Job satisfaction in midwives and its association with organisational and psychosocial factors at work: a nation-wide, cross-sectional study

Abstract

Background Midwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial work environment associated with midwives’ job satisfaction. A secondary objective was to identify differences in how midwives assess the organisational and psychosocial work environment compared to Swedish benchmarks. Methods This nation-wide, cross-sectional web survey study analysed midwives’ assessment of their organisational and psychosocial work environment using the COPSOQ III instrument. A multivariable, bi-directional, stepwise linear regression was used to identify association with job satisfaction (N = 1747, 99.6% women). A conventional minimal important score difference (MID ± 5 as a noticeable difference with clinical importance) were used to compare midwives’ results with Swedish benchmarks. Results A multivariable regression model with 13 scales explained the variance in job satisfaction (R2 = .65). Five scales, possibilities for development, quality of work, role conflict, burnout and recognition, explained most of the variance in midwives’ job satisfaction (R2 = .63) and had β values ranging from .23 to .10. Midwives had adverse MID compared to Swedish benchmarks with higher difference in mean values regarding quantitative demands (8.3), work pace (6.0) emotional demand (20.6), role conflicts (7.9) and burnout (8.3). In addition, lower organisational justice (-6.4), self-rated health (-8.8), influence (-13.2) and recognition at work (-5.8). However, variation and meaning of work showed a beneficial difference in mean values with 7.9 and 13.7 respectively. Conclusions Midwives reported high levels of meaningfulness in their work, and meaningfulness was associated with job satisfaction. However, midwives also reported adversely high demands and a lack of influence and recognition at work and in addition, high role conflict and burnout compared to Swedish benchmarks. The lack of organisational resources are modifiable factors that can be taken into account when structural changes are made regarding organisation of care, management and resource allocation. Midwives are necessary to a high quality sexual, reproductive and perinatal health care. Future studies are needed to investigate if job satisfaction can be improved through professional recognition and development, and if this can reduce turnover in midwives.

The Role of Midwives in the Course of Natural Childbirth—Analysis of Sociodemographic and Psychosocial Factors—A Cross-Sectional Study

“…In turn, Iranian research reports that a lack of job satisfaction has a significant negative impact on the quality of communication and patient care [ 43 ]. Swedish midwives, when assessing job satisfaction, emphasized the lack of professional recognition instead, drawing attention to the perceived conflict of roles and the feeling of burnout [ 44 ]. A Polish study of 350 nurses and midwives indicated that the average burnout rate was 34.7 per 100 points, and the most important factor related to burnout was emotional exhaustion.…”

Midwife-centred management: a qualitative study of midwifery group practice management and leadership in Australia

“…Leadership-as-practice is less about what one person does and is more about what can be accomplished by a collective, through day-to-day experiences [ 37 ]. Managers that contribute to a collective leadership demonstrate that the midwives are valued, encouraging their involvement in decision-making, thereby improving job satisfaction [ 12 ].…”

“…Managers are pivotal to the workplace culture and to the wellbeing of their staff, in turn reflecting on the care women and families receive [ 52 ]. The current crisis of the retention of midwives in the profession, calls for the managers’ workload to be taken seriously to enable them to support midwives to be healthy, happy and to stay in midwifery [ 10 , 12 , 52 ].…”

“…It might also encourage more research into burnout and emotional labour in management. Policy makers, need to deliver policies that improve access to MGP and consider its sustainability given the improved outcomes for women and babies [7], the reduced burnout of midwives [55] and improved satisfaction for both women [18] and midwives [8,12]. Service managers can support the implementation and sustainability of MGP by employing MGP managers that meet the criteria covered in this study and by giving them a sustainable workload.…”

“…Birth outcomes for women are also improved, with women experiencing fewer interventions during childbirth, higher spontaneous birth rates, fewer premature births and reduced foetal and neonatal loss [7]. MGP can positively influence midwives' work satisfaction and reduce burnout, helping to retain them in the profession [8,[10][11][12]. There are also positive benefits for health services that offer MGP, including cost benefits [13], reduced MGP midwife sick leave, as well as the attraction and retention of staff [4].…”