gms | German Medical Science

4th International Conference of the German Society of Midwifery Science (DGHWi)

Deutsche Gesellschaft für Hebammenwissenschaft e. V.

16.02.2018, Mainz

Professional biographies of midwives in Germany: critical incidents and turning points around the decision whether to stay in the profession or to leave

Meeting Abstract

  • corresponding author Christine Wehrstedt - University Witten-Herdecke, Witten, Germany; University of Applied Sciences Fulda, Fulda, Germany
  • Babette Müller-Rockstroh - University of Applied Sciences Fulda, Department of Nursing & Health, Fulda, Germany
  • Wilfried Schnepp - University Witten-Herdecke, Chair for family-oriented and community-based care, Witten, Germany

German Association of Midwifery Science. 4th International Meeting of the German Association of Midwifery Science (DGHWi). Mainz, 16.-16.02.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc18dghwiP38

doi: 10.3205/18dghwi44, urn:nbn:de:0183-18dghwi443

This is the English version of the article.
The German version can be found at: http://www.egms.de/de/meetings/dghwi2018/18dghwi44.shtml

Published: February 13, 2018

© 2018 Wehrstedt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Text

Background: In Germany, parallel to heavy increases of their health insurance midwives increasingly and with an ongoing tendency leave the out of hospital birth sector [1]. Current changes within professional regulations pose restrictions on midwives' professional opportunities and consequently childbearing mothers concerning their choice where and with whom to give birth with.

Aim/Research Question: The current PhD project analyses what factors contribute to changes within biographical careers in this field: To enter, remain or leave the out of hospital birth sector.

Methods: The current PhD project uses a combination of the grounded theory methodology and biographical research [2], [3], [4]. We analyse conceptual and behavioural career patterns of midwives ceasing or continuing respectively entering the out of hospital birth sector. So far 23 problem centred interviews [5] with midwives in Germany have been conducted between July 2015 and April 2017. The interviewees are midwives who are either active in or have left out of hospital birth attendance within the last four years before the interview.

Results: Analysis of the interviews demonstrates a multifactorial process of disconcertion in the researched field. Multiple tension fields are characterized by juggling between tensions and resources to sustain successful career biographies und identities. Turning points are influenced by normative and non-normative crises. Due to profound restrictions associated with changing regulations posed on the professional operational framework, as well idealistically as pragmatically motivated midwives tend to leave at the same time. Those who remain in the field develop a variety of coping strategies to compensate for those developments. Within those one of the most important aspects are well-functioning teams and networks. Particularly for younger midwives the sole practioner model is becoming decreasingly attractive.

Relevance: The public debate in Germany around the loss of midwives focusses primarily on financial aspects, herein particularly on the increase of liability insurance rates. Profound analyses is essential to evolve a comprehensive view on what contributes to support midwives in successfully continue to assist women to give birth at home and in midwife led birth centres, therefore also to maintain women's legally granted right to choose their preferred place of birth.

Recommendations/Conclusions: Preliminary results allow to conclude that a greater variety of changes and compensations than just insecure short term financial compensations are necessary to maintain the opportunity for mothers to give birth at home. While finances are important, freedom to frame and construct one's working environment together with women and the opportunity to live professional ideals are equally essential. Aspects which can make a contribution here will be deepened and expanded in the further process of the project.

Ethical criteria and conflict of interests: The research was submitted to an ethics committee and financed from own resources. The doctoral student is currently a scholarship holder at her university. The following conflicts of interest exist: The first author and a supervisor are midwives themselves.

The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].


References

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