Perceived job demands and resources of newly qualified midwives working in primary care settings in the Netherlands | 39 employment they enter into, when working in primary midwifery care; most have to work as a locum midwife for a considerable period of time. With the outcomes of this study, the professional organization of midwives is well positioned to start a discussion within the field of maternity care regarding the specific difficulties of being a locum NQM and the employment conditions Dutch primary care NQMs face in practice. Further studies using quantitative research designs can provide insight into the associations between different aspects and their effect on NQMs’ stress, work engagement and performance. Knowledge about NQMs’ work and personal characteristics can provide relevant information for building adequate support programs for NQMs which further enhances the quality of care provided by NQMs, and may also influence retention of NQMs to the profession. With the outcomes of this study, midwifery academies in the Netherlands and Belgium can better prepare their students for the period after graduation. They can align expectations of student midwives who are about to graduate about the kind of employment they are likely to face and the reality of working as a NQM in practice. The academies can facilitate students to acquire the necessary personal resources for practice, such as assertiveness, flexibility and sense of perspective. In collaboration with the professional organization of midwives, midwifery academies may facilitate NQMs through adequate support and training. CONCLUSIONS Dutch NQMs’ first years in primary midwifery care are perceived as highly demanding. NQMs often have to work as a locum self-employed midwife, fulfilling the sick and holiday leaves of other, more established, midwives. Job insecurity, a varying amount of working hours and working in different practices at a distance from their own homes characterise this type of self-employment. Working in different practices requires not only working with different client populations and autonomous decision-making, but also adaptation to different local arrangements. Dutch NQMs have to be competent in providing care, but on management/administrative tasks, they seem to be operating at the level of advanced beginners. NQMs’ first months after graduation are overwhelming: working and thinking about getting enough work. Building support systems may help NQMs find a balance between work and private life. Support from experienced midwives can play an important role in achieving this balance.
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