Working in smaller teams in community midwifery practices to foster continuity of carer: Midwives’ experiences – A qualitative study in the Netherlands

Marcelle van Wijngaarden*, Hinke Blonk, Renate Simmelink, Nadine van der Lee, Hanneke Harmsen van der Vliet-Torij, Marianne Nieuwenhuijze, Ank de Jonge, Corine Verhoeven

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.
Original languageEnglish
Article number101663
JournalWomen and Birth
Volume37
Issue number6
DOIs
Publication statusPublished - 1 Nov 2024

Keywords

  • Continuity of Care (MeSH)
  • Maternal Health Services (MeSH)
  • Midwifery (MeSH)
  • Midwives’ experience
  • Pregnancy (MeSH)
  • Smaller teams

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