gms | German Medical Science

Background: In Switzerland, there are numerous families with psychosocial burdens that can make it difficult to get an optimal start into life and childhood [1]. For couples with children under 3 years of age, the at-risk-of-poverty rate is 17.9 percent [2]. Accompanied by the National Program against Poverty, interdisciplinary networks are increasingly being set up in cantonal or community-related initiatives for early childhood support. In this field midwives are regarded as important network partners. Up to now, it is largely unknown whether and in what form independent midwives network and what attitudes and expectations they have towards (successful) networking activities.

Objectives: Identification of forms of networking between independent midwives, the attitudes and expectations towards networking and the assessment of advantages and challenges of networking.

Methods: A three-language online survey with independent midwives in Switzerland. 1’379 independent midwives who had carried out postpartum care in 2016 were invited to take part in this survey. The response rate was 29.1 percent (n=401).The socio-demographic data were analysed with descriptive statistics. Group comparisons of frequencies were performed with Chi-square tests and Cramer's-V.

Results: Our results showed that 130 midwives (37.6 %) were not organised in any kind of network (NW) whereas 108 midwives (31.2 %) were integrated in monodisciplinary (mon.) or interdisciplinary (int.) networks. In general, cooperating midwives were significantly more likely to care for socially disadvantaged families (p <0.001). 16.7 % of the midwives in networks and 9.2 % of the midwives who were not organised in networks regularly cared (about 20 %) for families with an increased need for support. Regardless of the form of the network, the assessment of the need for family support was most often backed-up and discussed through regular exchanges with colleagues (Ø NW 65.6 %, mon. NW 76.4 %, int. NW 72.2 %). Compared to the other variants/cases, midwives who were integrated in interdisciplinary networks expressed more frequently that they would be supported in the assessment of the families by regular interdisciplinary exchange (Ø NW 48.8 %, mon. NW 50.5 %, int. NW 66.3 %, p=0.038). In the event of an extended need for support for the family, midwives in interdisciplinary networks can more often rely on an already established network (p=0.001) or well-known contacts (p<0.001). Interdisciplinary networked midwives are more likely to see the advantage of networking such as being able to gain a better understanding of the perspectives and attitudes of practitioners from other professions (p=0.001) and see families with complex problems being supported more comprehensively (p=0.001). In addition, they see the value of their own work as being better used for families under strain (p=0.029). In contrast to midwives with monodisciplinary networks, more midwives feel relieved and no longer responsible for everything (58.1 vs. 42.1 %, p=0.026).

Conclusion: The results provide evidence that socially strained families as well as midwives themselves benefit from cooperation within interdisciplinary networks. This shows that the integration of midwives into networks makes it easier for socially disadvantaged families to gain access to midwifery care.

Ethical criteria and conflict of interests: The research was submitted to an ethics committee. The work was financed by third party funds from National Program against Poverty, Family Start Zurich. There is no conflict of interest.