1
|
Carvajal B, Hancock A, Lewney K, Hagan K, Jamieson S, Cooke A. A global overview of midwives' working conditions: A rapid review of literature on positive practice environment. Women Birth 2024; 37:15-50. [PMID: 37648619 DOI: 10.1016/j.wombi.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/24/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND In the United Kingdom (UK), a critical shortage of midwives puts pressure on the already overworked midwives working in maternity services. Considering the challenges that midwives in the UK face, this rapid review was conducted to inform a larger-scale initiative to improve the working conditions of midwives in an acute NHS Trust in the Midlands area of the UK. OBJECTIVE To describe midwives' perceptions and experiences of positive practice environments. METHODS A search strategy to identify literature about midwives' perceptions and experiences of positive practice environments was conducted in Medline, CINAHL Plus and Embase databases. Literature screening was conducted independently in two steps using an eligibility tool. The articles' quality assessment was conducted using the Mixed Method Appraisal Tool. Data were extracted using the Job Quality framework and managed using NVivo12. RESULTS Seventy articles were included in this review. Midwives' working conditions can be improved in all seven areas of the Job Quality framework. Most articles in the review reported the negative aspects of midwives' working environments, making it challenging for the team to define a positive practice environment for midwives. Despite this, authors discuss that a positive practice environment is at least sustained by ensuring midwives' ability to provide care; providing good employment conditions; developing respectful organisations; and increasing team resources, such as those that improve team resilience. CONCLUSIONS Midwives' working conditions are universally challenging. Failure to address the situation will compromise recruitment and retention, increasing the shortage of midwives. Provision of safe and respectful care appears to be directly linked to midwives' safe and respectful working conditions.
Collapse
Affiliation(s)
- Bielka Carvajal
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK; Division of Nursing, Midwifery and Social Work, The University of Manchester, UK; Departamento de Promocion de la Salud de la Mujer y el Recien Nacido, Universidad de Chile, Chile.
| | - Angela Hancock
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK; Division of Nursing, Midwifery and Social Work, The University of Manchester, UK; School of Nursing and Midwifery, Keele University, UK
| | - Katharine Lewney
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK
| | - Karen Hagan
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK
| | - Sarah Jamieson
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK
| | - Alison Cooke
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK; Division of Nursing, Midwifery and Social Work, The University of Manchester, UK; School of Nursing and Midwifery, Keele University, UK
| |
Collapse
|
2
|
Mharapara TL, Clemons JH, Greenslade-Yeats J, Ewertowska T, Staniland NA, Ravenswood K. Toward a contextualized understanding of well-being in the midwifery profession: An integrative review. JOURNAL OF PROFESSIONS AND ORGANIZATION 2023. [DOI: 10.1093/jpo/joac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract
Our integrative review synthesizes and evaluates two decades of empirical research on well-being in the midwifery profession to reveal (1) how researchers have studied midwives’ well-being; (2) key findings of research on midwives’ well-being; (3) underlying assumptions of this research; and (4) limitations of this research. We find that research on midwives’ well-being is disproportionately focused on individual midwives, who are assumed to be largely responsible for their own well-being, and that well-being in the midwifery profession is generally equated with the absence of mental health problems such as burnout, anxiety, and stress. Researchers have largely taken a narrow and instrumental approach to study midwives’ well-being, focusing on work-related antecedents and consequences, and overlooking the influence of nonwork factors embedded in the broader socioeconomic and cultural environment. Drawing on more comprehensive and contextualized well-being frameworks, we propose a research model that (1) expands the well-being construct as it applies to midwives and (2) situates midwives’ well-being in broader social, economic, political, and cultural contexts. Although developed in the midwifery context, our proposed research model can be applied to a host of professions.
