gms | German Medical Science

Background: According to the “Vertrag über die Versorgung mit Hebammenhilfe nach § 134a SGB V”, freelance midwives provide services before, during and after childbirth for all women. The services provided by freelance midwives include, in particular, prenatal care and support, obstetrical care, postpartum care, and childbirth preparation and postpartum regression courses. Pregnant women usually seek access to the low-threshold and non-stigmatizing services of freelance midwives on their own initiative.

Vulnerable women – especially those affected by poverty or a low educational status – are disproportionately often not reached by the care offered by freelance midwives. Regional difficulties in ensuring a comprehensive supply of midwifery care as well as the lack of knowledge of vulnerable women about the services offered by freelance midwives make access to midwifery services more difficult. In addition, language barriers, barriers to access to the profession, and also attitudes of midwives toward clients contribute to the gap in care.

The perspective of freelance midwives on the care of vulnerable women and their use of midwifery services will be explored.

Aim/Research question: The aim of the study is to determine the experiences of freelance midwives with regard to access to vulnerable women, their care and referral to other professional groups. It also asks about the challenges for the profession as well as the necessary competencies of midwives when working with vulnerable women.

Methods: As part of a group discussion, seven freelance midwives from urban and rural districts in North Rhine-Westphalia, Germany, were interviewed about their experiences in working with vulnerable women. Following the qualitative study approach, the transcribed data is analyzed by qualitative text analysis and by using the software MAXQDA. The project was approved by the ethics committee of the „Hochschule für Gesundheit Bochum“

Results: The following preliminary findings will be presented at the congress: Importance of an interprofessional network for freelance midwives in the care and referral of vulnerable women to other professional groups; special requirements for the competencies of freelance midwives in the care of vulnerable women; barriers to vulnerable women´s access to freelance midwives.

Relevance: During pregnancy and the early family formation phase, freelance midwives can empower vulnerable women and pave the way to further support services.

Recommendations/Conclusion: To care for and refer vulnerable women, freelance midwives should be integrated into local interprofessional networks.

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