Intentions to leave and actual turnover of community midwives in the Netherlands. A mixed method study exploring the reasons why | 111 I am thinking of an example, but I can’t find it, but I had this idea that my colleagues were more capable than I was. (P02) Outcomes Midwives really do quit when they see no way out, when they no longer feel any possibility of adjusting work conditions, either in reducing job demands or increasing job resources. And I always had the feeling, in those 20 years that we knew each other, that we were together and that we could solve it together. And for the first time I discovered that it wasn’t about solving things together... and in the end I left the partnership. (P06) Participants perceived changes in their performance, their work employability, and their commitment in the period before quitting their job. They felt less involved with the women they cared for and with their team. Moreover, they felt less engaged with changes in the organisation. The realisation of these feelings led some of them to ultimately make the decision to leave midwifery practice. Other participants were forced to leave midwifery due to a progressive illness or due to physical and/or psychological constraints developed because of their work. Personal life events were also mentioned as part of the decision for leaving the midwifery profession. I can’t muster up the empathy anymore. I think that, yes, maybe it had to do with grief. That I was more focussed on myself or something, not intentionally, but... (P02) Outcomes of the narrative analyses Participants perceived the final decision to leave midwifery practice as a process over time. They mentioned, among various other reasons, the fact that they were unable to change their job circumstances as a reason for deciding to leave the profession. A variety of factors, such as different job demands and a perceived lack of job resources sometimes combined with a lack of personal resources, contributed to leaving the profession. For example, the combination of the problems of the long shifts, the interdependence of the business partners (in this case, fellow midwives) in the midwifery practice, the changing demands of the clients and, at the same time, caring for their own families all contributed to their final decision to leave their jobs. I already knew I wasn’t going to do this forever. And I noticed the balance shifting more and more. In the beginning, the work energised me, and towards the end, it only depleted my energy. And then I really had a bit of a burnout, after that move. And even before that,
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