gms | German Medical Science

4th International Conference of the German Society of Midwifery Science (DGHWi)

Deutsche Gesellschaft für Hebammenwissenschaft e. V.

16.02.2018, Mainz

About this meeting


Monika Greening

Dear colleagues.

The theme of 4th International Conference of the German Society of Midwifery Science is "The academic midwife – practice and science". We are delighted that we could attract Professor Cecily Begley, a renown and internationally recognized researcher from Ireland, as the keynote speaker. She will share her experiences in the development of pre-service undergraduate Bachelor programmes in Ireland.

In a multistage project in a period of about 10 years she and her research group has educated lecturers up to PhD-level. The next step is to better interlink research and practice by including involved actors from practice. Cecily Begley is the chair of the department of Nursing and Midwifery at Trinity College Dublin in Ireland and she has numerous mandates in national bodies and in the development of standards. The topic of her presentation demonstrates the invaluable asset of collaboration between practice and research, and demonstrates its significant impact on women's healthcare.

Rainhild Schäfers and Björn Misselwitz impressively point out that obstetric interventions are related to system-immanent factors such as the size of a clinic or the time of day. In their contribution to the conference, Nina Knape and Friederike zu Sayn-Wittgenstein also deal with interventions. Using secondary data analysis, they focus on the relationship between workload and care density of midwives and the use of analgesia and anaesthesia procedures. In their presentation, they conclude that there is a significant correlation between the workload and the attendance of midwives, and the use of analgesia and anaesthetics. In Annekatrin Skeide's presentation, she describes the findings of an ethnographic study on the types of doing homebirth bodies through socio-material homebirth practices. Her findings are based on the method of participant observation and semi-structured interviews. In their presentation Fabienne Pradella et al. deal with the behaviour of pregnant Muslim women in Germany during Ramadan. A topic of great importance due to the growing number of Muslim citizens in Germany, to which so far little attention has been paid. A special focus is set on how pregnant Muslim women seek information about Ramadan and what kind of advice they receive from health care professionals. The thematic basis of the presentation by Lucia Ramirez-Montesinos and Soo Downe is the rates of chorioamnionitis in active versus expectant management after premature rupture of membranes. The development and set-up of a protocol for a pilot RCT is discussed in their presentation. Gertrud Ayerle et al. in their presentation, discuss the methodological challenges that occurred in the development of the study "Be-Up: active childbirth": starting with the conception of the intervention, the description of the outcomes, the randomization, the data collection and, not least, the monitoring of research process. The RCT investigates the independent effect of an alternative designed delivery room on maternal and neonatal outcomes within singleton pregnancy in cephalic presentation at term. The study period is three years. Patient safety and data quality were developed to the highest standard taking into account the ICH-Good Clinical Practice E6 guideline.

Again, in 2018, we are able to offer you a high-quality and interesting programme for the 4th International Conference. We would like to thank all speakers, students, practitioners and in particular the participants who took part in studies, and thus made it possible to share these presentations with you. The growing interest of both, researchers, students and practitioners from within Germany but also from abroad, makes us proud. It also shows, that the work of the German Society of Midwifery Science with their aim to advance research in Germany and internationally are of great importance, especially for the benefit of women and their families around the continuum of care, from pregnancy to the end of the breastfeeding-period.

Finally, we would like to thank our organizational team Annika Bode, Sonja Lindic and Joschua Heil for the successful organization of the conference during recent months and weeks as well as the organization of the conference on site. Special thanks go to the students of midwifery school in Mainz. The complex and elaborate organization of this conference would not have been possible without this wonderful - and voluntary - support. THANK YOU VERY MUCH!

On behalf of the board, I thank you for all the good wishes and support for the organization and composition of the 4th International Conference of the DGHWi. I wish you much pleasure in reading the conference proceedings.

