In the course of my work, I have repeatedly realised that there is still some uncertainty about the question: What exactly does a midwife do? Of course, she attends births. But there is a lot more to do in our profession.
Midwives are the trained experts for all questions relating to childbirth. By the way, did you know that there are also male midwives? Until the reform of the Midwives Act in 2019, they were referred to as "maternity nurses". Today, the job title "midwife" applies to all genders.
It is no exaggeration to say that midwifery is one of the oldest professions known to mankind. She is said to have helped the Egyptian sun god Re into the world, as a temple depiction from the 3rd millennium BC shows. You can read more about the history of our wonderful profession on my blog here read.
For decades, midwifery was a school-based profession that has now been academised. Since January 2020, midwives have been trained at universities. It is a dual study programme with many practical assignments. You complete this training with a Bachelor of Science degree.
Midwives provide support right from the start
Now we come to the field of activity. From the beginning of your pregnancy, even if it leads to an abortion, during labour and the postpartum period, right through to the end of breastfeeding, your midwife will be at your side as a competent and reliable companion. Many women probably still know this. However, only a few couples probably realise that we midwives also support women in connection with their desire to have children. This is because health insurance companies do not pay for this service in Germany.
It is precisely regulated which and how many midwife services the statutory health insurance funds must pay for. (Expectant) mothers are entitled to this. However, they have no legal right to receive midwife assistance. And this is precisely what puts many pregnant women in the predicament of not being able to find a midwife.
Around one in five mothers are left without a midwife after the birth of their child. Many midwives have too little time to provide (expectant) mothers with adequate care. This not only applies to the situation in the delivery room. It is especially true during pregnancy and the postnatal period. Obstetrics, as well as postnatal care, is one of the statutory activities reserved for midwives. No other professional group can or may replace midwifery assistance.
And because midwives have become so scarce, it is not surprising that a study found that one in three women who do not have midwifery care do not even know that they have one at all. Entitlement to midwife care has.
Midwives also support women in the event of Premature birth. Even if the mum has already been discharged from hospital and the baby is still being cared for in the paediatric clinic. This help is particularly valuable and important for breastfeeding. This is because it is often not easy to start breastfeeding premature babies. However, midwife support for mums of premature babies is also important to monitor and support the health of the mum, whose postpartum period is generally not as smooth as it should be.
The midwife is also present with the woman during and after Miscarriage. This is another reason why it is important for pregnant women to seek the help of a midwife at a very early stage. In Germany, pregnant women are not assigned midwives. This means that, on the one hand, they have the choice of which midwife should accompany them, but on the other hand, they also run the risk of not finding a midwife to look after them at home.
In any case, your midwife will provide you with holistic care. She will not only support you medically during your pregnancy and, if necessary, during labour and delivery as well as during the postpartum and breastfeeding period, but will also be concerned about your psychological and social well-being. That's why she is always ready to listen to all your questions and concerns. If necessary, she can also refer you to other support services.
Midwife support during pregnancy
A midwife can "officially" determine a pregnancy and also determine the corresponding Maternity passport exhibit. Except for the Ultrasound examinationsIn addition to all the medical examinations that can only be carried out by a doctor in Germany, the midwife can carry out all the planned check-ups if the pregnancy is free of complications: for example, check your blood pressure and weight as well as your blood and urine levels. She will also check the position, size and heartbeat of your unborn child at regular intervals, i.e. monitor its development during the pregnancy.
And also for various pregnancy complaints - such as Tiredness during pregnancy, Nausea during pregnancy, or Sleep problems during pregnancy- the midwife often knows what to do. She can also tell you immediately what to do in the event of premature labour or rupture of the membranes.
Your midwife is also always a good person to talk to if you are experiencing particular stress during your pregnancy. This could be money worries, conflicts in your partnership, previous traumatic births, miscarriages or particular insecurities or fears regarding the birth or parenthood. Don't be afraid to talk to your midwife or counsellor about all your worries that could affect your pregnancy. me to turn!
In addition, many colleagues also offer various courses designed to give parents confidence in dealing with the birth and the baby.
First and foremost, of course, is the Birth preparation courseand the Postnatal course. Preparing for the baby also includes learning the Baby carethe preparation for the Breastfeeding and the occupation with the sick or injured child in the First aid course for babies and children. In the Baby massage we teach midwives how to use massage techniques in such a way that the baby feels comfortable, its abdominal pain disappears and it can sleep better.
Not all midwifery services are paid for by the statutory health insurance funds. This is not because this midwifery help is unimportant for young families, but because health insurance companies only cover the costs of services that they themselves defined years ago as sufficient, economical and appropriate for mothers and babies.
This applies not only to many courses and original midwifery services, but also to soothing methods such as acupuncture, taping and massages.
If you make use of such services, you must bear the costs yourself.
Midwife support during the birth
When the baby is born, there is always a midwife at the labourer's side - regardless of whether the birth takes place in hospital, in a birthing centre or at home. In Germany, doctors are even obliged to consult a midwife during the birth. The only exception to this obligation to call in a midwife is in emergencies where a midwife cannot be called in to help in time.
