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Experiences of midwives' leaving Lead Maternity Care (LMC) practice

Abstract:

Background: The government funded self-employed midwifery model of practice is unique to New Zealand. The nature of such practice requires an on-call lifestyle, a willingness to take responsibility for whatever unexpected situations may occur, while still staying connected with family and friends. Midwives talk of the privilege it is to practice in such a way, yet even then they also decide to leave such practice. This article describes the experiences of three Lead Maternity Carer (LMC) midwives as they made their decision to leave their LMC practice. Method: An interpretive methodology was used to uncover the nature of lived experience. Three midwives who had recently left self-employed practice as Lead Maternity Carers were interviewed. Data were analysed through a process of reading, thinking, writing and re-writing. Findings: The collective story of the three midwives interviewed is one of being passionate and committed to midwifery practice. Paradoxically it is perhaps these characteristics that lead to midwives over-spending themselves and becoming burdened to the point of choosing to leave. Situations that provoke feelings of betrayal, excessive responsibility, and outrage tipped the balance. One situation too many brought awareness that it was time to ‘finish’. Conclusion: The findings illustrate the potential for a high emotional cost of providing continuity of midwifery care which can trigger the need to leave. Midwives might consider the possibility of seeking additional support to identify and deal with the emotional and physical demands of their work. The Midwife First Year of Practice programme and processes of professional support such as professional supervision may go some way in alleviating the isolation that can be part of LMC practice.

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burnout, Leaving LMC practice, midwifery workplace