Career plans of primary care midwives in the Netherlands and their intentions to leave the current job.

J Catja Warmelink,Therese A Wiegers,T Paul de Cock,Evelien R Spelten,Eileen K Hutton

doi:10.1186/s12960-015-0025-3

Abstract

BackgroundIn labour market policy and planning, it is important to understand the motivations of people to continue in their current job or to seek other employment. Over the last decade, besides the increasingly medical approach to pregnancy and childbirth and decreasing home births, there were additional dramatic changes and pressures on primary care midwives and midwifery care. Therefore, it is important to re-evaluate the career plans of primary care midwives and their intentions to leave their current job.MethodsAll 108 primary care midwives of 20 selected midwifery care practices in the Netherlands were invited to fill out a written questionnaire with questions regarding career plans and intentions to leave. Bivariate analyses were carried out to compare career plans and work-related and personal characteristics and attitudes towards work among the group of midwives who indicated that they intended to leave their current job (ITL group) and those who indicated they had no intention to leave (NITL group). Significant predictors of ITL were included in the multiple binary logistic regression with ‘intention to leave’ as the dependent variable.ResultsIn 2010, 32.7% of the 98 participating primary care midwives surveyed had considered an intention to leave their current type of job in the past year. Fewer ITL midwives wanted to be a self-employed practitioner with the full range of primary care tasks and work full-time. Significant predictors of the primary care midwives’ intention to leave included a lower overall score on the job satisfaction scale (OR = 0.18; 95% CI = 0.06–0.58; p = 0.004) and being between 30 and 45 years old (OR = 2.69; 95% CI = 1.04–7.0; p = 0.041).ConclusionOur study shows that, despite significant changes in the reproductive, maternal and newborn health service delivery that impact on independent midwifery practice, the majority of primary care midwives intended to stay in primary care. The absence of job satisfaction, and being in the age group between 30 and 45 years old, is associated with primary care midwives’ intention to leave their current job. Ongoing monitoring will be important in the future.

Highlights

In labour market policy and planning, it is important to understand the motivations of people to continue in their current job or to seek other employment
There were no significant differences between the two groups in mean age, there was a difference (p = 0.003) when we looked at a specific age group: 56.3% of the midwives between 30 and 45 years old had an intention to leave their current job versus 25.8% of the midwives younger than 30 or older than 45
Despite some of the uncertainties about the future of primary midwifery care, the majority of primary care midwives intended to stay in primary care and this appears to be associated with job satisfaction

Summary

Introduction

In labour market policy and planning, it is important to understand the motivations of people to continue in their current job or to seek other employment. Almost all (95%) of the primary care midwives work in group practices, often with two or three colleagues, as self-employed practitioner, as employee in a partnership or as locum (a substitute midwife) [2]. In 2010, 72% of the 2612 practising midwives in the Netherlands worked in primary care in 519 midwifery practices [2]. There is currently a debate on the reorganization of the maternity care system in the Netherlands It may be a major turning point in the history of the midwifery care, going from an echelon system with primary, secondary and tertiary care to a more integrated maternity care system, where care from different providers is more integrated [6,7]

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