title: An explorative study of factors contributing to the job satisfaction of primary care midwives.
abstract: OBJECTIVE
  the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives׳ job satisfaction and areas for improvement.
  
  
  METHODS
  a qualitative analysis was used, based on the constructivist/interpretative paradigm. Three open-ended questions in written or online questionnaire, analysed to identify factors that are linked with job satisfaction, were as follows: 'What are you very satisfied with, in your work as a midwife?', 'What would you most like to change about your work as a midwife?' and 'What could be improved in your work?'.
  
  
  METHODS
  20 of the 519 primary care practices in the Netherlands in May 2010 were included.
  
  
  METHODS
  at these participating practices 99 of 108 midwives returned a written or online questionnaire.
  
  
  RESULTS
  in general, most of the participating primary care midwives were satisfied with their job. The factors positively associated with their job satisfaction were their direct contact with clients, the supportive co-operation and teamwork with immediate colleagues, the organisation of and innovation within their practice group and the independence, autonomy, freedom, variety and opportunities that they experienced in their work. Regarding improvements, the midwives desired a reduction in non-client-related activities, such as paperwork and meetings. They wanted a lower level of work pressure, and a reduced case-load in order to have more time to devote to individual clients׳ needs. Participants identified that co-operation with other partners in the health care system could also be improved.
  
  
  CONCLUSIONS
  our knowledge, our study is the first explorative study on factors associated with job satisfaction of primary care midwives. While there are several studies on job satisfaction in health care; little is known about the working conditions of midwives in primary care settings. Although the participating primary care midwives in the Netherlands were satisfied with their job, areas for improvement were identified. The results of our study can be relevant for countries that have a comparable obstetric system as in the Netherlands, or are implementing or scaling up midwifery-led care.
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Midwifery Academy Amsterdam Groningen, The Netherlands. Electronic address: catja.warmelink@inholland.nl.
authors.forename: J Catja
authors.initials: JC
authors.lastname: Warmelink
authors.affiliation: Midwifery Academy Amsterdam Groningen, The Netherlands.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Hoijtink
authors.affiliation: Midwifery Academy Amsterdam Groningen, The Netherlands.
authors.forename: Marloes
authors.initials: M
authors.lastname: Noppers
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Therese A
authors.initials: TA
authors.lastname: Wiegers
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Midwifery Academy Amsterdam Groningen, The Netherlands.
authors.forename: T Paul
authors.initials: TP
authors.lastname: de Cock
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Midwifery Academy Amsterdam Groningen, The Netherlands.
authors.forename: Trudy
authors.initials: T
authors.lastname: Klomp
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Faculty of Health Sciences, McMaster University, Hamilton, Canada.
authors.forename: Eileen K
authors.initials: EK
authors.lastname: Hutton
mesh_terms: D000328:Adult; D005260:Female; D006123:Group Practice / Q000592:standards; D006801:Humans; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008875:Middle Aged; D009426:Netherlands; D009721:Nurse Midwives / Q000523:psychology*; D011247:Pregnancy; D011320:Primary Health Care / Q000592:standards*; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology
keywords: Job satisfaction; Midwives; Organisation of care; Primary care; Professionals׳ experiences; Qualitative methods