Changing times: why direct-entry midwives are re-training as Health Visitors and how this affects their professional identity

Abstract

In the wake of the Health Visitor Implementation Plan (HVIP) one county in Southern England noted an increasing number of direct-entry midwives leaving local maternity units to re-train as health visitors. The implications of this for workforce planning in both professions sparked an investigation into this phenomenon. The study aimed to explore reasons for re-training and how such midwives/health visitors viewed their professional identity. An online questionnaire was sent to all 37 midwives who had undergone health visitor training at the local University since the start of the HVIP in 2011. This was followed by a focus group and individual interviews. Full ethical approval was granted. Reasons for leaving midwifery centred on the over-stretched working environment leading to difficulty in maintaining client safety and unsupportive management systems. Other reasons included difficulty juggling family life with shift work and the lack of opportunities for career development. Specific reasons for becoming a health visitor included a desire to provide better continuity of care for clients within a safer working environment. Findings support earlier works on attrition from midwifery, however, this is the only study to date which has focused on direct-entry midwives moving to health visiting and suggests that urgent action is required to improve staffing levels and support if the midwifery profession is to retain this body of conscientious and highly-motivated professionals.