflect a position of such high responsibility."
Von Reiche added that people do not always understand the special care, both during pregnancy and after birth, that midwives provide.
"The public needs a complete picture of what midwives do. Many people do not realise that midwives are the strongest guarantee for starting a heathy family," she said.
Petitioning online
The campaign led by the main widwives' trade union for higher pay and better conditions for midwives' work has attracted publicity and thousands of signatures.
As negotiations between the insurance companies and the midwives' union have broken down, it is hoped the petition will force the government's hand to intervene in the situation.
"The issue is not just for a little group of midwives, but for all women who want to have children," said Wehling.
"Normally we do not have a big enough lobby, we are just a small group. But with this petition, the pregnant women and parents have to become our lobby and we have a bigger voice."
Author: Catherine Bolsover
Editor: Susan Houlton