For the board,
Monika Greening

Translation: Michaela Michel-Schuldt (M.Sc. Midwifery)

Words of welcome 1-5

Sabine Bätzing-Lichtenthäler

Ladies and gentlemen,

The work of midwives makes an essential contribution to providing children with a good start in life. Each child is unique and thus presents parents with new challenges in their daily lives. During pregnancy, birth and the time after a child is born, midwives are frequently the most important points of contact. It is with great pleasure that I take the opportunity presented by this conference to express my utmost appreciation and respect for the work you carry out.

The environment in which midwives practice their profession has changed. Despite the increasing cost of liability insurance premiums, much has changed for the better. The trusting partnership between the federal state government and the Rhineland-Palatinate Midwifery Association continues to focus on ensuring that these positive developments are lasting and sustainable. The Round Table on Maternity Care, established at the beginning of 2016 and comprising representatives from the field of midwifery as well as other key players and associations, aims to comprehensively and proactively incorporate the professional expertise of partners to continue to guarantee universal and high-quality maternity care in Rhineland-Palatinate. Here several issues are particularly relevant: the situation regarding skilled personnel, liability insurance premiums for midwives, the number and location of hospitals with obstetrical units, caesarean rates, midwife-led delivery units, quality criteria in maternity care as well as an insight into the work of the round tables on maternity care in other German federal states.

There continues to be no evidence of a downward trend in the number of midwives in Rhineland-Palatinate and the number of midwives per 100,000 women aged 15–44 is even on a steady increase thanks to the currently rising birth rate. The federal state of Rhineland-Palatinate has 35 obstetrical units all equipped with excellent personnel and facilities and thus continues to provide high-quality universal maternity care. A grand total of nine of these services are level 1 perinatal centres and thus provide the highest level of care.

The federal state government will remain a reliable point of contact for midwives in the future, providing them with an opportunity to raise their concerns and continuing to support collaborative solutions. I would like to express my gratitude to all of you working in maternity care and conducting research in the field of midwifery science for your important work and I would like to wish conference participants many interesting encounters and a most informative experience.

Sabine Bätzing-Lichtenthäler
Minister for Social Affairs, Labour, Health and Demographics of the German Federal State of Rhineland-Palatinate

Translation: Carla Welch (M.A.)


Rektor Prof. i.K. Dr. theol. Martin Klose

Dear midwives, dear researchers,
dear midwifery students,

I'm delighted to receive you at the 4th International Conference of the German Society of Midwifery Science at the Catholic University of Applied Sciences Mainz and wish you a warm welcome.
Since 2011 midwives are studying in the department of 'Health and Nursing Care' und thereby enrich with their special profile not only the department, but the whole university.
To me and to the entire university it is a special delight, that the dean of the department of 'Health and Nursing Care', Prof. Monika Greening, did bring the 4th International Conference of the German Society of Midwifery Science as well as the celebration of its 10th anniversary, to our university in Mainz. We feel very honored and express our thankfulness!

The manifold programme of the conference mirrors the whole range of topics midwives are dealing with in their practice and research. Regarding the health of women, children and families, they do not solely focus on obstetrics but always take into account topics concerning the society as a whole.

From the perspective of my own scientific discipline, theological ethics, numerous contributions to bioethical questions in the conference programme are particular eye-catching – and I am equally glad and grateful, that these topics are brought up. Ethical principles of equity, the right to self-determination, caring, averting damage and thereby all the questions raised by the so-called ethics of principles is a recurrent theme in diverse presentations of your conference.

Three presentations today are exclusively dealing with the question, how childbirth is influenced by "case load", "workload and density of care" or by the "birthing environment". The underlying dilemma can easily be identified: Is health care driven more by ethical or by economic parameters? Several scientific poster presentations raise another ethical core question, whether in diverse situations autonomy and participation of pregnant women can be respected, be facilitated and be granted.

Furthermore the dispute regarding the shift of midwifery education to an academic level is of high relevance to me as a principal of this university. Not less relevant are questions about education and competence development as shown in numerous contributions in the programme, regardless of whether dealing with concrete contents of academic teaching or structural questions.

