Osnabrück – October 31, 2026 -- The share of births with one-to-one midwife care during the key phase of labor has doubled from one in four to one in two since Germany's nationwide midwife services contract took effect, according to the statutory health insurers' association GKV-Spitzenverband.

Stefanie Stoff-Ahnis, deputy chair of the GKV-Spitzenverband, told the Neue Osnabrücker Zeitung that the result shows higher quality in care. The contract entered into force on November 1, 2025, and governs care by roughly 18,000 freelance midwives across Germany. According to the insurers, it has cut bureaucracy and raised pay.

Hourly rates rise 33% outside hospitals and more than double in clinics

For out-of-hospital work, hourly pay increased by just over 33% to about 74 euros. For one-to-one care in hospitals, the rate more than doubled to 85.40 euros per hour.

Stoff-Ahnis said the higher pay keeps midwives in the profession even as birth numbers fall.

Midwife density climbs to 28.5 per 1,000 births

The number of freelance midwives is stable while births decline. Coverage has therefore risen from 22.7 midwives per 1,000 births in 2023 to 28.5 currently.

Statutory insurers expect spending on midwife services to reach 850 million euros in 2026.

Continuous-care midwives grow from 250 to about 550

The number of "Begleit-Beleghebammen", who support women continuously from pregnancy through the postpartum period, more than doubled within a year, from 250 to roughly 550. Over the same period, the number of "Dienst-Beleghebammen", who work in shift systems, fell.