The emotional and professional wellbeing of Australian midwives: A comparison between those providing continuity of midwifery care and those not providing continuity

Fenwick, Jennifer; Sidebotham, Mary; Gamble, Jenny; Creedy, Debra

doi:10.1016/j.wombi.2017.06.013

Cited by 107 publications

(96 citation statements)

References 32 publications

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“…With respect to study location, the 27 studies spanned 17 countries. Seven studies were set in Australia 11,14,[17][18][19][20][21] , and two studies were from each of the following countries: United Kingdom 22,23 , Japan 24,25 , Denmark 13,26 , and Sweden 27,28 . See Table 1 for more details on study settings.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of and factors associated with burnout in midwifery: A scoping review

Sidhu¹,

Su²,

Shapiro³

et al. 2020

Eur J Midwifery

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INTRODUCTION Midwifery care meets the triple aims of health system improvement, i.e. good health outcomes, high client satisfaction, and low per capita costs. Scaling up access to midwifery care is a global priority yet the growth and sustainability of the profession is threatened by high levels of burnout and attrition. This scoping review provides a comprehensive review of the existing literature on burnout in midwifery, with a focus on prevalence, associated factors and potential solutions. METHODS Four electronic databases were searched to locate relevant literature up to July 2019. A total of 1034 articles were identified and reduced to 27 articles that met inclusion criteria. We summarize sample sizes, settings, study designs, burnout measures, prevalence of burnout, associated factors and potential solutions, and recommendations. RESULTS Prevalence of burnout was highest among Australian, Western Canadian and Senegalese midwives and lowest among Dutch and Norwegian midwives. Midwives working in caseload/continuity models reported significantly lower burnout compared to midwives working in other models. We identified 26 organizational and personal factors that were significantly associated with burnout, such as high workload, exposure to traumatic events, and fewer years in practices. Organizational support to improve work-life balance and emotional well-being, as well as more continuing education to raise awareness about burnout and how to cope with it, emerged as common strategies to prevent and address burnout. CONCLUSIONS Burnout is a serious and complex occupational phenomenon. More qualitative research is needed in this area, to better understand the lived experience of burnout. AFFILIATION

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Section: Resultsmentioning

confidence: 99%

Prevalence of and factors associated with burnout in midwifery: A scoping review

Sidhu¹,

Su²,

Shapiro³

et al. 2020

Eur J Midwifery

View full text Add to dashboard Cite

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“…This different way of practising results in greater job satisfaction and emotional wellbeing for midwives [41,55]. For example; working in CMC both enables and requires autonomy [41,55], and professional autonomy results in better job satisfaction and wellbeing [7,9,40,61].…”

Section: Programme Theory 3: Midwifery Practicementioning

confidence: 99%

“…Several studies have identified differences between midwives working in different models of care but were conducted after exposure to CMC, e.g. [7,9,11,55]. However, two very small prospective studies [36,70] showed positive changes in attitudes to professional role and role satisfaction following exposure to caseload/ MGP working.…”

Section: Programme Theory 3: Midwifery Practicementioning

confidence: 99%

“…Our literature scoping identified several countries attempting to grow CMC as a nationally available model of midwifery care. In the last decade, Australia has introduced government policy, legislation and midwifery education standards to re-orientate maternity services to ensure more women have access to CMC [7]. Despite this, changes to mainstream service delivery and expansion of existing midwifery continuity models remains slow with reports of less than 10% [7] to 19% [8] of Australian women having access to CMC.…”

Section: Introductionmentioning

confidence: 99%

“…In the last decade, Australia has introduced government policy, legislation and midwifery education standards to re-orientate maternity services to ensure more women have access to CMC [7]. Despite this, changes to mainstream service delivery and expansion of existing midwifery continuity models remains slow with reports of less than 10% [7] to 19% [8] of Australian women having access to CMC. New Zealand legalised midwives as autonomous health professionals and as Lead Maternity Carers (LMC) in 1990, enabling them to care for a caseload of women.…”

Section: Introductionmentioning

confidence: 99%

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Implementing continuity of midwife carer – just a friendly face? A realist evaluation

McInnes

Aitken-Arbuckle

Lake

et al. 2020

BMC Health Serv Res

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Background: Good quality midwifery care saves the lives of women and babies. Continuity of midwife carer (CMC), a key component of good quality midwifery care, results in better clinical outcomes, higher care satisfaction and enhanced caregiver experience. However, CMC uptake has tended to be small scale or transient. We used realist evaluation in one Scottish health board to explore implementation of CMC as part of the Scottish Government 2017 maternity plan.Methods: Participatory research, quality improvement and iterative data collection methods were used to collect data from a range of sources including facilitated team meetings, local and national meetings, quality improvement and service evaluation surveys, audits, interviews and published literature. Data analysis developed contextmechanism-outcome configurations to explore and inform three initial programme theories, which were refined into an overarching theory of what works for whom and in what context. Results: Trusting relationships across all organisational levels are the context in which CMC works. However, building these relationships during implementation requires good leadership and effective change management to drive whole system change and foster trust across all practice and organisational boundaries. Trusting relationships between midwives and women were valued and triggered a commitment to provide high quality care; CMC team relationships supported improvements in ways of working and sustained practice, and relationships between midwives and providers in different care models either sustained or constrained implementation. Continuity enabled midwives to work to full skillset and across women's care journey, which in turn changed their perspective of how they provided care and of women's care needs. In addition to building positive relationships, visible and supportive leadership encourages engagement by ensuring midwives feel safe, valued and informed.Conclusion: Leadership that builds trusting relationships across all practice and organisational boundaries develops the context for successful implementation of CMC. These relationships then become the context that enables CMC to grow and flourish. Trusting relationships, working to full skill set and across women's care journey trigger changes in midwifery practice. Implementing and sustaining CMC within NHS organisational settings requires significant reconfiguration of services at all levels, which requires effective leadership and cannot rely solely on ground-up change.

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Norwegian midwives' perceptions of their practice environment: A mixed methods study

Lukasse

Henriksen

2019

Nursing Open

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AimTo investigate Norwegian midwives’ perceptions of their working environment.DesignA nationwide postal survey in 2014 collected information from 489 midwives, including the Practice Environment Scale and seven open‐ended questions concerning the workplace.MethodsPsychometric‐, descriptive‐ and comparative analysis was used for the quantitative data and content analysis for the qualitative data.ResultsPsychometric analyses yielded five subscales: Quality of management; Resource adequacy; Midwife‐doctor relations; Opportunities for development; and Midwifery foundation for care. Content analyses identified four main themes: Lack of resources; Insufficient support; Staying in midwifery; and Lack of influence. Subthemes only found in the qualitative analysis were as follows: Fear of adverse events and The strain of shift work. Most midwives rated the PES subscales Midwife‐doctor relations and Quality of management favourable. In contrast, the theme Lack of influence showed that midwives felt powerless in a constantly changing work environment and ruled by the medical model of care.

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The emotional and professional wellbeing of Australian midwives: A comparison between those providing continuity of midwifery care and those not providing continuity

Cited by 107 publications

References 32 publications

Prevalence of and factors associated with burnout in midwifery: A scoping review

Prevalence of and factors associated with burnout in midwifery: A scoping review

Implementing continuity of midwife carer – just a friendly face? A realist evaluation

Norwegian midwives' perceptions of their practice environment: A mixed methods study

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