Overall the diversity of subjects and methodologies in your conference programme shows, that midwives did yet achieve a lot in the field of science - so much, that you can be rightly proud of. To complete my speech, there are three issues pending: a word of thanks, a congratulation and a wish.

As your host and as principle my cordial thanks go to everybody, who did contribute to the preparation and organization of this conference – and a special thank you to my colleague Prof. Greening, to you, dear Monika.

My wholehearted congratulations on the 10th anniversary of the German Society of Midwifery Science and I have to say: Keep up the good work!

I wish you all a rich day full of new insights and inspirations!

Rector Prof. i.K. Dr. theol. Martin Klose
Mainz Catholic University of Applied Sciences

Translation: Gabriele Krüger (Midwife, MaS International Health)


Ulrike Geppert-Orthofer

Dear Colleagues, Researchers and Future Midwives,

The German Society for Midwifery Science's International Conference has become a permanent fixture in the yearly agenda of all women and men practicing or conducting research in the field of maternity care. This is already the fourth time that practitioners and researchers have come together to share scientific knowledge. After each conference, participants return to their work inspired and with renewed motivation. In this way, the German Society for Midwifery Science's International Conference has built a bridge between theory and practice. In Germany, this bridge is still incredibly difficult to cross and involves a long and arduous path. This is one reason why I am so excited about Cecily Begley's keynote speech on the interaction between science and professional experience to improve maternity care for mothers and children.

I hope very much that we will all have the staying power to remain on this path. I believe that with the triad of science, practice and professional policy, we can successfully proactively shape maternity care and thus also the working conditions of midwives. This 4th International Conference which follows the motto "The academic midwife – practice and science" makes a valuable contribution to the achievement of this goal. Another important building block is close cooperation between the DGHWi and the German Midwifery Association (DHV). As the President of the German Midwifery Association I am delighted to be able to work towards improving this cooperation.

On behalf of the German Midwifery Association, I would like to take this opportunity to wish the DGHWi the greatest of success as a scientific professional society for midwifery and hope that its 4th International Conference is packed with fruitful expert discussions generating valuable new insights.
Warmest wishes.

Ulrike Geppert-Orthofer
President of the Germany Midwifery Association (DHV e.V.)

Translation: Carla Welch (M.A.)


Ursula Jahn-Zöhrens

Dear colleagues and midwives-to-be,

I am delighted to address you with a couple of words as the chair of the "Hebammengemeinschaftshilfe (HGH) e. V." (Midwifery community support association). Research, including academization is the focus of the HGH since several years and therefore this international conference is another part of our joint puzzle.

Academization in midwifery progresses quickly and until 2020 this process should be completed. Thus, Germany finally will catch up with the standards in educational conditions of our neighbouring countries, a demand that our profession raises since a long time. To be a midwife means to take responsibility for mothers, children and their families, means to distinguish between physiology and pathology, means observing care from the background on the one hand and quick interference on the other hand. The art of midwifery is considered a medical "craft" with high practical relevance, empathy is expected from us and also a conscious body perception. Do we lose these skills when we study in universities, instead of being taught at hospitals with midwifery schools attached? Does science create colleagues, who are intellectualized and who are not familiar with their seven senses?

Doubts like these are expressed, when the matter of academic midwifery education is being discussed. I see things quite the opposite way:  midwives have to carry a lot of responsibility, they need a lot of knowledge ("to do little") and have to pass on their experience in a sound way, to keep their place in the world of natural sciences. And for that we need the academization. Our constant endeavour must be to combine practice and research for the benefit of the women we accompany, as highlighted in the title to the presentation by Professor Begley.

Today, as part of this event, experts will share with us how research supports practice: Oral and poster presentations give us an insight into scientific work to strengthen our profession. Researchers encourage us, pass on their knowledge and practice meets theory for a common discourse.

In this sense, I wish you a day that satisfies your thirst for knowledge, good conversations and discussions around the presentations and thank you very much to the Board of DGHWi and all those responsible for the very interesting and diverse program.

