Table 2 Factors impacting mental health (from most to least Negative/Very Negative ratings)
From: A mixed-method study exploring barriers and facilitators to midwives’ mental health in Ontario
Factor | n | mean (SD) | % Negative or Very Negative | % Neutral | % Positive or Very Positive |
|---|---|---|---|---|---|
Other health professionals’ lack of understanding of midwifery (e.g., lack of understanding re: role, scope of practice, training) | 275 | 1.78 (0.7) | 89.1% | 9.1% | 1.8% |
The physical impact of stress resulting from midwifery | 274 | 1.90 (0.79) | 81.8% | 15.3% | 2.9% |
Ability to get adequate sleep | 275 | 1.88 (0.97) | 81.1% | 10.2% | 8.7% |
Midwifery’s work-life balance | 275 | 1.88 (0.9) | 80.4% | 12.4% | 7.3% |
Ability to maintain healthy eating habits | 274 | 1.99 (0.96) | 79.6% | 10.6% | 9.9% |
Comfort with level of preparation upon graduation for running a business | 274 | 1.98 (0.77) | 74.8% | 23.4% | 1.8% |
Time available for exercise | 274 | 2.06 (0.98) | 74.5% | 15.7% | 9.9% |
Midwifery’s on-call schedule | 274 | 2.23 (0.94) | 66.1% | 23.7% | 10.2% |
Power dynamics within midwifery practice groups | 272 | 2.12 (0.99) | 64.3% | 27.2% | 8.5% |
Ability to maintain social relationships outside of work | 274 | 2.35 (1.04) | 61.7% | 22.6% | 15.7% |
Flexibility of the midwifery model of care | 275 | 2.32 (1.1) | 61.5% | 19.3% | 19.3% |
Level of preparation upon graduation for the nonclinical aspects of the midwifery profession (e.g., business, interpersonal, etc.) | 275 | 2.39 (0.82) | 58.9% | 33.1% | 8.0% |
Availability of time off/support to deal with illness | 275 | 2.34 (1.14) | 58.2% | 22.6% | 19.3% |
Level of compensation for work performed | 275 | 2.55 (1.03) | 56.7% | 21.5% | 21.8% |
Lack of accountability of midwifery practice groups/practice partners | 274 | 2.26 (0.99) | 54.7% | 38.3% | 6.9% |
Bullying within midwifery practice groups | 273 | 2.27 (0.96) | 54.6% | 38.5% | 7.0% |
Availability of time off/support following difficult or traumatic events | 273 | 2.52 (1.18) | 52.4% | 21.6% | 26.0% |
Level of mental health support at work | 274 | 2.48 (0.96) | 51.1% | 34.7% | 14.2% |
Payment structure of the midwifery profession | 275 | 2.68 (1.06) | 48.0% | 26.2% | 25.8% |
Ability to maintain relationships at home | 275 | 2.66 (1.03) | 47.6% | 29.5% | 22.9% |
Difficulty filling positions/retention within midwifery practice groups | 275 | 2.51 (0.81) | 44.0% | 49.5% | 6.6% |
Expectations from clients | 274 | 2.69 (0.84) | 43.8% | 40.2% | 16.1% |
Physical nature of midwifery work | 275 | 2.73 (0.95) | 41.1% | 37.1% | 21.8% |
My level of decision-making power/autonomy within my midwifery practice group | 273 | 2.96 (1.2) | 38.1% | 22.3% | 39.6% |
Opportunity for time off | 275 | 2.97 (1.16) | 37.1% | 22.2% | 40.7% |
Differing philosophies within midwifery practice groups | 275 | 2.68 (0.81) | 36.7% | 51.3% | 12.0% |
Relationships with consultants | 275 | 2.97 (1.03) | 35.3% | 27.6% | 37.1% |
Clients’ lack of understanding of midwifery (e.g., lack of understanding re: role, scope of practice, training) | 275 | 2.70 (0.68) | 35.3% | 57.5% | 7.3% |
Relationships with hospital nursing staff | 273 | 3.03 (1.08) | 35.2% | 22.3% | 42.5% |
Job security in the midwifery profession | 274 | 3.13 (1.21) | 34.3% | 17.9% | 47.8% |
My level of agency regarding my career path/goals | 274 | 3.00 (1.07) | 33.6% | 30.7% | 35.8% |
Relationships with hospital administration | 275 | 2.92 (0.98) | 33.1% | 34.9% | 32.0% |
Requirements to work to the full scope of practice (e.g., epidurals, induction of labour) | 275 | 2.91 (0.91) | 30.6% | 46.2% | 23.3% |
Transitioning from a student to a new registrant position | 275 | 3.14 (0.98) | 30.2% | 29.1% | 40.7% |
My level of agency within my practice group | 272 | 3.08 (1.13) | 29.8% | 27.2% | 43.0% |
Ease of obtaining hospital privileges | 273 | 2.94 (1.02) | 28.9% | 42.5% | 28.6% |
Restrictions on ability to work to the full scope of practice (e.g., epidurals, induction of labour) | 273 | 2.82 (0.82) | 27.5% | 58.2% | 14.3% |
Broadening of the ways in which midwives can work (e.g., Expanded Midwifery Care Models) | 274 | 3.16 (1.04) | 22.6% | 37.6% | 39.8% |
Level of support at home | 275 | 3.66 (1.07) | 18.2% | 15.6% | 66.2% |
Increased utilization of delegation from other healthcare providers (e.g., medical directives from physicians to prescribe substances not in the midwife’s pharmacopeia) | 275 | 3.20 (0.86) | 16.4% | 47.6% | 36.0% |