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CONFERENCE PROCEEDING
Midwives need autonomy to thrive: Cross-country survey links low workplace decision latitude to high stress and attrition
1
Charite Universitätsmedizin Berlin, Institut of Midwifery, Berlin, Germany
2
Trinity College Dublin- the University of Dublin, School of Nursing and Midwifery, Dublin, Ireland
3
University of Akureyri, School of Health- Business and Natural Sciences-Faculty of Nursing, Akureyri, Iceland
4
University College Cork, School of Nursing and Midwifery, Cork, Ireland
Eur J Midwifery 2026;10(Supplement 1):A574
ABSTRACT
BACKGROUND:
Autonomy in decision-making is a critical factor contributing to midwives' professional satisfaction (Moran et al., 2023; Ball et al., 2002; Hunter, 2014). According to the Job Demand-Control Model (JDCM), higher levels of workplace autonomy can mitigate the negative effects of job-related stress. Despite its significance, autonomy is insufficiently captured in current assessments of midwives’ working conditions (Wangler et al., 2021).
OBJECTIVES:
The objective of this study was to examine the relationship between workplace autonomy and stress in a sample of European midwives.
METHODS:
Design: A descriptive, cross-sectional study design was employed. Participants: Midwives from Germany, the United Kingdom, Iceland, and Ireland were recruited through social media platforms to complete an online survey. Measures: Workplace autonomy was measured using the Decision Latitude subscale of the Job Content Questionnaire (JCQ), while workplace stress was assessed via the Psychological Demands subscale. The presence and severity of posttraumatic stress disorder (PTSD) symptoms were evaluated using the PTSD Symptom Scale – Self-Report (PSS-SR).
RESULTS:
463 midwives participated in the survey (Germany: n = 259; UK: n = 46; Iceland: n = 43; Ireland: n = 115). Low decision latitude was significantly associated with higher levels of both workplace psychological stress (p = 0.001) and traumatic stress (p = 0.001). Midwives reporting low decision latitude were more than 2.5 times as likely to express an intention to leave the profession (OR = 2.6; 95% CI: 1.7–4.0).
CONCLUSIONS:
These findings highlight the critical role of workplace autonomy in mitigating psychological and traumatic stress among midwives. Low decision latitude not only contributes to increased stress levels but also significantly elevates the risk of workforce attrition.
KEY MESSAGE:
Enhancing decision-making autonomy may be a key strategy for improving midwives’ occupational wellbeing and retention. International efforts to improve maternity care must prioritize models of care that enable high levels of workplace autonomy for midwives. Poster session 2 (Group A)
Autonomy in decision-making is a critical factor contributing to midwives' professional satisfaction (Moran et al., 2023; Ball et al., 2002; Hunter, 2014). According to the Job Demand-Control Model (JDCM), higher levels of workplace autonomy can mitigate the negative effects of job-related stress. Despite its significance, autonomy is insufficiently captured in current assessments of midwives’ working conditions (Wangler et al., 2021).
OBJECTIVES:
The objective of this study was to examine the relationship between workplace autonomy and stress in a sample of European midwives.
METHODS:
Design: A descriptive, cross-sectional study design was employed. Participants: Midwives from Germany, the United Kingdom, Iceland, and Ireland were recruited through social media platforms to complete an online survey. Measures: Workplace autonomy was measured using the Decision Latitude subscale of the Job Content Questionnaire (JCQ), while workplace stress was assessed via the Psychological Demands subscale. The presence and severity of posttraumatic stress disorder (PTSD) symptoms were evaluated using the PTSD Symptom Scale – Self-Report (PSS-SR).
RESULTS:
463 midwives participated in the survey (Germany: n = 259; UK: n = 46; Iceland: n = 43; Ireland: n = 115). Low decision latitude was significantly associated with higher levels of both workplace psychological stress (p = 0.001) and traumatic stress (p = 0.001). Midwives reporting low decision latitude were more than 2.5 times as likely to express an intention to leave the profession (OR = 2.6; 95% CI: 1.7–4.0).
CONCLUSIONS:
These findings highlight the critical role of workplace autonomy in mitigating psychological and traumatic stress among midwives. Low decision latitude not only contributes to increased stress levels but also significantly elevates the risk of workforce attrition.
KEY MESSAGE:
Enhancing decision-making autonomy may be a key strategy for improving midwives’ occupational wellbeing and retention. International efforts to improve maternity care must prioritize models of care that enable high levels of workplace autonomy for midwives. Poster session 2 (Group A)
| eISSN: | 2585-2906 |
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