How obstetrics is better


“How am I supposed to do it this time?”, Antje asked gripping often, before you went to work. The 44-working Years as a midwife at a Hamburg clinic. It is not long, however, since her Job seemed to be an almost impossible task.

There were just too many Pregnant women, you should take care of at the same time. You rushed of women who had premature labor, to women, where the amniotic SAC had burst. In Parallel, she prepared other women on the cesarean section. You are emitting is actually quiet and expectant mothers should take Worries, and fear, lived in constant fear: fear to be overlooked in the rush, something to make a mistake.

These days were sometime not an isolated case but a normal case. The Overtime accumulated. Sometimes prey did not even have time to go to the toilet. But not only was she suffering the Overload, they had to send Pregnant women with labor pains to a different hospital, because on your Station midwives were missing or the delivery room was crowded. “We had the feeling that the patients cannot meet,” says Griffin, Mrs Gesine Grabichler. The two have been working for more than 18 years of age at the Asklepios clinic in Hamburg Altona (AKA).

Each year, more than 3000 children to the world, and the trend here is upward. Why you have not changed just the hospital? Because the Situation would elsewhere have been a little better. Since 1991, 40 percent of the maternity wards were closed down in Germany. The remaining facilities have problems to close the gap – especially since the number of births increases again. (For more on the care of Pregnant women in Germany, read here.)

Newborn in the nursery

Not to whine, but improve

Grabichler and gripping are women who don’t whine for long, but get out of this. “Water?” asks, gripping at the Meeting in the hospital. She grabs a pitcher, fills it with water from the tap, puts a stack of glasses over the Opening. Scarf, jacket, and papers of terminals at the same time under her Arm. Griffin’s not as you’d matter-of-factly she balances everything in a labor room. Through the open window, the scream of an increasingly penetrates mother in the room.

As the Situation in the hospital deteriorated further, not Packed, gripping and Grabichler this Situation. Together with your 30 colleagues, she opted for an unusual step: they made themselves independent and founded their own company, the midwife office Altona. They had already thought of that once, ten years ago, but the risks of self-employment is spared. In the summer of 2017 they tied the knot finally.

Model München

Grabichler knew of a colleague that the midwives were established at the Munich red cross hospital also jointly set up a company. They visited the Station, took tips from the ladies there, and introduced the concept, then in Hamburg.

It was not easy to convince all of the midwives and the hospital management of the idea. For the women of the step meant a permanent contract of employment with a fixed income. For the clinic business from employees to partners all of a sudden, the self-organize. Thus, a whole Department from the staff disappeared cost, at the same time, the clinic dispensed since then, aware of a part of the Insurance payment per birth.

Nevertheless, decided at the end all work together for the midwife office Altona. This is now almost two years. The first conclusion: All of us have benefited. The clinic has a functioning maternity unit, the midwives are more satisfied with their work situation, and the patients are better cared for.

Twelve-hour shifts: great!

The success brought unusual measures. First of all the midwives in order to put the layer system. Instead of eight hours on the piece you are now working for twelve hours. “This may sound to outsiders, strenuous, but for us, this is much better,” explains Grabichler. Previously, she has worked almost always significantly more than eight hours. At the time the Overtime hours were, well, the working time is planned.

Through the Twelve-hour shifts, you can accompany single births constant, where the end of the shift, often torn out. At the same time, you must come less often to work. “What are, for me, today, two services, it meant a eight-hour day with three services,” Grabichler. Since the changeover, she works with a full site an average of 146 hours in the month, before that it was significantly more.

The new shift system has also improved the supply. Instead of three, at least four midwives are now at the same time on the Station, another can be called added to the Distress. In addition, the midwives may care for only two births in parallel. The letter from the statutory health insurance funds accept all the professional midwives in front, so you don’t have too many “customers” at the same time.

The protection mechanism also works in the other direction. As the midwives were still employed, did not apply these Limits. As a result, the daily load with up to five births was created in parallel.

Who does not work, also deserves nothing

“Since we are independent, we are also sick less often,” says Greif. Because you can divide your services now, and thus more satisfied. On the other hand, the self-employment brings a greater pressure to stay healthy. Who does not work, also deserves nothing. “This is a big risk factor that we are all aware of,” explains Greif.

Because the midwives can now deal directly with the sickness funds, you earn, however, significantly more. How high is your monthly income is, you don’t want to say. This depends also on how much the work of a midwife.

The new Form of cooperation offers not only advantages but also challenges. For example, between human. The midwife Kontor Altona works democratically. All decisions will be voted on, even about the interview request from the MIRROR. The communication is via chat, and vote on lists, on which all equal can choose.

The decision to become self-employed, met the nearly 30 women together. In the case of disputes, mediators are also selected from the Team. “This kind of cooperation can already be nervous times” gripping. “But in the long term the benefits will outweigh.”

But the project is the path to happiness for all midwives? Grabichler and gripping to have their doubts: “The Freelancer does not fit to everyone.” Those who seek security in the Job, should consider the step carefully. “Our model is suitable only for the larger clinics.” Only in such an environment, each individual midwife is able to supervise adequately births, in order to secure their existence. Just because the midwives work in Altona in a large hospital and a large Team, you can organize a company within a company and the work split. This relieves each individual. In small clinics, the model would not work, but more load.

“The doctor there is no such thing”

And pressures caused by the self-employment, especially through the duty of Documentation. Any treatment must be the midwives of their patients acknowledge. An error in the date ranges, and the insurance company denied the payment. “Imagine the doctor you would have any power against drawing, each blood collection, each Sample,” says Grabichler. “To the doctor it’s not, but we do such a thing.”

Gripping and Grabichler not regret, however, that you have made independently. You can imagine now, for the first Time, to work until retirement as midwives.

Summary: The midwives of the Asklepios hospital in Hamburg-Altona, have made nearly two years ago, together and independently. Since then, they are no longer employees of the clinic, but business partners. The work situation of midwives and the care of Pregnant women have improved significantly since then. The model in question is, however, only for larger clinics and also is not the answer to all the problems of the obstetrician is on the inside.