I completely agree with the comments below from AIMS about shortages of
midwives. When I did research into Burnout in a national sample of
Midwives in the UK, the most important predictors of burnout were long
working hours and low job control. Midwives who worked in hospital teams
had the highest levels of burnout, partly because this was the group
that the lowest levels of job control. This is related to retention
because 50% of midwives who had high levels of burnout said that they
did not intend to be working in midwifery in 5 years time compared to
29% who still had high levels of accomplishment.Conversely, midwives who
worked in the community who were GP attached had the lowest levels of
burnout and the highest levels of job control.
Qualitative work also indicated that midwives who were working in teams,
in both hospital and community who shared a caseload found the work gave
them little feelings of accomplishment, because they never got to know
women. The team system depersonalised midwives to women and vice versa,
and the midwives felt they had little control over how they organised
their work. Wheras midwives who carried their own caseload had very
high levels of accomplishment and job control. Incidentally this group
found it easiest to incorporate childcare responsibilities into their
working lives as well.
You can read more about this in the latest issue of MIDIRS where there
is a short summary of the research paper (Sandall,J. (1998) Risk,
Decision and Policy, 3,3,213-232.)
I think what we are seeing is the result of midwives disillusionment
with what has happened following changing childbirth. Midwives are still
low paid, maternity care is becoming increasingly dominated by obstetric
intervention and attempts to provide real personal care or continuity of
carer and midwife led care have been meanly or under resourced.
Added to this is a less than welcoming attitude to midwives who have
family responsibilities who want to return to work along with the
assumption that those who cannot work full time (plus) are not committed
to midwifery or women.
I'm not sure how low we have to go, or what tragedies have to happen
before this issue gets tackeled?
--
Dr Jane Sandall
Reader in Midwifery
Dept. Midwifery
City University
London, E1 2EA
Tel: 0171 505 5871
Fax: 0171 505 5866
[log in to unmask] wrote:
>
> UK midwives and consumers mailing list. ARM website address: - http://www.radmid.demon.co.uk/midwives.html
>
> PRESS RELEASE - 30th July 1999
>
> ASSOCIATION FOR IMPROVEMENTS IN THE MATERNITY SERVICES
> 21 Iver Lane, Iver, Buckinghamshire, SLO 9LH
> Tel: 01753-652781 Fax: 01753-654142 email: [log in to unmask]
>
> There is no shortage of midwives. There is a huge pool of midwives who are
> no longer willing to work in obstetrically dominated cnetralised hospitals.
> The Edgware Midwifery Birth Centre provides midwifery care to local women.
> They have a waiting list of midwives wanting to work there. Women want to be
> looked after by a midwife they know who has looked after them during their
> pregnancy.
> In many cases Trusts have cut midwifery staffing levels to the point where
> midwives have become burnt out and women and babies are put at risk. They
> have also diluted staff by refusing to pay for more senior and experienced
> midwives.
> Until there are changes which enable midwives to practice midwifery instead
> of obstetric nursing the shortages will continue. Thousands of trained
> midwives could be encouraged to return to the NHS if they were supported in
> practising real midwifery.
> Unfortunately care is going in the wrong direction. The Government is
> supporting a scheme to establish "Higher Level Practice" a system which is
> intended to establish a select group of "specialist nurses" and which is
> totally inappropriate to midwifery. The midwife is already a specialist and
> she should be paid and respected as such. Instead of imposing this
> irrelevant development on midwifery Trusts should be encouraged to implement
> schemes which enable midwives to manage their own case loads. This
> initiative will result in increased recruitment, safer care, and happier
> mothers.
>
> NOTE: Midwives should not miss this opportunity to contact their own MP,
> Frank Dobson, and the media and impress upon them the problems. This is an
> opportunity to get their attention, do not miss it!
> For further information contact Beverley Beech on (01753) 652781
> Fax (01753) 654142; email: [log in to unmask]
>
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