[Health and Professional Satisfaction of Freelance and Employed Midwives: Results of a Survey of Midwives in Baden-Wuerttemberg]. / Gesundheit und berufliche Zufriedenheit von freiberuflichen und angestellten Hebammen: Ergebnisse einer Hebammenbefragung in Baden-Württemberg.

BACKGROUND: A shortage of midwives has been the subject of discussion in Germany in recent years. In this study, we asked midwives in Baden-Wuerttemberg about their health and professional satisfaction. METHOD: In collaboration with the Baden-Wuerttemberg Midwives Association, an online midwives survey was conducted from October 16 to December 10, 2017. Using a visual analog scale (0-100 points), the WHO-5 questionnaire (0-100 points) and the Copenhagen Burnout Inventory (0-100 points), data on health, well-being and burnout were collected. Job satisfaction was assessed on a 7-point Likert scale. Seven hundred and twenty-two midwives participated in the survey. For this study, 545 to 608 data sets were analyzed. RESULTS: Of the studied midwives, 78.1% rated their health as good or very good (≥60 points). No statistically significant difference was observed between freelance midwives, employed midwives, and midwives who worked in both occupation forms (P=0.12). Midwives who were exclusively (15.0%) or partially (12.6%) employed were more likely to have very low well-being (≤25 points) than freelance midwives (7.3%; P=0.023). In addition, midwives who were exclusively (41.5%) or partially (39.4%) employed were more likely to have a moderate or high risk of burnout (≥50 points) than freelance midwives (20.6%; P<0.001). A lower health rating, lower well-being or higher burnout risk were associated with higher professional dissatisfaction in one or more domains. In multivariable analyses, higher burnout risk in particular was associated with higher job dissatisfaction in various domains. CONCLUSIONS: A large proportion of midwives in our study showed symptoms of depression and/or burnout. On average, the health status of midwives seems to be above the health status of women from the general population in Germany, but the well-being of midwives below. We recommend further investigation of how the stress of midwives can be reduced in the course of advancing midwifery and obstetric care structures.

Burnout among midwives and attitudes toward midwifery: A cross-sectional study from Baden-Württemberg, Germany.

INTRODUCTION: Midwifery services are a cornerstone of maternal care, but the mental health of midwives is at risk in many work settings. The aim of this study was to assess burnout and attitudes toward midwifery among midwives in Baden-Württemberg, Germany. METHODS: A cross-sectional online survey among midwives was conducted from 16 October to 10 December 2017. Burnout was assessed using the Copenhagen Burnout Inventory (CBI). RESULTS: A total of 602 survey respondents were studied; 48.3%, 38.2%, and 23.3% of midwives reported moderate or high (CBI score ≥50) levels of personal burnout, work-related burnout, and client-related burnout, respectively. Midwives with moderate or high burnout in at least one CBI dimension worked more weekly hours, were more commonly employed, and worked more frequently in the hospital. In turn, midwives with low burnout levels worked fewer weekly hours, more commonly freelance, and more frequently community based (all p<0.001). Moderate or high burnout levels were associated with a reduced likelihood to recommend midwifery as a profession (OR=0.34; 95% CI: 0.23-0.49) and an increased likelihood to intent leaving the profession (OR=3.39; 95% CI: 2.0-5.9) in a multivariable regression adjusting for midwife characteristics and work practices. CONCLUSIONS: Burnout symptoms were common among midwives. Burnout could be a health risk for midwives and a challenge to the profession by discouraging present and future midwives from practicing midwifery.