New midwifery contract backfires, leaving mothers and professionals in crisis

A new midwifery contract, introduced on 1 November 2025, was meant to improve one-on-one care for women in labour. Instead, it has left many freelance midwives struggling financially. Hospitals are closing, and those remaining face staff shortages as experienced professionals leave the field.

The changes have also worsened access to care, forcing pregnant women to travel longer distances and risk being turned away during emergencies. The contract was developed with input from major midwifery associations but failed to address key practical concerns. Freelance midwives like Anja Samborski and Denise Katron have criticised the lack of fair pay and recognition for their high-pressure work. They also highlight unfair billing practices and the abolition of flat-rate allowances, which once helped stabilise their earnings.

Night shift bonuses have been drastically cut, reducing income further. For a four-hour ‘ideal’ birth, the hourly rate increase amounts to just €40 gross—barely enough to cover costs. Larger hospitals, where overheads are higher, leave midwives even worse off.

Beyond pay, the contract has done little to ease administrative burdens. Midwives still rely on paper forms, and incorrect payment deductions remain common. Digitalisation, promised as part of the reforms, has yet to materialise.

The consequences extend beyond finances. Hospital closures mean women now face longer journeys to reach care, increasing risks during labour. Every clinic that shuts down leaves a gap in the region, forcing expectant mothers into precarious situations.

Some institutions, like Marienstift Hospital, have taken steps to retain staff by improving financial security. But without broader changes, the exodus of midwives is likely to continue. The current contract runs until the end of 2027, with no chance for renegotiation before then.

Midwives are calling for fairer wages, stricter patient-to-midwife ratios, and real support for their life-saving work. Without these, they warn, the profession—and the women who depend on it—will suffer even more. The new contract has pushed many freelance midwives to the brink of leaving their jobs. With no renegotiation possible until 2028, the strain on maternity services will likely grow. Longer travel times, higher risks in labour, and fewer available midwives are now the reality for women across the country.