New midwife assistance contract: What parents should know!
Starting November 1, 2025, important changes for the care of pregnant women, parents, and families will come into effect with the new midwifery assistance agreement. Here you can find out at a glance what the new regulations mean, which services will continue to be guaranteed, and what parents should pay attention to now.
Subject matter experts: Sarah Sofia van Beek, doula, anthropologist (M.A.), and Kathrin Westphal, social worker (B.A.), educator, maternity nurse, specialist consultant at pme Familienservice.
The new midwifery assistance agreement will take effect on November 1, 2025, and will introduce a standardized billing system and stricter documentation requirements for freelance midwives. The most important services—from prenatal care to postnatal recovery—will remain unchanged.
Parents should look for a midwife early on and also consider digital services, as local availability may be limited.
What you can expect in this article
What does the new midwife assistance agreement say?
The new midwife assistance agreement will apply from November 1, 2025 , to all freelance midwives who bill statutory health insurance companies. The aim is to create a uniform, transparent billing system. Midwives employed by clinics or birthing centers are not affected.
Key changes to the midwifery assistance agreement:
- Introduction of a 5-minute billing model: Services such as prenatal care, postnatal care, maternity care, counseling, and courses are recorded and billed by the minute instead of at a flat rate as before.
- Strict documentation and verification requirements: Each service must be confirmed in detail and often signed by the insured person.
- Strict requirements for quality management and data protection.
- New remuneration structure for birth care: 1 : 1 care (one woman in labor per midwife) is remunerated at a higher rate. If a midwife cares for two or three women at the same time, the remuneration is reduced. This is intended to create an incentive for individual, continuous care.
The aim of these changes is to enable appropriate, cost-effective, and quality-assured care. At the same time, the bureaucratic burden on midwives is increasing significantly.
Which services are still guaranteed under the new midwifery assistance agreement?
All key midwifery services will remain unchanged:
- prenatal care
- obstetrics
- Postpartum period and follow-up care
- breastfeeding counseling
- Help with complaints
- Birth preparation
- Consultations, e.g., on nutrition and complementary foods.
What does the new midwife assistance agreement mean for expectant parents and young families?
- The legal entitlement to midwifery care remains unrestricted.
- The 5-minute billing system allows care times to be billed more accurately and enables more individualized and needs-based care. This also means that all services are documented, confirmed, and recorded accurately.
- This creates more administrative and documentation work for midwives. Care services could therefore be limited in certain regions, especially in rural areas.
- Parents shouldcarefully confirm and document allservices in the future.
Midwife associations point out that despite some adjustments to remuneration, bureaucratic pressure remains high. This can affect care provision in some regions—in rural areas in particular, there is a risk that midwives will reduce their services or give up their freelance work.
For families, this means that it may become more difficult to find a midwife or to reliably plan certain forms of care (e.g., out-of-hospital births).
What can expectant parents do now?
- Find a midwife early on: It is best to get in touch right at the beginning of your pregnancy to secure a place.
- Choose your place of birth and birth team carefully: If you want one-to-one care, you should explore alternatives early on.
- Take advantage of other support services: actively seek out prenatal care, postnatal care, postnatal exercise, breastfeeding, and nutrition counseling.
- Build a support network: involve friends, family, or other professionals (e.g., doula, maternity nurse).
A doula or maternity nurse can provide emotional and practical support to mothers and families, especially when their social environment is limited.
Support can enhance the mother's well-being and help parents avoid feeling overwhelmed. This allows them to experience the special time surrounding the birth in a more relaxed and conscious manner.
pme offer: Midwife service before and after birth
pme Familienservice , in collaboration with NotdienstHebamme, Familienservice flexible online counseling and certified online courses. Parents can quickly get answers to questions about pregnancy, childbirth, postpartum care, and infant care via video chat, phone, or email, as well as participate in online courses on birth preparation, postnatal recovery, and breastfeeding.
The service bridges gaps in care, but does not replace personal care on site; rather, it complements it in a meaningful way.
You can find more information about our partnership with NotdienstHebamme on our service portal My Familienservice. Not yet a customer of pme Familienservice? Contact us!
