Promoting a sustainable midwifery workforce: Working towards ‘ecologies of practice’
Almost every research project I have undertaken, or been part of, in recent times has produced data from midwives that highlight their dissatisfaction with a work culture of cutting costs, maximizing outputs and meeting targets, and where there is no time to step back and reflect on practice (Deery 2008). Midwives, recently qualified and experienced, have also expressed dissatisfaction with working conditions (Ball et al. 2002; Deery and Fisher 2010), clinical support (Kirkham and Stapleton 2000; Deery 2005) and lack of resources (Deery 2009). Some of my recent clinical shifts have been spent with community midwives who said that they did not know how much longer they could keep going. Indeed, one of the midwives told me how she began to get palpitations when she was driving to work. As soon as the Health Centre became visible her anxiety levels rose and she began thinking ‘I’ve so much to do – I don’t know how I’ll get through the day’. As she was telling me this she was clutching her chest clearly despairing ‘of ever catching up or otherwise getting out from under the pressing burden of work’ (Lipsky 1980: 37).