Untangling the elements of midwives' occupational wellbeing:a study among newly qualified and experienced midwives

In this thesis, we studied the occupational wellbeing of newly qualified and experienced midwives in the Netherlands. We found differences in midwives’ attitudes and behaviour towards the socialization and support of NQMs (newly qualified midwives) in practice, towards the learning and development needs of NQMs in practice, towards the expected levels of organizational and managerial competence of NQMs, and towards responsibility for the organization of the practice. NQMs and experienced midwives in the Netherlands are highly engaged in their work in maternity care. NQMs are significantly more engaged than experienced midwives. Determinants of midwives’ positive wellbeing are various factors, such as working with colleagues and ‘with women’, together with trainable personal resources, such as resilience and optimism. One in three midwives intend to leave the profession. Determinants of intentions to leave, and reasons for leaving the profession are a combination of high workload, practice owner roles and responsibilities, and family responsibilities. Components of support for NQMs as agreed by stakeholders include proper induction in practice, expansion of tasks and responsibilities with performance feedback from practice owners or managers, 24/7 back-up during a shift, and mentoring and coaching on work experiences. Systemic, organizational, and cultural aspects of midwifery care hinder the implementation of formal support. Establishing a transition period for all NQMs in their first year of practice was recommended, supported by stable employment combined with practice support. Components of support for NQMs on which there is consensus among stakeholders can be implemented at local and regional level, where practice owners and managers should take responsibility for implementation