196 | Chapter 8 practice. Leadership and organizational skills at master level include working as a midwife in collaborations at regional or national level. In addition, leadership, entrepreneurship, mentoring, and coaching should be developed by midwives at master’s level. For future research For future midwifery research, we recommend three different approaches to studying NQMs’ wellbeing. Firstly, design-based research is recommended to design the various required components of support for NQMs based on literature and previous research outcomes. Effective components of support can be designed for NQMs in specific work environments – the hospital and the community – and can be used as a blueprint for implementation of support at a regional level. Secondly, participatory action research is recommended, focusing on the implementation of components of support for NQMs during the transition-into-practice at the local or regional level. Both the design-based and the action research approach will enable researchers to better understand the implementation of these components, and how to prioritize, monitor, and improve these implementations. In addition, successful implementations could be replicated elsewhere, and facilitators and barriers could be identified on an international scale. Finally, research that explores and measures the effectiveness of different components of support, and their contribution to the wellbeing of NQMs and their performance in practice, is also recommended. Across the whole midwifery profession, we recommend a longitudinal approach to gain insight into midwives’ wellbeing over time, and whether there are fluctuations in midwives’ wellbeing, and in their intentions to leave or to remain in the profession. With these data, trends in midwives’ wellbeing over time, and at different stages of their careers, can help provide more causal insights into determinants, help monitor recommended changes, and, hopefully, ultimately help build a more sustainable midwifery workforce, and identify new opportunities for interventions where needed. CONCLUSIONS For NQMs, the transition-into-practice in maternity care in the Netherlands is a big step from being a student to being a registered and responsible midwife in community and hospital environments. The community and the hospital each have their own workrelated challenges. In communities, NQMs mostly work as locum midwives, where they face the challenge of combining providing care with organizational and administrative tasks, mainly without the support of a fellow midwife. In hospitals, NQMs have to learn to manage several birthing suites, and to work partly autonomously and partly under the supervision of an obstetrician. NQMs need support from fellow midwives in both work
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