CHANGES IN MIDWIVES ATTITUDES TO THEIR PROFESSIONAL-ROLE FOLLOWING THE IMPLEMENTATION OF THE MIDWIFERY DEVELOPMENT UNIT

Objective: to examine changes in midwives' attitudes to their professi onal role following the implementation of the midwifery development un it (MDU). Design: prospective cohort study. Setting: the MDU is based at a major teaching hospital in Glasgow, UK. The MDU midwives provide care via a new self-rostering system which is intended to improve cont inuity of care, Midwives aim to provide total care for each woman from the antenatal period through delivery and the postnatal period, Parti cipants: 21 midwives who joined the MDU were compared with a group of 64 midwives at the hospital who were also eligible and who continued i n their usual pattern of work (non-MDU midwives). Measurements: an aud it questionnaire was distributed to MDU and non-MDU midwives prior to the implementation of the unit and about is months afterwards. In addi tion, the MDU midwives were sent the questionnaire every three months. Extra questions were added dt each time period in order to identify s pecific problems, This information was then fed back to the midwifery management team to aid in the planning and implementation of the care programme. Findings: the MDU midwives experienced a significant positi ve change in attitudes; no significant change was evident for the non- MDU group. There was no evidence of increased stress in the MDU midwiv es. In general, both groups of midwives had positive attitudes towards the unit and felt that MDU-style care had a role to play in the futur e provision of maternity care. A number of areas of concern were also highlighted, such as the system of liaison with colleagues.Conclusions : innovative models of midwifery care such as an MDU can have a positi ve impact on midwives' attitudes towards their professional role. Impl ications for Practice: if change is managed in a systematic manner whi ch involves the midwives, it may be possible to increase midwives' pro fessional satisfaction, while at the same time minimising any negative effects such as increased stress.