Et meningsfuldt og udfordrende arbejde: Et kvalitativt studie om hvad der konstituerer kendt jordemoder og hvordan jordemødre oplever at arbejde som kendt jordemoder

Objective: to investigate how midwives experience caseload midwifery and what constitutes this model of care seen from the midwives’ perspective.
Design and setting: Phenomenology of practice was the analytical approach to this qualitative study of caseload midwifery in Northern Denmark. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews.

Participants: Thirteen out of eighteen midwives working in caseloads were observed during one or two days in the antenatal clinic and interviewed at a later occasion.


Findings: The recognition and the feeling of doing high quality care generate job satisfaction.
The obligation and pressure to perform well and the disadvantages on the midwives’ private lives is counterbalanced by the feeling of doing a meaningful and important job.
Working in caseload midwifery creates a feeling of working in a self-governing model within the public hospital, without losing the technological benefits of a modern birth unit.
For pregnant women with a challenging personality or attitude towards others, Caseload midwifery may provide an extra opportunity to feel recognized and respected.

Key conclusions: Caseload midwifery is a work form with an embedded and inevitable commitment and obligation that brings forward the midwife’s desire to do her utmost and in return receive appreciation, social recognition and a meaningful job with great job satisfaction.
There is a balance between the advantages of a meaningful job and the disadvantages for the personal life of the midwife, but benefits were found to outweigh disadvantages


Implications for practice
Caseload midwifery should be expanded. In expanding this model of care, it is necessary to understand that the midwives’ personal lives need to be prepared for this work-form. The number of women per full time midwife, as well as the succession rate, has to be surveilled as job-satisfaction is dependent on the midwives’ capability of still fulfilling expectations.