A global overview of midwives’ working conditions: A rapid review of literature on positive practice environment

Carvajal, Bielka; Hancock, Angela; Lewney, Katharine; Hagan, Karen; Jamieson, Sarah; Cooke, Alison

Abstract

Background
In the United Kingdom (UK), a critical shortage of midwives puts pressure on the already overworked midwives working in maternity services. Considering the challenges that midwives in the UK face, this rapid review was conducted to inform a larger-scale initiative to improve the working conditions of midwives in an acute NHS Trust in the Midlands area of the UK.

Objective
To describe midwives’ perceptions and experiences of positive practice environments.

Methods
A search strategy to identify literature about midwives’ perceptions and experiences of positive practice environments was conducted in Medline, CINAHL Plus and Embase databases. Literature screening was conducted independently in two steps using an eligibility tool. The articles’ quality assessment was conducted using the Mixed Method Appraisal Tool. Data were extracted using the Job Quality framework and managed using NVivo12.

Results
Seventy articles were included in this review. Midwives’ working conditions can be improved in all seven areas of the Job Quality framework. Most articles in the review reported the negative aspects of midwives’ working environments, making it challenging for the team to define a positive practice environment for midwives. Despite this, authors discuss that a positive practice environment is at least sustained by ensuring midwives’ ability to provide care; providing good employment conditions; developing respectful organisations; and increasing team resources, such as those that improve team resilience.

Conclusions
Midwives’ working conditions are universally challenging. Failure to address the situation will compromise recruitment and retention, increasing the shortage of midwives. Provision of safe and respectful care appears to be directly linked to midwives' safe and respectful working conditions.

• Journal Article Type: Article
• Acceptance Date: Aug 23, 2023
• Online Publication Date: Aug 28, 2023
• Publication Date: 2024-02
• Deposit Date: May 10, 2024
• Journal: Women and Birth
• Print ISSN: 1871-5192
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 37
• Issue: 1
• Pages: 15-50
• DOI: https://doi.org/10.1016/j.wombi.2023.08.007
• Keywords: Working Conditions; Midwives; Workload; Rapid Review
• Public URL: https://keele-repository.worktribe.com/output/825890
• Additional Information: This article is maintained by: Elsevier; Article Title: A global overview of midwives’ working conditions: A rapid review of literature on positive practice environment; Journal Title: Women and Birth; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.wombi.2023.08.007; Content Type: article; Copyright: © 2023 The Author(s). Published by Elsevier Ltd on behalf of Australian College of Midwives.