54 | Chapter 3 make choices that you think would not have been necessary. So that in particular - and even more so at night when you are alone in the delivery room.’ (P3 ) Providing care for women Working with women in mid- and high-risk care confronted NQMs with new challenges. Women with specific needs, specific socioeconomic- and cultural backgrounds or mental and psychiatric disabilities required effort and experience, which participants reported as lacking. ‘… about the ethical things that I sometimes find difficult. We have a large refugee center nearby and we sometimes have difficulties with people from a different culture who want different things. Partners with different opinions about pregnancy and birth. Once I felt enormously threatened by a partner, because I did not work like the midwives act [in their country of origin]. And those are tricky things… We really learned it differently from how they want it. Yes, and then you do want to go a bit with the culture, but yes, you naturally also want to continue to do medically responsible things.’ (P4) Job insecurity NQMs mentioned the type of employment during their first year in practice as challenging, such as flexible or temporary contracts. These types of employment were perceived by NQMs as insecure. NQMs sometimes felt like a conditional team member: they had to prove themselves as a hospital-based midwife in a short timeframe. ‘I now increasingly have the end date in my mind… I'm still looking at other job vacancies. Yes, because they cannot give me clarity yet. That feels … quite annoying because I really feel like I am a part of this team ... and then you are confronted with the fact that you do not have a permanent contract yet.’ (P2) Job resources Important job resources, according to the participants were: working in a team; working with women; variety of the work; and employment conditions. Working in a team NQMs work as members of multidisciplinary teams with obstetric nurses, pediatricians and obstetricians. Teamwork provides NQMs with possibilities for collaboration and provides them with company during shifts and breaks. Shared tasks and responsibilities and the opportunity to delegate tasks to other team members were seen as important job resources.
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