BACKGROUND:
Equitable access to midwifery care is crucial for improving maternal and newborn health outcomes globally. However, structural and systemic differences significantly affect how midwifery services are planned and delivered. In Germany, qualitative studies suggest considerable local inequities in midwifery service provision. Since Germany does not collect national data on midwifery workforce and its distribution, a comprehensive understanding of the extend of regional disparities is not possible. Conversely, New Zealand utilizes a centralized, register-based system designed to support equitable coverage across all populations.

OBJECTIVES:
This study aimed to assess how different approaches in midwifery workforce planning influence equity in maternal healthcare access.

METHODS:
Using an adapted version of Germany’s physician-based planning guideline (BPL-RL), midwifery workforce and population data from Germany and New Zealand were systematically analyzed. Geographic Information Systems (GIS) were employed to visualize and identify regions with insufficient midwifery coverage. To identify potential disparities linked to social determinants of health, socioeconomic data were incorporated.

RESULTS:
Applying a systematic planning model to German data reveals substantial disparities in midwifery care, particularly in rural and peripheral areas and among socioeconomically disadvantaged populations. In contrast, such regional and social inequalities appear less pronounced in New Zealand, likely due to its structured planning system and targeted rural incentives.

CONCLUSIONS:
This analysis underscores the potential of tailored, equity-focused workforce planning to improve access to maternal health for all women, regardless of their socioeconomic status. Adapting key components from New Zealand’s approach—particularly those addressing rurality and cultural safety—could strengthen equitable midwifery access in Germany and other similar health systems.

KEY MESSAGE:
Equity in midwifery care may be supported by centralized planning, rural incentives, and strategies that address socioeconomic disparities. Workforce - planning