Effort-reward imbalance of independent midwives in one federal state of Germany (Bavaria): A cross-sectional study

Mössinger, Clara; Weigl, Matthias und Sayn-Wittgenstein, Friederike zu (2019): Effort-reward imbalance of independent midwives in one federal state of Germany (Bavaria): A cross-sectional study. In: GMS Zeitschrift für Hebammenwissenschaft, Bd. 6

Abstract

Background: In Germany, independent midwives are self-employed midwives who either work in a caseload model providing continuity in antenatal, intrapartum and postpartum care or as self-employed core midwives covering shifts in hospital labour wards. Crucial changes in the service have become evident over the last decade. As a result, the number of midwives working in freelance care models is plummeting, resulting in an imminent service shortage for Germany’s maternity care system.

Objective: To measure the effort-reward imbalance ratio amongst independent midwives providing intrapartum care in Bavaria in order to predict their intention to leave the profession.

Methods: The effort-reward imbalance (ERI) model measures the ratio of effort and reward in occupational contexts. A self-reported online survey was conducted on a convenience sample of 107 participants to measure the prevalence of ERI ratio scores ≥1. This is a strong predictor of intention to leave the profession amongst health care providers.

Results: Responses from 45 independent midwives were included who had attended a median of 50 births (SD 54.6) in 2013 with a mean of 10 years of professional experience (SD 9.7). The prevalence of an imbalanced effort and reward situation was 73 percent (N=33), with a median of 1.2 (SD 0.3). The participating midwives reported that low pay and the anticipated deterioration in their professional situation were the negative aspects of midwifery. Professional recognition from important people (colleagues, superiors) was cited as a relevant balancing factor.

Conclusions: This study found that nearly three-quarters of the examined sample experienced an imbalance of effort and reward in their profession. This can be interpreted as a predictor of future job leavers. Despite the limitations of this study, the results suggest a further decrease in independent midwives providing continuity of care in hospital and homebirth settings in Bavaria in the future.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2366-5076
• Sprache: Englisch