Severe Midwife Shortage in Israeli Hospitals Sparks Crisis Affecting Mothers' Care
Israeli hospitals, especially in peripheral regions, face a critical shortage of midwives, severely impacting the quality of care for birthing women. Orna, a veteran midwife with 20 years of experience, describes extreme stress and helplessness due to understaffing, often managing multiple laboring women simultaneously. Official staffing ratios require one midwife per two or three women, but in practice, night shifts may have only two midwives covering labor and delivery rooms plus triage, forcing midwives to juggle up to five patients at once.
The shortage is exacerbated in peripheral hospitals lacking specialized high-risk pregnancy departments, increasing the workload on labor wards. Midwives report insufficient time for essential support tasks like breastfeeding guidance and emotional care. Despite Israel's high birth rate, around 180,000 births annually, nearly double the OECD average, the healthcare workforce has not expanded accordingly. Current staffing standards are based on outdated agreements from 1997 and do not reflect the increased clinical complexity of modern births.
Reports from the State Comptroller and midwives' organizations highlight occupancy rates often exceeding 100%, sometimes reaching 150%, and warn of the risks to maternal and neonatal safety. Many midwife positions are filled by non-medical support staff due to economic pressures, further straining care quality. Midwives describe burnout, with many reducing clinical hours or leaving the profession. The shortage also fuels demand for private doulas, creating socioeconomic disparities in birth support.
Gynecologists confirm the strain, noting fragmented care and prioritization of low-risk births to attract patients, while high-risk women receive less continuous attention. Experts call for urgent systemic reforms, including updating staffing formulas to ensure one midwife per laboring woman, exclusive employment of qualified midwives in delivery wards, and separation of triage and labor staffing. The Ministry of Health states current staffing aligns with international norms and that additional staff are deployed during peak times, denying significant complaints about care quality.
Beyond midwives, Israel faces broader healthcare workforce shortages, including nurses and doctors, with staffing levels below OECD averages. Infrastructure deficits and aging population challenges compound the crisis. Without comprehensive reforms, hospitals will continue to struggle, and birthing women will bear the consequences.