Ursula Jahn-Zöhrens
Vorsitzende der Hebammengemeinschaftshilfe
January 2018


Dr. Gertrud M. Ayerle
Elke Mattern M.Sc.

Dear Readers,

Members of the DGHWi Board and staff at Head Office have been planning for the 4th International Conference for a long time. They are not the only ones who have been busy, however; many other members of this scientific professional society along with two masters students from the Katholische Hochschule Mainz have shown great commitment and dedication to the planning and organisation of the conference.

The call for abstracts was conducted by Professor Lea Beckmann supported by numerous colleagues in the anonymous review of the abstracts that were submitted (peer-review process). These colleagues are listed by name in the column on the review process. Mrs Annika Bode M.A. and Sonja Lindic B.Sc. (a masters student). made up the organisational team which received the authors' abstracts and CVs and were responsible for correspondence with these authors. They supported the Board in publicising and promoting the conference nationally and internationally. They also handled all contractual issues, managed the registration process for all participants and, in cooperation with Joshua Heil, coordinated the on-site planning and organisation of the conference. Annika Bode M.A. was the point of contact for Mrs Sabine Winkler at DGHWi's Head Office and for the Board.
The editorial team was responsible for the conception and layout of these conference proceedings which are a special supplement to the Journal of Midwifery Science 01/2018.

Over 50 abstracts were submitted for the 4th International Conference. We would like to express our gratitude for the keen interest shown by the professional community, both nationally and internationally. We are very happy that around 100 participants are expected to be present at this year's Conference. Not only have we received registrations from Germany but also from Australia, Ireland, Norway, Austria, Switzerland and the UK.

This supplement to the Journal of Midwifery Science (Zeitschrift für Hebammenwissenschaft) includes the abstract for the keynote speech and for the presentations and poster presentations all of which can be accessed in the following formats:

  1. as a print version, which can also be accessed as a pdf file via the DGHWi e. V. website; as in the past, a hard copy of the conference proceedings can also be ordered from our Head Office;
  2. in the German Medical Science (GMS) online portal where the abstracts will be permanently accessible free of charge via For many of the presentations, there will also be a link enabling you to download a pdf of the final version of the poster (for each abstract).

The German Medical Science portal is the interdisciplinary portal of the Association of the Scientific Medical Societies in Germany (AWMF). It was developed in cooperation with the German Institute of Medical Information and Documentation (DIMDI) and the Information Centre for Life Sciences (ZB MED) and provides free access to high-level peer-reviewed medical research and scientific articles, abstracts and position papers, including those relevant to the field of midwifery.

Each individual abstract, both in the print and online version, will include a bibliographic description and/or citation at the end. The citations in the on-line publication will be assigned a DOI address. A DOI or Digital Object Identifier is a means of unique identification and of locating the text on the Internet. This DOI can be typed into the search field on or simply entered into any standard search engine enabling you to find the abstract directly. Since the abstracts are saved separately (independent of the websites, which may be subject to changes), this method represents a significant advantage, also for the authors of the abstracts: with this permanent document identifier, their abstracts can be located indefinitely.

We hope that DGHWi's 4th International Conference in Mainz proves to be a most stimulating and enjoyable experience.

Dr Gertrud M. Ayerle and Elke Mattern M.Sc.
Editorial Team

Translation: Carla Welch (M.A.)


Merging practice and science to improve maternity care

Cecily Begley
Chair of Nursing and Midwifery, Trinity College Dublin, Ireland
Visiting Professor in University of Gothenburg, Sweden


Prof. Cecily Begley, Chair of Nursing and Midwifery, Trinity College Dublin, Ireland.
Prof. Begley, a registered midwife, has led many research teams to successful completion. Her main research interests are in promoting normality in childbirth and encouraging women-centred maternity care. She has published over 160 peer-reviewed papers, and is Visiting Professor at the University of Gothenburg, Sweden.

Prof. Begley co-ordinates (with Dr Deirdre Daly) the MAMMI study (Maternal health And Maternal Morbidity in Ireland), a national study of morbidity faced by 3,000 first-time mothers in pregnancy and up to one year post-natal. She also leads the REDUCE study, a pilot and feasibility trial designed to reduce unnecessary caesarean section in Ireland.