The midwife is your most important companion at every stage of labour - she helps you, for example, to breathe through the contractions and cope with the pain, advises you on the various postures you can adopt, guides you safely through the different stages of labour, gives you tips to support your personal birth companion and, of course, strengthens you mentally. Some hospitals also have midwife-led labour rooms. In this case, a midwife leads the birth and a doctor is only called in if necessary. In some hospitals, the women giving birth can also bring their midwife with them to attend the birth.
The ideal condition at birth is a 1:1 supportThis means one midwife per woman giving birth during the entire labour process. In everyday hospital practice, however, it is not uncommon for 1:3 care to be a reality. Sometimes one midwife has to attend to up to three women giving birth at the same time. This situation is caused by a combination of a lack of staff, an enormous workload and more "paperwork". To prevent expectant parents from becoming anxious in such a situation, it is important that both parents, or all those involved in the birth, gain a lot of knowledge and ideas from the Birth preparation course to the birth.
Midwife support during the postpartum period
During these particularly sensitive six to eight weeks after the birth, the midwife will visit you at home. Initially daily, then every few days as required. This is not just about health issues for mother and child. Of course, your "aftercare midwife" will also have to monitor the regression of your Uterus the Lochiaand the healing process of any birth injuries. She will also check your baby's weight and observe whether the navel is healing properly. She also has lots of tips on baby care and knows when and how you can start postnatal exercises.
Very important: Your midwife will also support you with breastfeeding your child, provide you with practical advice and assistance and know what to do in the event of minor or major difficulties. And if you are bottle-feeding your child, she is also your contact person for this. Because the first few hours after the birth have a big influence on the success of breastfeeding, it is so important that you prepare yourself well for breastfeeding even if you have a midwife visiting you at home. The Breastfeeding coursewhose videos you can watch again and again.
Midwifery assistance always means holistic support for the family. If, for example, the BondingIf you still need a little support between mother and child, the midwife is at your side. If you are still unsure about how to deal with the newborn or have any questions, the midwife will know the answers. If the "crying days" (baby blues) come after the birth because your body is undergoing massive hormonal changes, she will give you reassurance, strengthen you and explain this normal phenomenon to you. Even if a Postpartum depression If you do have a contraction, which can be the case for 10 to 20 per cent of mothers, you should not hesitate to confide in your midwife.
She is the contact person for all questions and concerns. As during pregnancy, she can also provide further help and support during the postnatal period if required.
Fortunately, fathers, or the second parent, are increasingly taking "baby leave" after the birth of their child and can thus spend part of the postpartum period with their family. They too sometimes have questions or uncertainties that they can turn to the midwife with.
Midwife support until the end of the breastfeeding period
Statutory health insurance covers the costs of up to 20 midwife visits or midwife consultations in the first 10 days after the birth - and up to 16 consultations up to the end of the 12th week after the birth.
If the mother still has problems with breastfeeding after this time Weaning or for the introduction of Complementary foodshe can contact her midwife a maximum of eight more times. A doctor's prescription is not required for this. This is only necessary if more than these eight midwife consultations are required.
Mums often confuse questions about introducing complementary foods with problems. They are then surprised that they receive an invoice for this midwife's help. It is important to know how to successfully introduce complementary foods, but this is not part of the midwife's area of activity, which is covered by statutory health insurance. So that you can organise the introduction of complementary foods well for you and your baby, you will find here the right course.
In any case, the mother can be sure of advice from her midwife until the end of the breastfeeding period if this is necessary.
Where midwives work
Midwives work in different areas and in different forms of work. They work as employees, freelancers or combine both forms of work.
The freelance midwife: Many of my colleagues are freelancers. This means that they do not work as employees, but are self-employed. They look after pregnant women in all the areas of activity listed above, i.e. during pregnancy, during home births and after the birth. They bill their services to the health insurance company or privately. Some midwives also run their own birth centres and/or supervise the births that take place there. The online midwifery service from notdiensthebamme.de is a freelance midwife.
Some freelance midwives can even look after "their" pregnant women during the birth in a clinic. Of course, this is not possible "just like that" - for this she must have a so-called Document contract with the hospital. In this case, one speaks of a Attending midwife. The woman giving birth also has access to the medical staff and a ward bed.
The employed midwife: Many of my colleagues work as employed midwives. Most of them are employed in a maternity clinic, i.e. in the delivery room or on the postnatal ward. Other workplaces for employed midwives include midwife practices and birthing centres. Some are also employed in the field of training as knowledge mediators, such as in midwifery schools or in the academic sector. In addition, some work for organisations in the Early help)where they are used, for example, as so-called Family midwife support families in the first year of a child's life.
Many midwives also work Freelance and employed in combinationFor example, they are employed part-time in a clinic and also work freelance in preventive medicine and counselling. Politics has made it difficult for our profession. For freelance midwives, the cost of professional indemnity insurance has risen immensely, but the remuneration for their services remains meagre and the working hours are inimical to private life. As a result, some midwives are giving up freelance labour and birth support and focusing on pre- and postnatal care.
You have probably already heard that there is now unfortunately a great shortage of midwives. That's why it's important that you look for a midwife right at the start of your pregnancy.
So that you can get midwife help at any time, there is the offer of notdiensthebamme.de. Not only can you get advice and help during pregnancy, the postpartum period and the baby's time, workshops and courses, but you can also become a member of the parent community and enjoy many benefits. Here you can become part of the community.
