Tell us about the German Midwives Association: when was the association founded and how many members does it have?
The German Association of Midwives (DHV) was founded in 1954. Reflecting Germany's federal system, the DHV serves as the headquarters organization for the 16 federal states. Midwives themselves join the association through state chapters, and the membership currently totals more than 22,000. From 2023 onwards, the DHV also offers membership to midwife-led birth centres. We are proud that 81 out of the approximately 115 birth centres in Germany are currently members of the association.
What are the education and training requirements for midwives in Germany?
In Germany, the education and training requirements for midwives are well structured and regulated to ensure a high level of care. To apply for a midwifery training program, candidates must have completed secondary education. In some cases, completing a nursing training program may be sufficient.
Since 2020, midwifery training in Germany has been upgraded to a bachelor's degree programme in line with EU regulations. This is a major change from the previous system in which midwives were trained in vocational schools. The programme usually lasts 3-4 years and is offered at a technical university.
Upon successful completion of their degree program, candidates must pass a national exam that assesses their knowledge and practical skills. Successful candidates must then register with the relevant local health authorities and obtain a license to work as a midwife in Germany.
Midwives are required to participate in continuing education, which involves attending regular courses, workshops and conferences, to maintain and update their skills and knowledge. Those who completed their midwifery training before the bachelor's degree requirement was introduced have a pathway to upgrade their qualifications through additional courses and certification.
What initiatives and programs are in place to support midwives in Germany?
In Germany, midwives are required by law to be present at every birth, whether at home or in a hospital. Hospitals must ensure they have enough midwife staffing to fulfil this requirement. Several universities offer master's and doctoral programmes in midwifery, and various federal state initiatives promote midwifery and physiological birth. These initiatives are supported by active lobbying by the German Association of Midwives (DHV) and 16 regional midwife associations.
This lobbying effort includes:
Strengthen collaboration between midwives and emergency services. Provide return programmes for midwives who have not practised midwifery for several years. Include midwives in school education programmes to share their expertise on pregnancy, birth and postnatal care.
Midwives are also involved in private organisations, such as the Good Birth Alliance and various parental organisations, which work to improve care during pregnancy and childbirth and the working conditions of midwives. Midwifery associations represent the interests of midwives, initiate support programmes and play an important role in promoting midwifery practice in Germany. Notable initiatives include:
Establishing a national network of midwifery units and developing standards for midwife-led birth centres.
DHV is in close dialogue with legislators, providing input on draft legislation to strengthen the role of midwives in primary care, and is negotiating with statutory health insurance schemes regarding the scope of services and payment for freelance midwives.
Women can receive midwifery support from early pregnancy through to birth and up to one year after giving birth. Health insurance covers services up to 12 weeks after birth without any additional reason. DHV provides its members with professional and legal advice, medical indemnity claims support, access to a quality management system and professional indemnity insurance.
In addition, the DHV organises training courses in skills, emergency response and communication. The biennial National Midwifery Congress is the largest in Europe. The German Association for Medical Education strives for harmonisation in midwifery, and the German Association for Midwifery Science (DGHWi), founded in 2008, provides guidelines and organises an International Midwifery Science Symposium every two years. Both the DGHWi and the DHV collaborate with other health professionals to develop and update clinical guidelines.
What are the main challenges facing midwives in Germany?
In Germany, midwives face some major challenges. Paying a fair wage to both employed and freelance midwives is an important issue, as is ensuring good working conditions in hospitals. Another challenge is gaining recognition for the quality and safety of out-of-hospital births. Furthermore, strong hierarchical structures in hospitals, universities and society remain a challenge for midwives.
What are your expectations from the ICM Congress in Berlin and why do you think it will be an interesting event for midwives?
We are delighted that the ICM Congress in Berlin will bring together colleagues from all over Europe to Germany. It will be a great opportunity for midwives to meet, spend time together, learn and have meaningful conversations. We look forward to stimulating exchanges and interesting presentations by other European midwives. From our previous experiences at the German Society of Midwifery (DGHWi) International Symposium and the ICM Triennial Congress, we know that our colleagues place great importance on interacting with midwives from other countries. This Congress will be a great opportunity to expand our international network.
