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New Midwife Contract Takes Effect, Putting Bavaria’s Beleg System at Risk

Professional groups warn the new pay rules could quickly thin midwife ranks in Bavaria.

Overview

  • The Hebammenhilfevertrag took effect on 1 November, replacing flat rates with time-based pay that AOK Bayern says strengthens postpartum visits.
  • The Deutscher Hebammenverband cites a survey showing midwives in about half of Beleghebammen teams plan to resign within six months in response to the new terms.
  • Clinic-based freelancers now receive 80% of the hourly rate for one active birth but only 30% for monitoring additional simultaneous births, a structure intended to favor one-to-one care.
  • Beleghebammen staff roughly three-quarters of Bavarian delivery units, raising the risk of service reductions or even temporary closures if teams shrink.
  • The contract also splits inpatient from outpatient responsibilities, which the German Society for Obstetrics says could delay care, and it limits billable brief advice and course no-show charges, reducing flexibility for midwives.