• Stine Sofie Bernd Bille
4. semester, Læring og Forandringsprocesser, Kandidat (Kandidatuddannelse)
This thesis examines in a qualitative investigation, how midwives experience different dilemmas in their practical work. Build on a dilemma-based dialogic method, the aim has been to create insight in the midwives’ experienced challenges, to be able by extension to discuss possible retention considerations.

An important aspect for the investigation has been to involve the midwives throughout the project. For that reason, the empirical material has been gathered by informal conversations, questionnaires, interviews and my concept “Dilemma-Dialogue”. Dilemma-Dialogue is inspired by Peter Hagedorn-Rasmussen’s et al. methodology dilemma thinking, and thereby also the action research tradition. The intention has been, besides creating increased insight into the midwives’ experienced dilemmas, to create an opportunity for the midwives, through dialogue with each other, to seek to break a social tendency to turn the difficult feelings in connection with dilemmas inwards. In this way, by forming the foundation for a more collective approach to the challenges in the midwives' practice, the method could perhaps thus help to push the pronounced individualization tendencies, that are evident in what Anders Petersen terms the achievement society. The theoretical inspirations of the thesis are based on critical theory and constitute, in addition to Anders Petersen’s work on the achievement society, aspects from respectively Jürgen Habermas's theory of system and lifeworld and Hartmut Rosa's understanding of social acceleration.

The analysis itself is inspired by a rhizomatic form of analysis, and contains three readings of the empirical evidence, each with their own focused section. The first reading clarifies how midwives experience being in a dilemma between living up to their understanding of midwifery and at the same time navigating the efficiency of time and tasks. In the second reading, it becomes clear that the function of the maternity ward both as a healthcare offer for pregnant women, but equally as an educational context for midwifery students, contributes to put the trained midwife in dilemmas where she must navigate between the two functions of the maternity ward. In the third reading, it becomes clear that especially newly educated midwives may tend to turn the difficult feelings that can arise inward, when faced with dilemmas at work. It becomes clear that there may be a tendency towards an individualized approach to the challenges. There is no clear answer to whether increased dialogue on maternity wards can be a method to de-individualize the midwives' experiences and instead create a more collective view of the challenges. Dialogue requires time and co-influence if it is to lead to change from the midwives' perspective. Two elements that the midwives already feel there is too little of in their daily work.

Fundamentally, things such as: increased resources, better pay and greater influence on the organization of the work will probably contribute to better well-being among the employees in the maternity wards, thereby increasing the likelihood that the midwives will stay in their employment. In addition, it would be beneficial to take a closer look at the midwives' area of responsibility. By combining the midwives' employment so that they could develop within their entire area of responsibility, for example through the Kendt Jordemoderordning arrangement, you could probably help create a more balanced work life and reduce the risk of burnout. In addition, it is advantageous to take a closer look at the prerequisites for midwifery education. Presumably, a more collective approach to the challenges experienced on the maternity wards will also contribute to the midwives not turning the difficult feelings inwards to the same extend. In the dialogue with colleagues and management experienced dilemmas might be seen as an expression of structural circumstances. This could ease the sense of responsibility and the moral stress that can lead to the midwives ultimately being forced to leave their jobs. The fight for better conditions for midwives is better fought together.

This thesis can be regarded as an exemplary study of the challenges a care profession can face in modern society, and where the public sector has difficulty retaining staff. To maintain a high professional level within the care professions in the future, we should take a closer look at how we ensure a good working environment from a societal perspective.
Antal sider59
ID: 544224592