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Workload of primary-care midwives
1Netherlands institute for health services research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands. t.wiegers@nivel.nl
Midwifery
|December 19, 2006
Summary
Primary care midwives work 29 hours weekly, dedicating 22 hours to clients. Despite increased time per client, the total workload for midwives remains high, averaging 65 hours weekly.
Area of Science:
- Healthcare research
- Midwifery practice
- Workload assessment
Background:
- A 2000 strike highlighted midwife shortages and excessive workloads.
- Government interventions included increasing midwifery school capacity and reducing standard caseloads.
- Further insight into actual primary care midwife workload was needed to evaluate improvements.
Purpose of the Study:
- To assess the actual workload of primary care midwives in the Netherlands.
- To determine the impact of policy changes on midwife workload.
- To provide data on time allocation in midwifery practice.
Main Methods:
- A 4-year prospective survey of primary care midwives.
- Annual 3-week work diaries and questionnaires from a representative sample of midwives.
- Data collection included detailed timetables and practice organization information.
Main Results:
- Primary care midwives averaged 29 working hours per week, with 22 hours dedicated to client-related activities.
- Midwives were on call for an average of 53 hours per week, with 17 working hours occurring during on-call periods.
- Direct client care time increased by nearly 20%, with a significant rise in time spent during labor and birth.
Conclusions:
- The average working hours for primary care midwives remained constant at 29 hours per week between 2001 and 2004.
- There was a shift towards fewer clients per midwife but increased time allocated per client.
- The findings indicate a qualitative change in client care despite stable overall working hours.
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