10 | Chapter 1 This thesis deals with the occupational wellbeing of midwives in the Netherlands with a focus on newly qualified midwives (NQMs) and their transition into practice. In this introductory chapter, the concept of occupational wellbeing is explained, including the current situation of the art of occupational wellbeing of midwives. Furthermore, the work environment of midwives in the Netherlands is described, particularly of NQMs. This chapter concludes with the overarching problem statement for this thesis, related research questions, and an outline of the thesis. Midwives’ occupational wellbeing Wellbeing is defined as: ‘When individuals have the psychological, social, and physical resources they need to meet a particular psychological, social, and/or physical challenge. ‘1 Occupational wellbeing is defined as a broad construct that includes individual and organizational factors that interact and lead to the well-being of employees.2 Occupational wellbeing results in a spectrum ranging from positive feelings of autonomy, satisfaction, competence at one end, and negative aspects of work resulting in anxiety and low well-being at the other end.2,3 Occupational wellbeing in healthcare research is often characterized one-sidedly by the prevalence of burnout,4 stress, depression, and anxiety.5 Other measured variables of midwives’ well-being are job strain and intentions to leave the profession.6-8 Occupational wellbeing consists of two different independent processes, a motivational process and a health impairment process, both with different outcomes.9 On the one hand, the health impairment process leads to burnout and negative performance, and on the other hand, the motivational process leads to work engagement and positive performance.9 The literature mainly reports two different constructs of positive wellbeing: job satisfaction and work engagement.9,10 Although job satisfaction and engagement are both positive states of mind, engaged professionals are proactive and more driven in their work than satisfied professionals.11 Work engagement is also more related to work performance than job satisfaction.11 Work engagement is defined as: ‘a positive, fulfilling, work-related state of mind that is characterized by vigour, dedication to the work, and by absorption’.10 Although research on positive wellbeing within the midwifery profession is scarce, outcomes have been reported on job satisfaction or intentions to stay in the profession.12-15 These studies among midwives show that high levels of job satisfaction are associated with less turnover and absenteeism. Satisfied midwives enjoyed the type of work and did not want to leave their job.16 Contributing factors to midwives’ job satisfaction are positive collaborations with colleagues, having meaningful work content, autonomy at work, and a manageable workload.12,17 A few small studies on midwives’
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