TY - JOUR
T1 - Working in smaller teams in community midwifery practices to foster continuity of carer
T2 - Midwives’ experiences – A qualitative study in the Netherlands
AU - van Wijngaarden, Marcelle
AU - Blonk, Hinke
AU - Simmelink, Renate
AU - van der Lee, Nadine
AU - van der Vliet-Torij, Hanneke Harmsen
AU - Nieuwenhuijze, Marianne
AU - de Jonge, Ank
AU - Verhoeven, Corine
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/11/1
Y1 - 2024/11/1
N2 - Background: Midwife-led continuity of carer (MLCC) improves health outcomes and increases pregnant women's satisfaction. Working in smaller teams in community midwifery practices is one of the ways to promote continuity of carer. Aim: To gain insight into the experiences of Dutch community midwives regarding working in smaller teams, by identifying motivators and barriers. Methods: A qualitative study was conducted using individual, semi-structured interviews (n=9). The sample was purposively selected. The interviews were analysed using the Abbreviated Grounded Theory. Findings: Four themes were identified: 1) Ideal implementation of working in smaller teams, 2) Best care for pregnant women, 3) Conflicts with the current maternity care system, 4) Personal interests of the midwife. The core concept connecting all themes was midwives’ experiences of an 'inner conflict' regarding working in smaller teams. Conclusion: A strong motivation for working in smaller teams is the wish to provide the best care for pregnant women through offering more continuity of carer. The structure of maternity care, financially and organisationally, acts as a barrier in the transition to working in smaller teams. How community midwives manage these motivators and barriers depends on their personal interests, vision, and personal life. The balance between the motivators and barriers can create an inner conflict among the midwives. This inner conflict encompasses an ethical issue: what is the best care and what is it worth? A discussion within the professional group concerning the practical and ethical aspects of working in smaller teams is needed to find ways to reduce the inner conflict of community midwives who wish to work in smaller teams, thereby promoting the implementation of MLCC.
AB - Background: Midwife-led continuity of carer (MLCC) improves health outcomes and increases pregnant women's satisfaction. Working in smaller teams in community midwifery practices is one of the ways to promote continuity of carer. Aim: To gain insight into the experiences of Dutch community midwives regarding working in smaller teams, by identifying motivators and barriers. Methods: A qualitative study was conducted using individual, semi-structured interviews (n=9). The sample was purposively selected. The interviews were analysed using the Abbreviated Grounded Theory. Findings: Four themes were identified: 1) Ideal implementation of working in smaller teams, 2) Best care for pregnant women, 3) Conflicts with the current maternity care system, 4) Personal interests of the midwife. The core concept connecting all themes was midwives’ experiences of an 'inner conflict' regarding working in smaller teams. Conclusion: A strong motivation for working in smaller teams is the wish to provide the best care for pregnant women through offering more continuity of carer. The structure of maternity care, financially and organisationally, acts as a barrier in the transition to working in smaller teams. How community midwives manage these motivators and barriers depends on their personal interests, vision, and personal life. The balance between the motivators and barriers can create an inner conflict among the midwives. This inner conflict encompasses an ethical issue: what is the best care and what is it worth? A discussion within the professional group concerning the practical and ethical aspects of working in smaller teams is needed to find ways to reduce the inner conflict of community midwives who wish to work in smaller teams, thereby promoting the implementation of MLCC.
KW - Continuity of Care (MeSH)
KW - Maternal Health Services (MeSH)
KW - Midwifery (MeSH)
KW - Midwives’ experience
KW - Pregnancy (MeSH)
KW - Smaller teams
U2 - 10.1016/j.wombi.2024.101663
DO - 10.1016/j.wombi.2024.101663
M3 - Article
SN - 1871-5192
VL - 37
JO - Women and Birth
JF - Women and Birth
IS - 6
M1 - 101663
ER -