One year after the implementation of the Midwife Assistance Contract, the care provided to pregnant women has seen a significant improvement. Stefanie Stoff-Ahnis, Deputy Chair of the GKV-Spitzenverband, told the Neue Osnabrücker Zeitung that the share of one-on-one care during the critical phase of labor has doubled, rising from one in four births to one in two. She described this as a positive achievement for enhancing the quality of care.
This nationwide Midwife Assistance Contract, which came into force on November 1, 2025, governs the services provided by approximately 18,000 self-employed midwives across Germany. According to the source, the agreement has led to reduced bureaucracy and better compensation for midwives. Stoff-Ahnis further noted that because of these changes, midwives are able to remain in the caregiving profession despite the declining birth rate, which has subsequently improved the coverage rate.
Financially, the hourly rate for outside clinical work has increased by over 33 percent, reaching approximately 74 Euros. In the hospital, the rate for one-on-one care has more than doubled to 85.40 Euros per hour.
Despite the fact that the number of self-employed midwives has remained constant while the birth rate has decreased, the density of care has improved. For 1,000 births in 2023, there were 22.7 midwives, a figure that has risen to 28.5 currently. Concurrently, projections indicate that health insurance expenditures for midwifery assistance are expected to climb to 850 million Euros in 2026.
Furthermore, the number of “accompanying certifying midwives”-those who continuously support women from pregnancy through the postpartum period-has doubled within one year, increasing from 250 to around 550. Conversely, the number of rotational, or shift-based, certified midwives has decreased.
