gms | German Medical Science

Background: In Germany a tight working situation for midwives and a loss of midwifery workforce is perceived in the last years. Additionally there is a lack of data on the number of midwives and their services rendered. It is challenging that no central midwifery registration exists in Germany. Several workforce surveys in Germany focused different federal states except NRW.

Aim: The research project HebAB.NRW –midwifery care in North Rhine-Westphalia will examine the overall supply with midwifery care in this federal state using two subprojects with explorative cross-sectional surveys, questioning mothers three months after giving birth and midwives. In addition to the descriptive representation of midwives’ fields of work the Aim of the study is to identify influencing factors on working midwives’ professional and emotional wellbeing. The international implemented WHELM (Work, Health and Emotional Life of Midwives) study [1] examines the work environment and the professional and emotional wellbeing of midwives. The overarching Aim of the WHELM study is to assess the state of health in relation to the vocational context.

Method: All midwives working and living in NRW will be questioned by surface mail or online regarding their professional activity. The questionnaire also contains two validated instruments of the WHELM study [1]. The instruments being used are the German versions of the Copenhagen Burnout Inventory (CBI) [2] and the revised Perception of Empowerment in Midwifery Scale (PEMS) [3]. Access is sought through professional associations, birthing centres, lists of midwives and by directly addressing the head midwife of hospitals with an obstetric department in NRW. A pretest will examine the validity and reliability of the explorative survey and the cross culture adaption of the translated PEMS into German. Along with the invitation to the national delegate’s conference of the German Association of Midwives in November 2017, all delegates from other German federal states than NRW receive an invitation to take part in the pretest of the study. It is expected that Data collection will take place from January 2018 to September 2018.

Results: Midwives’ fields of work in NRW will be represented. Using the CBI and PEMS in New Zealand and Australia [4] showed significant differences in burnout scores and perception of empowerment between employed and freelancing midwives, who practice caseload and continuity of care. Similar results are expected for Germany.

Relevancy: The results of the research project can provide insights into deficits and strengths in the professional context of midwives in NRW. Measures can be deducted that could positively influence the work environment, so that midwives prospectively can provide all women in the reproductive phase with appropriate midwifery care related to women’s needs and stay healthy themselves.

Conclusion: The research project provides the opportunity to get detailed insights into midwifery care in NRW and thus allows conclusions for all of Germany, because of its geographic characteristics and a high birth rate. In addition to that, reasons to stay in or intentions to leave the profession can be shown. The WHELM study has already been conducted in Australia, New Zealand, Sweden, Norway, Canada and Great Britain. Thus an international comparison of working conditions and their effects on midwives will be possible.

Obtaining representative data regarding midwives’ professional activity and emotional health enables the development of measures to strengthen midwifery in the future.

Ethical criteria and conflict of interests: The research/project will be submitted to the Ethics Committee of the Hochschule für Gesundheit, University of Applied Sciences (hsg), in October 2017. The work was financed by third party funds from Landeszentrum Gesundheit Nordrhein-Westfalen (LZG.NRW). There is no conflict of interest.