Norwegian midwives' perceptions of their practice environment: A mixed methods study.

Area of Science:

• Nursing and Midwifery
• Healthcare Management
• Occupational Health

Background:

• The working environment significantly impacts healthcare professionals' job satisfaction and patient care.
• Understanding midwives' perceptions is crucial for improving midwifery practice and retention.

Purpose of the Study:

• To investigate Norwegian midwives' perceptions of their working environment.
• To identify key factors influencing job satisfaction and challenges in midwifery practice.

Main Methods:

• A nationwide postal survey conducted in 2014.
• Data collected from 489 midwives using the Practice Environment Scale and open-ended questions.
• Quantitative data analyzed using psychometric, descriptive, and comparative analyses; qualitative data analyzed using content analysis.

Main Results:

• Five subscales emerged from psychometric analysis: Quality of management, Resource adequacy, Midwife-doctor relations, Opportunities for development, and Midwifery foundation for care.
• Four main themes identified through content analysis: Lack of resources, Insufficient support, Staying in midwifery, and Lack of influence.
• Midwives generally rated midwife-doctor relations and quality of management favorably, but expressed powerlessness due to a lack of influence in a medical model-dominated environment.

Conclusions:

• While some aspects of the working environment are perceived positively, significant challenges exist regarding resources, support, and professional influence for Norwegian midwives.
• Addressing the lack of influence and improving resource adequacy are critical for enhancing the midwifery work environment.
• Qualitative findings highlighted specific concerns such as fear of adverse events and the strain of shift work, which warrant further attention.