Occupational Situation of Midwives in Institutions with and without Midwife-led Care in in a Swiss Canton

Abstract

Compared to traditional models of care, midwife-led models of care provide better opportunities for midwives to make use of their full scope of practice. This has consequences for their professional satisfaction. The aim of this survey was to gain an overview of the occupational situation of midwives in the maternity units of a Swiss canton and to compare the situations between institutions with and without midwife-led care. An online-survey was developed based on a literature search. All 17 institutions with maternity units in the canton of Zurich were eligible to participate. Data was analysed descriptively using Stata 15. 16 maternity units (94.1%) participated in the survey: 12 public hospitals, 2 private hospitals, and 2 midwifery-led birthing centres. A total of 5 units (31.3%) provided midwife-led births or were birthing centres. In institutions providing midwife-led care, women and midwives were more likely to know each other before admission to birth (60.0 vs. 9.1%, p=0.063), fewer routine interventions were carried out (e. g. venous access: 20.0 vs. 81.8%, p=0.036), midwives had more decision-making competences as well as responsibility (e. g. autonomous discharge check-up: 60.0 vs. 9.1%, p=0.063) and used supervisions more often (60.0 vs. 9.1%, p=0.013). Fostering midwife-led models of care increases continuity of care and decreases the application of routine interventions. It also fosters the independent assumption of tasks.