The work situation for midwives at delivery wards - models of care and job satisfaction

Based on previous research in Sweden and Iceland a theoretical midwifery model of woman centred care in the Nordic context (MiMo) has been developed. In the MiMo-project the overall research question is if care based on a theoretical model can improve the delivery outcome and satisfaction with care for women, and decrease stress and improve work satisfaction for midwives. During the last year midwives in Sweden have called out the need for more resources to maternity care, claiming that one of the important factors missing is opportunities to give safe and supportive care to the woman. Studies shows that more than one third of Swedish midwives report some kind of burnout. One in three midwives had considered leaving the profession. Lack of staff and resources, as well as stressful work environments are associated with all three subscales of midwives' burnout. A cross-sectional population study report that the most common work related stress in women is due to work interfering with leisure time, low influence at work, individual demands and commitment and also indistinct organisation and conflicts. 

Aim 

The overall aim of this doctoral project is to study the work situation for midwives at delivery wards related to 1) the influence of models of care, job satisfaction, the delivery outcome and satisfaction of care for women, and 2) experiences from midwives and other health professionals.

Methods

A mixed method design with both qualitative and quantitative methods will be used. The MiMo-study is a controlled before-after study at two units for normal deliveries at Sahlgrenska University Hospital, Sweden, The intervention comprised a one-day (8 hours) education about the MiMo-model together with regularly scheduled reflection groups for midwives during one year Mars 2015-Mars 2016. The secondary outcomes are midwives’ experiences, assessed by means of questionnaires, including stress, burn-out, work satisfaction, working conditions and working life and at last sense of coherence. MiMo is further evaluated by focus group interviews with the same professionals in each group; midwives, managers, obstetricians and assistant nurses before the intervention started, and after the interventions was finished. Focus group interviews with managers, obstetricians and assistant nurses will in this doctoral project be used with the aim to obtain a deeper understanding of other professionals’ experiences of midwifery work during childbirth. Based on the findings in in the first two studies individual interviews will be held with midwives to obtain a deeper understanding of midwives experiences of their work situation. A cross-sectional study with a random sample of 1000 midwives at delivery wards in different hospitals in Sweden will answer the same questionnaires about work satisfaction, work conditions and working life, burnout, stress, health and quality of life, and Sense of Coherence as in the MiMo-study. 1000 postpartum women from the same hospitals will answer the SEC 2.0 about satisfaction with their care, and the delivery outcome (spontaneous vaginal birth, emergency caesarean section, instrumental vaginal birth) will be collected from the hospital’s medical journals.