ArticleGesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))2023
[Healthcare in Pregnancy and Access to Midwives according to Socio-Economic Situation: An Analysis with Routine Data from BARMER Health Insurance].
Article in Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- [Applying the German demand planning guideline to maternity care provision: regional and socioeconomic disparities].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Article
- [Postpartum Care by Midwives: Socioeconomic Status has a Strong Influence on the Amount of Care Received An Analysis with Routine Data from BARMER Health Insurance].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2024Article
- Academic education of midwives in Germany (part 2): Opportunities and challenges for the further development of the profession of midwifery. Position paper of the Midwifery Science Committee (AHW) in the DACH Association for Medical Education (GMA).GMS journal for medical education · 2024Article
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Authors and funding
3 authors.
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Abstract
backgroundSocio-economic status is an important cause of inequality in health status and access to healthcare. This also applies to pregnancy, birth and the postpartum period. Healthcare during pregnancy plays a crucial role in the success of the life phase around birth. On the basis of routine data from BARMER health insurance, the study investigated which services pregnant women received during pregnancy depending on their socio-economic situation.
methodsThe study population comprised 237,251 women insured with BARMER with 278,237 births in 2015-2019. The services billed by gynaecologists and midwives during pregnancy were considered in relation to the socio-economic situation of the women involved.
resultsPhysicians dominated the provision of preventive healthcare. For almost 98% of the pregnant women, a medical preventive healthcare flat rate was billed in at least three quarters. A regular participation of the midwife in preventive healthcare from the fourth month of pregnancy with more than four preventive services was the case in only 1.2% of women. Women from low-income backgrounds received fewer antenatal healthcare services from both gynaecologists and midwives, with 31% of women with low income having no antenatal midwife contact at all, compared to only 11% of high-income women. High-income earning women were also more likely to have had early contact with a midwife (47 vs. 37% in the first trimester). The timing of the first contact seemed to be relevant for the subsequent cooperative antenatal healthcare by both professional groups.
conclusionThe potentials of midwifery healthcare are not being leveraged. Midwives should be significantly more involved in prenatal healthcare overall, and access to midwives must be improved, especially for socially disadvantaged women. These women could benefit in particular from midwifery healthcare, as it takes greater account of social aspects in healthcare and also provides outreach services.
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