Review Process for the presentations at the 4th International Conference

During the preparatory phase of the 4th International Conference of the DGHWi (German Society of Midwifery Science) researchers were needed to assess the abstracts, submitted within the deadline of the 'Call for Abstracts'. Therefore, all 44 members of the DGHWi with a PhD degree or PhD students and candidates were informed and asked to participate in the review process. We would like to thank all the 24 members, who contributed with their eagerness to the success of the conference:

  • Dr. Gertrud M. Ayerle
  • Prof. Dr. Nicola Bauer
  • Prof. Dr. Lea Beckmann
  • Prof. Dr. Annette Bernloehr
  • Karin Brendel-Hof  M.Sc.
  • Dr. Ines Brock
  • Prof. Dr. Claudia Hellmers
  • Dr. Tina Jung
  • Prof. Dr. Cornelia Kahl
  • Prof. Dr. Nina Knape
  • Prof. Dr. Ute Lange
  • Dr. Christine Loytved
  • Elke Mattern M.Sc.
  • Michaela Michel-Schuldt M.Sc.
  • Karin Niessen Dipl. Nursing education
  • Prof. Dr. Jessica Pehlke-Milde
  • Mirjam Peters M.Sc.
  • Beate Ramsayer PhD
  • Prof. Dr. Rainhild Schäfers
  • Martina Schüter-Cruse Dipl. Pedagogy
  • Dr. Marion Schuman
  • Susanne Simon Dipl. Nursing education
  • Prof. Dr. Dorothea Tegethoff
  • Theresia Werner-Bierwisch Dipl. Nursing education

After two extensions, the Call for Abstracts for 4th International Conference: The academic midwife – Practice and science, ended on the 31st October 2017.

To ensure the blinding of the review process, the submission of the abstracts was organized through two editable, electronic forms. The abstract with a maximum of 3.500 signs (plus/minus 10%) including space characters was submitted by the authors using an anonymized data file, either in English and German or English only.

The recommended abstract outline complied with common international standards and included: background, aim/research question, methodology, findings, relevance and recommendations/conclusions. Authors were asked to specify ethical criteria of their study. Additionally, the authors informed the reviewers about the context in which the research was conducted and how the study was financed. Fixed answer options included: bachelor thesis, master thesis, dissertation or other and third-party funded studies/third-party funded projects or self-financed study/self-financed project.

The authors had unrestricted access to the criteria of the review process of the abstracts through the website. Receipt and forwarding of the anonymized papers to 2 reviewers was conducted by the organizational team of the conference.

The reviewers received the anonymized abstract and additionally information about the background, in which the research was conducted and whether the abstract was submitted as an oral presentation or poster. Within the assessment, the reviewers also gave recommendations, whether the papers were eligible as an oral presentation or poster presentation. Following five criteria evaluating the abstracts were assessed by a scoring system (1= lowest rating; 6= highest rating): 

  1. Is the justification of the study/project clearly explained?
  2. Is the methodology sufficiently described?
  3. Are the core outcomes/findings presented or is a reference made that core outcomes/findings are presented?
  4. Will the presentation add new findings to pre-existing knowledge in this field?
  5. Are recommendations given for professional practice?

More than 50 abstracts were submitted. Thereby the number substantially increased compared to the past years. Due to this positive increase, a differentiated organization of the program was possible, according to the wishes of the authors and recommendations of the reviewers. The final acceptance of the submitted abstracts was decided in consensus by the board of the DGHWi.

Six abstracts were selected as an oral presentation and 24 as posters that will include a short presentation. Further papers were accepted with the possibility of poster exhibition without oral presentation. Five additional posters were not accepted. The criteria of the review will be revised by the board of the DGHWi, based on the reviewers numerous remarks and amendments, submitted during the review process regarding the actual assessment process.

Translation: Gabriele Krüger (Midwife, MaS International Health)