gms | German Medical Science

Background: Midwifery care of women and their families in pregnancy, childbirth and the postpartum period has shown good results [1] and employs promotion of health and preventive methods, as demanded of modern healthcare systems [2]. At the same time, in Germany there seems to be a lack of midwifery service coverage which results in women not receiving care especially in metropolitan areas [3].

Aim: A collection of new structures of midwifery care that are either already implemented or in a tangible concept stage and differ significantly from established and traditional midwifery services in Germany.

Methods: A structured literature research was performed in german an english databases. Additionally 17 guideline-based interviews with experts from all regions of Germany were conducted to find further, not yet documented, new care structures.

Results: All in all 19 care structures or concepts were identified: already implemented at least as projects are the midwife led labour ward, the family midwife, the family health midwife, the family nurse partnership and a project for integrated care. Further new care structures like online consultation services, midwife centers, post-partum ambulatories and practices with employed midwifes and other health professions have emerged in the last years. At some point financial aids for midwives by state institutions and online midwife search engines were developed. Rather occasionally, development of family-friendly duty rosters is taking place, midwives work in a Medizinisches Versorgungszentrum (MVZ) or a midwife emergency call is organised. Helpful concepts for future development of midwifery care models are the midwifery center, concept of midwife led care and the relation led birthing culture.

Relevance: This survey of new structures in german midwifery care can serve as the base for further concepts of care models and future development of midwifery care in general.

Conclusions: The findings of this research show a heterogeneous picture of care structures. There are great regional differences resulting in the fact that certain models are considered as new in some regions while being already regarded as well established in other regions. Rarely any of the models target the whole Betreuungsbogen [4]. Conception of new care structures should not only look at existing gaps in care provision but also aim at optimisation of the whole peripartum care by midwives.

Ethics and conflicts of interest: No vote on ethics was obtained. The research was supported by external funding. There are no conflicts of interest.

The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].