BRAMÅ – Improving the Working Environment for Midwives
Short description
The project examines the health and working environment of midwives. It focuses on factors that promote health as well as those that may have a negative impact on well-being. The project explores why midwives leave the profession and what encourages them to remain.
It also investigates midwives’ organisational and social working environment and how they assess their health and sense of coherence. Examining how these factors are related can provide important new knowledge and a stronger basis for promoting the positive aspects of midwifery work and preventing or reducing factors that make the working environment demanding.
Background
All 21 regions in Sweden report an acute shortage of midwives. This poses major challenges to the provision of high-quality sexual and reproductive healthcare in both inpatient and outpatient settings. Midwives report demanding working conditions and high workloads, and many choose to leave the profession. In 2022, 54% of midwives in a random sample had considered leaving the profession. There is therefore an urgent need for new and specific knowledge about midwives’ working conditions, the factors that contribute to their intention to leave the profession and those that encourage them to remain. In both the short and long term, low staff turnover is expected to contribute to greater patient safety and improved quality of care across all areas of midwifery practice.
Aim
The overall aim is to longitudinally analyse factors in midwives’ working environment that predict intentions to leave or remain in the profession, and to examine whether these factors differ between inpatient and outpatient settings. The project also investigates factors associated with the high prevalence of part-time work within the profession.
Methods
The study comprises a six-year follow-up of a national cohort of midwives established in 2020 (n=2,060), following a three-year follow-up conducted in 2023 (n=1,916). A web-based questionnaire was distributed to all midwives who were members of the Swedish Association of Midwives and the Swedish Association of Health Professionals through their membership registers.
The questionnaire includes validated instruments: COPSOQ III for the organisational and psychosocial working environment, BAT 23 for work-related burnout and SOC 13 for sense of coherence. It also includes questions about intentions to leave the current workplace and the midwifery profession, as well as background variables. This data collection focuses particularly on differences between inpatient and outpatient settings and on factors contributing to the high prevalence of part-time work.
Expected results
The project will identify context-specific working environment factors in both inpatient and outpatient settings that predict whether midwives change workplace or leave the profession altogether, as well as factors that contribute to their decision to remain.
The findings can be used to improve midwives’ working conditions, reduce staff turnover and support a sustainable midwifery workforce, which is expected to contribute to improved healthcare and greater patient safety. The project is expected to generate knowledge that can support employers, professional and trade union organisations, politicians and decision-makers in their efforts to retain midwives and create the conditions for a sustainable working life within the midwifery profession.