title: Career plans of primary care midwives in the Netherlands and their intentions to leave the current job.
abstract: BACKGROUND
  In labour market policy and planning, it is important to understand the motivations of people to continue in their current job or to seek other employment. Over the last decade, besides the increasingly medical approach to pregnancy and childbirth and decreasing home births, there were additional dramatic changes and pressures on primary care midwives and midwifery care. Therefore, it is important to re-evaluate the career plans of primary care midwives and their intentions to leave their current job.
  
  
  METHODS
  All 108 primary care midwives of 20 selected midwifery care practices in the Netherlands were invited to fill out a written questionnaire with questions regarding career plans and intentions to leave. Bivariate analyses were carried out to compare career plans and work-related and personal characteristics and attitudes towards work among the group of midwives who indicated that they intended to leave their current job (ITL group) and those who indicated they had no intention to leave (NITL group). Significant predictors of ITL were included in the multiple binary logistic regression with 'intention to leave' as the dependent variable.
  
  
  RESULTS
  In 2010, 32.7% of the 98 participating primary care midwives surveyed had considered an intention to leave their current type of job in the past year. Fewer ITL midwives wanted to be a self-employed practitioner with the full range of primary care tasks and work full-time. Significant predictors of the primary care midwives' intention to leave included a lower overall score on the job satisfaction scale (OR = 0.18; 95% CI = 0.06-0.58; p = 0.004) and being between 30 and 45 years old (OR = 2.69; 95% CI = 1.04-7.0; p = 0.041).
  
  
  CONCLUSIONS
  Our study shows that, despite significant changes in the reproductive, maternal and newborn health service delivery that impact on independent midwifery practice, the majority of primary care midwives intended to stay in primary care. The absence of job satisfaction, and being in the age group between 30 and 45 years old, is associated with primary care midwives' intention to leave their current job. Ongoing monitoring will be important in the future.
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands. catja.warmelink@inholland.nl.|Midwifery Academy Amsterdam Groningen (AVAG), Dirk Huizingastraat 3-5, 9713 GL, Groningen, the Netherlands. catja.warmelink@inholland.nl.
authors.forename: J Catja
authors.initials: JC
authors.lastname: Warmelink
authors.affiliation: Netherlands institute for health services research (NIVEL), Utrecht, the Netherlands. t.wiegers@nivel.nl.
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. pauldc@hotmail.co.uk.|Midwifery Academy Amsterdam Groningen (AVAG), Dirk Huizingastraat 3-5, 9713 GL, Groningen, the Netherlands. pauldc@hotmail.co.uk.
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. evelienspelten@yahoo.com.|Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia. evelienspelten@yahoo.com.
authors.forename: Evelien R
authors.initials: ER
authors.lastname: Spelten
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands. huttone@mcmaster.ca.|Faculty of Health Sciences, McMaster University, Hamilton, Canada. huttone@mcmaster.ca.
authors.forename: Eileen K
authors.initials: EK
authors.lastname: Hutton
mesh_terms: D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D004651:Employment; D005260:Female; D006801:Humans; D033182:Intention; D007588:Job Satisfaction; D008880:Midwifery; D009426:Netherlands; D009721:Nurse Midwives; D016017:Odds Ratio; D010563:Personnel Turnover; D011247:Pregnancy; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D000078329:Workforce