The inventory after more than a year of the corona pandemic shows that midwives are chronically overburdened, especially in cities. The paperwork is overwhelming, the workload is high, the salary is low. A midwife reports on her everyday life in the delivery room.
The sweat runs, the blood drips, the screams of the woman can be heard halfway through the ward. Just a few meters further a similar picture, another woman giving birth is crying, screaming and yelling – “Women can be incredibly loud”. The supervising midwife runs from room to room, looks after the families, lends a hand and often does not even have the time to go to the toilet in one shift. After around 1800 births in 13 years, Lena * therefore says: “My birth battery is empty.” Lena (* name changed by the editors) is employed midwife in a Hamburg hospital. Her job is her calling, she loves her trade, and yet switches to freelance work – without childcare.
In one shift, Lena is responsible for an average of two to four women giving birth and has to look after three births at the same time on a particularly full night: “Years of obstetrics are physical work and also psychologically demanding, especially when you care for several women. If I know, it is the child is coming here, but next door I can already hear from the noises that another woman needs care – that tears you up. ” The corona pandemic brought even more detailed hygiene regulations and further exposed the problems that already existed. Nevertheless, the pandemic is not the reason that Lena, like many other midwives, can no longer stand it in the delivery room after 13 years.
Bad salary, too few staff, pure stress
The working conditions in some maternity wards are almost precarious, as shown by a report by the IGES Institute from last year. The situation is particularly problematic in large cities: in a survey of representatives of clinics and midwives for a study, every fourth obstetrician said she was thinking about giving up her job. This is mainly due to the excessive workload, said 85 percent of those surveyed. Because a midwife does not “just” look after births on the ward. At the same time she has to clean, fill up cupboards, answer the phone and, above all, fill out more and more documents: “Hospitals are increasingly paying attention to quality assurance. You have to document and sign a lot more, and not everything is digitized. That takes up a lot of space. As a result of course, care time is lost. ”
In the study, half of the midwives also criticized the lack of staff. In order to ensure better care for pregnant women, the German Midwives Association issued new guidelines for births. Among other things, the association calls for 1: 1 support, as is customary in other European countries, according to Association President Ulrike Geppert-Orthofer in the “Ärzteblatt”. A demand that Lena supports, but currently classifies as hardly realistic: “At the moment, 1: 1 care cannot be made possible in terms of personnel because there would have to be around 20 to 30 percent more midwives in the delivery room.”
The new midwifery course is intended to enhance the profession – but many clinics cannot guarantee the practical requirements
The midwives are absent everywhere: More people would be needed to look after them and employees to take over the paperwork for the midwives, at least during the birth phases. To become a midwife, you had to complete an apprenticeship for a long time, until the Bundestag decided in 2019 that the profession should be academized: Instead of training at a midwifery school, a bachelor’s degree is now required. Lena also hopes that this could improve the status of the profession. Despite the course, the practical part is high: the students should spend 25 percent of their time in active obstetrics, at best in the delivery room.
But here too there is a lack of staff in many clinics. “In order to be able to guarantee the care of the students, the personnel key has to be correct and it is currently not correct. Even looking after the women is sometimes difficult, then the midwifery students come along. That is simply not possible at the moment,” says Lena.
Many hospitals do not seem to understand what is being done in obstetrics
The study by the IGES Institute also criticizes another point: the salary. More than every second midwife is dissatisfied or very dissatisfied with her wages. Lena reports a net monthly salary of 1800. In addition, there are shift allowances, but the final amount can hardly compensate for the responsibility and stress that employees have on their shifts.
Not least because of this, Lena, with her 13 years of work experience in the delivery room, is an exception: “Many young midwives reduce their hours much earlier. They are simply exhausted, overworked, take it home with them – because they look after many women on duty and hardly ate anything have probably not even been to the toilet. I can understand that after a year or two you no longer work full-time or go into self-employment right away. ”
Liability insurance costs freelancers 10,000 euros a year
Lena is also starting her own business now, although she hardly expects more salary: “As a freelance midwife, I don’t earn much more, but I can organize my time more freely and the working conditions are better. However, there are many deductions, especially for insurance. Ultimately, for example, I earn between 12 and 15 euros for a postpartum visit. Another craftsman wouldn’t even go into a house for that. ” After all, she can then organize the day herself, and sometimes has free weekends. A quality of life that she did not have for years.
The majority of midwives love their job, want to care for pregnant women and women giving birth, their hearts are attached to it, says Lena. Nevertheless, after 13 years she is throwing in the towel for the time being, at least in the birthing room. For her, the great thing about her job is diversity: as a self-employed midwife, you still have more than enough to do with courses, postpartum care and preventive care. She can imagine returning to the birthing room at some point if the circumstances change: “For this we need midwives. And they have to be well paid so that the women stay employed and don’t leave after a few years.”
swell: IGES Institute / “Ärzteblatt” / Hamburg Association of Midwives
This article originally appeared on stern.de.