Intentions to leave and actual turnover of community midwives in the Netherlands. A mixed method study exploring the reasons why | 107 The life events were related to events in a participant’s personal life that interfered with their work as a midwife. For instance, a pregnancy-related life event was making it hard for a participant to work with pregnant women. Traumatic events during shifts, such as the resuscitation of newborns and death of newborns, affected their work. One midwife said that the impact of this event affected her self-confidence. She doubted whether she could handle the enormous responsibility of working as a midwife. Quantitative demands Work overload was mentioned as a quantitative job demand related to leaving the profession. Participants stated that they were overloaded during their shifts, i.e. making home visits, supporting home births and receiving a high level of phone calls affected their wellbeing. So, during your shift, these are all things that you get asked to do: Can you arrange this, can you do that, can you, this lady feels, eh, less movement, but my consultations are running really late, can you go and have a look at her? (P03) Organisational demands Participants mentioned two different organisational demands: setting up partnerships, and the amount of administrative and organisational tasks. Setting up partnerships refers to the efforts it took to agree with colleagues about work procedures and collaboration within the practice. Building up an organised practice took time and effort, to reach consensus about work procedures. Furthermore, participants felt that the time spent on administrative and organisational tasks had increased over the years. Increasing tasks at the organisational level, such as regional meetings, meetings with insurance companies and financial matters of the practice were perceived as overshadowing their work. They experienced this part of their work as interfering with the more satisfying aspects of the profession; working with pregnant individuals. And then there were all these new things and at one point I thought, I just don’t want to do this anymore. I thought, I don’t feel like changing anymore, it is already costing me so much energy. I am not going to spend time reading up on care standards and... I don’t want this anymore, I don’t want any more changes, I no longer had the energy to change. (P04) Lack of job resources Job resources relate to social, work, organisational and developmental resources. During the interviews, a lack of job resources was perceived as a deficiency.
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