[Quality assurance in midwifery outside the hospital: reasoning and suggestions for its execution]

Childbirths outside the hospital make up a small but during the last years increasing part of births. At the same time a process of sorting out midwifery institutions outside the hospital is taking place. The quality of providing obstetric care outside the hospital is called in question by clinical obstetricians as a result of a supposed high risk. Meanwhile the results of a lot of studies, including also those from Germany, allow an evaluation of indication, quality and the limits of midwifery outside the hospital. Against this background quality assurance acquires a special importance. Currently there are no legal regulations for quality assurance in midwifery outside the hospital as they exist for clinical obstetrics and other fields of medical and nursing care. Establishing measures for quality assurance systematically is a necessary step towards acceptance and professionalization of midwifery outside the hospital. It should be possible to draw upon the experiences of medical and clinical quality assurance. This work presents a complete and differentiated model for organizing and implementing quality assurance and refers to its function in professional practice.