Working in smaller teams in community midwifery practices to foster continuity of carer: Midwives’ experiences – A qualitative study in the Netherlands

van Wijngaarden, Marcelle; Blonk, Hinke; Simmelink, Renate; van der Lee, Nadine; van der Vliet-Torij, Hanneke Harmsen; Nieuwenhuijze, Marianne; de Jonge, Ank; Verhoeven, Corine

Abstract

Background
Midwife-led continuity of carer (MLCC) improves health outcomes and increases pregnant women’s satisfaction. Working in smaller teams in community midwifery practices is one of the ways to promote continuity of carer.

Aim
To gain insight into the experiences of Dutch community midwives regarding working in smaller teams, by identifying motivators and barriers.

Methods
A qualitative study was conducted using individual, semi-structured interviews (n=9). The sample was purposively selected. The interviews were analysed using the Abbreviated Grounded Theory.

Findings
Four themes were identified: 1) Ideal implementation of working in smaller teams, 2) Best care for pregnant women, 3) Conflicts with the current maternity care system, 4) Personal interests of the midwife. The core concept connecting all themes was midwives’ experiences of an 'inner conflict' regarding working in smaller teams.

Conclusion
A strong motivation for working in smaller teams is the wish to provide the best care for pregnant women through offering more continuity of carer. The structure of maternity care, financially and organisationally, acts as a barrier in the transition to working in smaller teams. How community midwives manage these motivators and barriers depends on their personal interests, vision, and personal life. The balance between the motivators and barriers can create an inner conflict among the midwives. This inner conflict encompasses an ethical issue: what is the best care and what is it worth? A discussion within the professional group concerning the practical and ethical aspects of working in smaller teams is needed to find ways to reduce the inner conflict of community midwives who wish to work in smaller teams, thereby promoting the implementation of MLCC.

Citation

van Wijngaarden, M., Blonk, H., Simmelink, R., van der Lee, N., van der Vliet-Torij, H. H., Nieuwenhuijze, M., de Jonge, A., & Verhoeven, C. (2024). Working in smaller teams in community midwifery practices to foster continuity of carer: Midwives’ experiences – A qualitative study in the Netherlands. Women and Birth, 37(6), Article 101663. https://doi.org/10.1016/j.wombi.2024.101663

• Journal Article Type: Article
• Acceptance Date: Jul 31, 2024
• Online Publication Date: Aug 17, 2024
• Publication Date: 2024-11
• Deposit Date: Sep 19, 2024
• Publicly Available Date: Sep 20, 2024
• Journal: Women and Birth
• Print ISSN: 1871-5192
• Electronic ISSN: 1878-1799
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 37
• Issue: 6
• Article Number: 101663
• DOI: https://doi.org/10.1016/j.wombi.2024.101663
• Public URL: https://nottingham-repository.worktribe.com/output/38897786
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1871519224001239?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: Working in smaller teams in community midwifery practices to foster continuity of carer: Midwives’ experiences – A qualitative study in the Netherlands; Journal Title: Women and Birth; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.wombi.2024.101663; Content Type: article; Copyright: © 2024 The Authors. Published by Elsevier Ltd on behalf of Australian College of Midwives.