Community midwife caseloads and their effect on stress and performance. (16th November 2010)

• Record Type: Journal Article
• Authors: Cross-Sudworth, F; Williams, M; Bird, I; Gardosi, J
• Is Part Of: Archives of disease in childhood. Volume 95(2010)Supplement 1
• Page Start: Fa98
• Page End: Fa98
• Publication Date: 2010-11-16
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/adc.2010.189761.31
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Background: The majority of maternity care is provided in the community, yet there is little information regarding the workload, stress level and performance of the community midwife (CMW). Method: Survey of 278 CMWs serving six large maternity units with a total annual birth rate of ca. 35 000. Anonymous, semistructured questionnaires were used to obtain both quantitative and qualitative data. Results: 213 questionnaires were returned (response rate 77%). The average caseload of respondents was 154. High or very high stress levels were reported by 118 respondents (57%). They also tended to have long working days, with an additional 5 h worked per week. 97 (47%) were dissatisfied with support received from their own Trust. Many expressed difficulty in performing well, achieving only a suboptimal level of service for the women they were caring for: only 63 (31%) felt able to prepare women appropriately for birth and 113 (54%) thought that they were able to give sufficient support to breastfeeding mothers. Conclusion: CMWs appear to work under substantially high caseloads, which in this survey was more than 50% above the recommended level.1 This was associated with long working weeks, high stress levels and a feeling of insufficient support from the employing Trust. There was a wide perception by CMWs that the level of care they provided was suboptimal as a result. Quality maternity care requires better attention to appropriate workforce levels and support for midwives working in the community.