Redesigning German Maternity Records: Results from a Pilot study

The German maternity record (GMR, "Mutterpass") is the most important document for pregnant women and their health care providers during antenatal care. While the serological and ultrasound sections have been updated regularly, the document's catalogue of pre-existing factors has remained unaltered since 1986. We investigated whether a health-focused revision of the GMR would serve the needs of pregnant women and their care providers.

A revised version of the Mutterpass was developed by a multidisciplinary panel of experts, focusing on health and salutogenesis. The new document highlights the uncomplicated pregnancy, and gives pregnant women the opportunity to make their own notes and to choose an appropriate place of birth after consultation with the doctor or midwife. These changes were developed within the requirements of the latest version of the German maternity guidelines (GMG) mandatory during the revision process. To test for user-friendliness and acceptance, 23 persons--8 consultants, 7 midwives and 8 pregnant women--were asked to evaluate the revised GMR. Comments could be entered in the GMR itself and in an electronic survey. Notes in the GMR (n=296 comments) were assigned to one of 7 categories (e. g. general comments, structural aspects) by 2 reviewers. After 6 weeks one of the reviewers repeated her evaluation.

20 of the 23 persons approached wrote comments in the document, 19 participated in the electronic survey. Consultants and midwives predominantly stated that they would prefer to work with the revised GMR (92%). Pregnant women appreciated the space for their own notes (83%). Most respondents (90%) had a good general impression. Inter-observer agreement was kappa=0.43, intra-observer agreement kappa=0.55.

This health-focused version of the German maternity record is a first step towards optimising maternity records in Germany. Future investigations should consider revisions going beyond the content of the mandatory guidelines.