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Staying or leaving: A telephone survey of midwives, exploring the sustainability of practice as Lead Maternity Carers in one urban region of New Zealand

Abstract:

The sustainability of Lead Maternity Carer (LMC) midwifery practice is an issue of growing concern. In one urban region of New Zealand there appeared to be a large number of LMC midwives indicating that their way of working was unsustainable, resulting in fewer midwives being available to provide primary maternity care. A structured telephone survey of 94 practising and non-practising LMC midwives from this region was undertaken to identify reasons that support midwives to continue practising as LMC midwives and also to identify reasons why midwives leave practice. Continuity of care and the quality of the relationships that are developed with women were the main reasons that supported and sustained LMC midwives in practice. Paradoxically these reasons also caused midwives to leave. Seventy eight percent of the midwives surveyed stayed on-call for births, an indication of the lack of home/work balance that they were able to attain. Midwives need to develop work practices that acknowledge the rewards of continuity, while at the same time provide the space for rest, for family, and for friends.

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job satisfaction, midwifery sustainability, work life balance