General introduction | 11 wellbeing reported on work engagement.18,19 Midwives showed high levels of work engagement, and determinants of work engagement were working with pregnant individuals and their families, which is perceived as meaningful work. Studies on other professions and occupations show that working with clients, autonomy, and social support are associated with high work engagement.20 As well as occupational determinants, personality traits such as self-esteem, self-efficacy, optimism, and proactive behaviour are associated with high work engagement.21,22 Negative wellbeing among midwives is often operationalized in burnout symptoms.5 International research shows that work-related burnout among midwives ranges between 20 and 60 per cent.5,23 Determinants of burnout include a low maturity level, being young, not much work experience, and being single.5 Furthermore, a lack of staff, low salary, poor professional recognition and organization, and a negative work environment contribute to burnout symptoms among midwives.5 On the other hand, findings in midwifery research show factors in the work which protect against burnout symptoms.5 These factors include working with pregnant individuals, supportive relationships with colleagues, and working with like-minded fellow midwives.6 Furthermore, personal resources, which were referred to in the previous paragraph as contributing to high work engagement, also protect against burnout symptoms. These factors are self-esteem, self-efficacy, optimism, and proactive behaviour. 21,22 Transition-into-practice Occupational wellbeing of newly qualified midwives (NQMs) is related to their transitioninto- practice experiences.24 Transition-into-practice for newly qualified health professionals is viewed as ‘a foundational period of time, at the start of a career, whereby a newly qualified practitioner can build competence and confidence as an autonomously working professional’.25 For midwives, this marked period from graduation as a midwife towards working as a registered midwife is regulated and legislated.25 In countries such as the United Kingdom and Australia, NQMs are required to complete a period of supervised working in practice before being permitted to work autonomously with pregnant women.25 In other countries such as New Zealand, Canada, and The Netherlands, NQMs are registered immediately after graduation and able to work in practice autonomously: providing care across the entire scope of midwifery practice.24 In contrast to other countries,24-26 transition-into-practice experiences of NQMs in the Netherlands have not yet been studied. Transition- into-practice in midwifery research seemed to depend on the work environment NQMs choose to work in.24 In hospital settings, NQMs learn to evaluate and assess risks, and they are socialized to work as an efficient and effective team member within an institution rather than working ‘with the
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