[The Bavarian Midwives Bonus - A Contribution to Monitoring Freelance Midwifery Care in Bavaria].

BACKGROUND

Supply bottlenecks in midwifery care could intensify due to increasing birth rates in Bavaria. Midwives are already fully booked and can only take care of pregnant women by increasing their working hours. The situation of self-employed midwives is particularly precarious. Bavaria has been supporting self-employed midwives by granting the Bavarian midwife bonus of up to € 1,000 per year since September 2018. This analysis aims to describe the current status of the unique Bavarian midwife bonus scheme and to describe current programmes to improve care in obstetrics in Bavaria.

METHODS

All midwives who were self-employed, had their primary residence in Bavaria and had cared for at least four births in the application year were eligible for the Bavarian midwife bonus. We used data from application years 2017 and 2018 to describe the number of applications per year and the socio-demographic characteristics of the applicants and analyzed the regional distribution of the midwives and the regional supply density.

RESULTS

In 2017, a total of 723 midwives received the bonus, in 2018 already 852 midwives. The average age of the applicants, who were exclusively female, was 44 years in the application year 2018. In 2018, 37 midwives per 100,000 women aged 15-44 were self-employed in obstetrics in Bavaria. A regional comparison showed an above-average supply density in the Upper Palatinate (52) and Lower Bavaria (54) and a below-average supply density in the Upper Franconia (13).

CONCLUSION

The analysis of the Bavarian midwifery bonus enables a glance, albeit limited, into the supply situation of self-employed midwives in Bavaria. Whether the political instruments can improve the supply situation in Bavaria have to be evaluated using newly generated representative data. Central registration of midwives in Bavaria could be useful.