Collapse
Affiliation(s)
- Tago L Mharapara
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Janine H Clemons
- Midwifery Department , MH Building 640 Great South Road, Manukau, 2025 , New Zealand
| | - James Greenslade-Yeats
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Tanya Ewertowska
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Nimbus Awhina Staniland
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Katherine Ravenswood
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| |
Collapse
|
3
|
Buultjens M, Gill J, Fielding J, Lambert KA, Vondeling K, Mastwyk SE, Sloane S, Fedele W, Karimi L, Milgrom J, von Treuer K, Erbas B. Maternity care during a pandemic: Can a hybrid telehealth model comprising group interdisciplinary education support maternal psychological health? Women Birth 2022; 36:305-313. [PMID: 36184532 PMCID: PMC9551992 DOI: 10.1016/j.wombi.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/21/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022]
Abstract
Background The transition to parenthood is one of the most challenging across the life course, with profound changes that can impact psychological health. In response to the coronavirus disease 2019 (COVID-19), came the rapid implementation of remote antenatal care, i.e., telehealth, with fewer in-person consultations. A change in service delivery in addition to the cancellation of antenatal education represented a potential threat to a woman’s experience – with likely adverse effects on mental health and wellbeing. Aim To explore a hybrid model of pregnancy care, i.e., telehealth and fewer in-person health assessments, coupled with concurrent small group interdisciplinary education delivered via video conferencing, extending into the postnatal period. Methods Using a quasi-experimental design with an interrupted time series and a control group, this population-based study recruited low-risk women booking for maternity care at one community health site affiliated with a large public hospital in Victoria, Australia. Findings Whilst there was no difference in stress and anxiety scores, a significant interactive effect of the hybrid model of care with time was seen in the DASS depression score (−1.17, 95% CI: −1.81, −0.53) and the EPDS (−0.83, 95% CI: −1.5, −0.15). Discussion The analyses provide important exploratory findings regarding the positive effects of a hybrid model of care with interdisciplinary education in supporting mental health of first-time mothers. Conclusion This study demonstrates that small group online education scheduled in conjunction with individual pregnancy health assessments can be executed within a busy antenatal clinic with promising results and modest but dedicated staff support.
Collapse
Affiliation(s)
- Melissa Buultjens
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Jessica Gill
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jennifer Fielding
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Katrina A Lambert
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Kirsty Vondeling
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Sally E Mastwyk
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Sarita Sloane
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Wendy Fedele
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Leila Karimi
- School of Applied Health, Psychology Department, RMIT University, Melbourne, Australia.
| | - Jeannette Milgrom
- Parent-Infant Research Institute (PIRI), Australia and Melbourne School of Psychological Science, University of Melbourne, Australia
| | | | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| |
Collapse
|
4
|
Who is at risk of burnout? A cross-sectional survey of midwives in a tertiary maternity hospital in Melbourne, Australia. Women Birth 2022; 35:e615-e623. [DOI: 10.1016/j.wombi.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/21/2022]
|
5
|
Matthews R, Hyde R, Llewelyn F, Shafiei T, Newton M, Forster DA. Factors associated with midwives' job satisfaction and experience of work: a cross-sectional survey of midwives in a tertiary maternity hospital in Melbourne, Australia. Women Birth 2021; 35:e153-e162. [PMID: 33935006 DOI: 10.1016/j.wombi.2021.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/25/2021] [Accepted: 03/28/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Significant factors affecting the Australian maternity care context include an ageing, predominantly part-time midwifery workforce, increasingly medicalised maternity care, and women with more complex health/social needs. This results in challenges for the maternity care system. There is a lack of understanding of midwives' experiences and job satisfaction in this context. AIM To explore factors affecting Australian midwives' job satisfaction and experience of work. METHODS In 2017 an online cross-sectional questionnaire was used to survey midwives employed in a tertiary hospital. Data collected included characteristics, work roles, hours, midwives' views and experiences of their job. The Midwifery Process Questionnaire was used to measure midwives' satisfaction in four domains: Professional Satisfaction, Professional Support, Client Interaction and Professional Development. Data were analysed as a whole, then univariate and multivariate logistic regression analyses conducted to explore any associations between each domain, participant characteristics and other relevant factors. FINDINGS The overall survey response rate was 73% (302/411), with 96% (255/266) of permanently employed midwives responding. About half (53%) had a negative attitude about their Professional Support and Client Interaction (49%), and 21% felt negatively about Professional Development. The majority felt positively regarding Professional Satisfaction (85%). The main factors that impacted midwives' satisfaction was inadequate acknowledgment from the organisation and needing more support to fulfil their current role. CONCLUSION Focus on leadership and mentorship around appropriate acknowledgement and support may impact positively on midwives' satisfaction and experiences of work. A larger study could explore how widespread these findings are in the Australian maternity care setting.
Collapse
Affiliation(s)
- Robyn Matthews
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia.
| | - Rebecca Hyde
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
| | - Fleur Llewelyn
- The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
| | - Touran Shafiei
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia
| | - Michelle Newton
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
| | - Della A Forster
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
| |
Collapse
|