gms | German Medical Science

Background: Every woman has a legal claim during her pregnancy, birth, puerperium and until the end of the lactation period, to get the support of a midwife [1]. Nevertheless, it seems that in some regions in Germany it is difficult to ensure an overall midwifery care [2], [3]. Furthermore, midwifery care is not easily accessible for example women lacking resources or with migration background and it is challenging to get access to midwifery care predictively [4].

Because of this issue the midwifery agencies were founded. The objective of the agencies is to simplify and to structure the search for midwives and to facilitate independent midwives due to organized matching and the involved work processes [5]. In North Rhine-Westphalia there are already 9 existing midwifery agencies. These include the midwifery agencies in Duesseldorf and Bochum. The agency in Duesseldorf was founded in 2015 and is financed by the community. In 2018 the agency in Bochum was established by the “Arbeiter-Samariter-Bund”.

Objective: The objective is to evaluate the success of the agencies in Bochum and Duesseldorf as well as the effects and changes to the cooperating independent midwives. Consequential the following questions need to be answered:

1.

Is it possible to facilitate the independent midwives through a membership in a midwifery agency?

2.

Is there an imbalance between the proposition and the demand of the midwifery care, by the placement rate through to the midwife agency?

Method: Within the master thesis, the members of the midwifery agencies in Bochum and Duesseldorf (N=139) participated. During July 2nd and September 15th in 2018, on a retrospective and explorative survey (online and via postal mail). In the period between January and September 2018, the requests for midwifery care, which were received by both agencies, have been analyzed. The analyses was done with SPSS^® (version 24), processes of descriptive and inference statistics have been used.

Results: The response rate of the survey was 55.4% (n=77). 68.8% of the midwives indicate that their satisfaction increased since they are members of the midwifery agency. Especially midwives with a newly qualified seem to benefit of that (rpbis=–0.216 p(unilateral)=0.030; n=77). 81.8% of the midwives indicate that it was possible to make use of free capacities because of the agencies, so they were able to gain a more continuous workload. This increase in efficiency leads to a higher rate of accepted requests for their service through the midwives (14.3%).

The placement rate for the agency in Bochum is 86.8% (n=269). The median placement duration is seven days. The agency in Duesseldorf achieved a placement rate of 56.6% (n=1.260) and a median placement duration of six days.

Relevance: First evaluation about effectiveness, efficiency and sustainability of two midwifery agencies in Germany.

Conclusion: Midwifery agencies can be a key factor, to facilitate the work of independent midwives and to create a continuously stable workload of their capacities. But it is not possible to fully compensate the imbalance between the proposition and demand of midwifery care. The further establishment should be encouraged on a nationwide level.

Ethics and conflicts of interest: A vote on ethics was obtained. The research was financed by own resources. There are no conflicts of interest.