BACKGROUND:
Despite legal entitlements, access to midwifery care remains limited for many women in Germany. Midwifery Coordination Centers (MCCs, Hebammenzentralen) were introduced to enhance service coordination by matching childbearing women with independent midwives. International models show promise: a Swiss pilot demonstrated improved continuity of care (Grylka-Baeschlin et al., 2020), while a U.S. study in North Carolina found that care coordination increased early prenatal care uptake and service utilization among vulnerable populations (Hillemeier et al., 2018). These findings underscore the need to evaluate MCC effectiveness within the German healthcare context.

OBJECTIVES:
To evaluate the implementation and effectiveness of MCCs in improving access to midwifery care and supporting independent midwives. The study also explores systemic challenges and opportunities for future development.

METHODS:
A multi-phase mixed-methods approach, guided by Skivington et al.'s (2021) framework for evaluating complex interventions, was employed. The evaluation comprised: (1) a literature review to define MCC models in Germany; (2) focus group discussions with stakeholders to explore the significance, challenges, and opportunities of MCCs; (3) qualitative interviews with four MCC coordinators to assess their perceived impact; (4) a quantitative descriptive analysis of coordination outcomes; and (5) additional focus groups with midwives on the coordination of acute care services.

RESULTS:
MCCs facilitate timely matching between women and midwives, reduce administrative burden, and promote both intra- and interprofessional communication. However, key challenges remain, including sustainable funding, regional disparities, and limited integration into broader healthcare structures.

CONCLUSIONS:
MCCs can improve midwifery care access and coordination but require systemic support to achieve their full potential.

KEY MESSAGE:
Midwifery Coordination Centers (MCCs) improve access to care by connecting women with midwives and easing coordination. Aligned with the State of the World’s Midwifery report (UNFPA/ICM/WHO 2021), MCCs show promise but need sustainable funding, better integration, and regional equity to fully address gaps in midwifery care access in Germany. Poster session 2 (Group A)