The Greens criticize the fact that the federal government is not planning any fundamental reforms despite known problems in obstetrics and midwifery care. Although the government identifies existing deficits, it does not draw any further conclusions from them. “Anyone who recognizes the need for action but remains inactive is consciously accepting inadequate care around pregnancy and birth,” said Green health politician Kirsten Kappert-Gonther, chairwoman of her parliamentary group in the Bundestag’s health committee. The basis for their criticism is a response from the Federal Ministry of Health to a small question from Alliance 90/The Greens, which the taz has received. First reported the mirror.
In its response, the Federal Ministry of Health, led by Minister Nina Warken (CDU), makes it clear that the states are responsible for inpatient care – this also includes obstetrics. They should ensure that there are enough offers in the regions and that they match the respective needs.
At the same time, the ministry refers to a report from the North Rhine-Westphalia state government on the situation of outpatient midwifery care. It states that there is a shortage of midwives in some places. Not all women have the same access to support around pregnancy and birth. Women with low incomes, low education or language problems are particularly affected. In addition, midwives in some regions report that they receive more requests than they can handle.
The 2025 midwifery study by the Future Foundation also shows that this is not a regionally limited problem. According to this, every second midwife nationwide is thinking about leaving her career. The study cites a high workload, increasing bureaucratic effort and a persistent shortage of staff as the main reasons.
Supply bottlenecks feared
From the Greens’ perspective, the federal government is exacerbating the existing supply gap by failing to implement necessary reforms. In addition to the lack of measures to achieve the goal of “health around birth”, there are no changes to strengthen the representation of midwives in contract negotiations with health insurance companies. Kappert-Gonther emphasized that good obstetric care can only succeed with continuity and close cooperation between midwives and doctors. “For this to happen, midwifery skills must be strengthened and midwife-run facilities must finally be integrated into cross-sector care structures,” says the politician.
In this context there was recently Discussions about the midwifery assistance contractwhich has been in effect since November 2025. This was preceded by broken negotiations between the German Midwives Association and the GKV umbrella association of health insurance companies. An independent arbitration board, which is called in if the contracting parties cannot reach an agreement, approved the draft of the National Association of Statutory Health Insurance Funds. The new contract has regulated midwives’ remuneration since November. Freelance midwives in particular criticize the fact that they are now paid less. The German Midwives Association fears regional supply bottlenecks and even the closure of entire delivery rooms in the long term.
Kappert-Gonther also criticized the federal government’s handling of mental illnesses related to pregnancy and birth. The federal government has no knowledge of the actual need for care for mental illnesses before and after birth, said Kappert-Gonther.
According to various studies, 10 to 15 percent of mothers suffer from depression that occurs before or during childbirth. In some cases there is even talk of up to 20 percent. This makes these diseases one of the most common complications in this phase of life. Kappert-Gonther said: “Instead of launching comprehensive screening, the federal government is shirking its responsibility.”