Midwifery in Germany Its past and present

Abstract

This article introduces midwifery in Germany to the North American midwife. The development of the midwifery profession since the 12th century is presented. Some regulations that govern midwifery practice today were initiated by the clergy, city government, and physicians during past centuries. Present-day midwifery training and professional opportunities are described. The organization and pecullarities of the German health care system and some effects of German reunification that are relevant to midwifery practice are also discussed. Midwives work in several areas and are regulated by federal and state laws which support and secure their practice. The promotion of midwifery interests frequently encounters resistance by obstetricians. There is a long-standing conflict related to an overlap of skills and services that both professions claim as their own. In recent years, more women have demanded and used midwifery services. In 1992, 811,774 deliveries were performed by midwives in 1,176 German hospitals with varying styles of labor management. This variety ranged from university hospitals, which emphasized modern technologies, to institutions that supported a comprehensive midwifery approach. The author challenges the classical practice of midwifery and contrasts it with a delivery that incorporates several features in a comprehensive approach.