Italian midwives in Europe: a qualitative study on the experiences of professional migration
Keywords:
Midwifery, Midwives, human migration, professional autonomy, qualitative researchAbstract
Aim. To explore the reasons for Italian midwives’ decision to migrate, and their lived professional and emotional experiences.
Methods. A descriptive phenomenological study was conducted recruiting Italian midwives who were working abroad in European countries. We offered a telephone or web interview. Two researchers conducted, audio-recorded, and fully transcribed the interviews and other two researchers, independently, performed a content analysis.
Results. Thirty-two midwives having professional experiences in the UK, Ireland, Germany, Switzerland, and Spain were interviewed. Five themes emerged: 1) Education, 2) Migration decision-making, 3) Professional experience abroad, 4) Midwives’ perceptions of their role, 5) Satisfaction versus desire to return. Our findings show a general dissatisfaction with Italian job opportunities in terms both of access to employment and work conditions. This scenario is complicated by the status of the professional midwifery in Italy.
Conclusion. Stakeholders should ensure that the migration of Italian midwives is not synonymous with dispersion but is a channel of professional growth and mutual exchange.
References
1. World Health Organization (WHO). Global strategy on human resources for health: Workforce 2030. Geneva: WHO, 2016.
2. Federazione Nazionale degli Ordini della Professione Ostetrica (FNOPO). Le ostetriche italiane che migrano all’estero. Lucina 2018; 3: 34.
3. Abdul-Mumin KH. The process of internationalization of the nursing and midwifery curriculum: A qualitative study. Nurse Educ Today 2016 Nov; 46: 139-45. doi: 10.1016/j. nedt.2016.09.003. Epub 2016 Sep 16.
4. Comitato Unitario Permanente degli Ordini e Collegi Professionali. Secondo Rapporto sulle Professioni Regolamentate in Italia: numeri, dimensioni, tendenze, cambiamento. Rome: Cresme Ricerche, 2016.
5. Colaceci S, Cicero RV, Giorgini G, et al. Italian midwives’ education needs analysis on essential competencies for childbirth care: A cross-sectional study. Midwifery 2021 Dec; 103: 103147. doi: 10.1016/j.midw.2021.103147. Epub 2021 Sep 15.
6. Mastrillo A. Corsi di Laurea delle Professioni Sanitarie. Dati sull’accesso ai corsi e programmazione posti nell’A.A. 2020-21. 2020.
7. Ahmad OB. Brain drain: the flight of human capital. Bull World Health Organ. 2004 Oct; 82(10): 797-8. Available on: https://apps.who. int/iris/handle/10665/269265 [Last accessed: 2022 April 20].
8. Deasy C, O Loughlin C, Markey K, et al. Effective workforce planning: Understanding finalyear nursing and midwifery students’ intentions to migrate after graduation. J Nurs Manag. 2021 Mar; 29(2): 220-8. doi: 10.1111/jonm.13143. Epub 2020 Sep 22.
9. Sundler AJ, Lindberg E, Nilsson C, Palmér L. . Qualitative thematic analysis based on descriptive phenomenology. Nurs Open 2019 Apr 7; 6(3): 733-9. doi: 10.1002/nop2.275.
10. Kirchherr J, Charles K. Enhancing the sample diversity of snowball samples: Recommendations from a research project on anti-dam movements in Southeast Asia. PLoS One 2018 Aug 22; 13(8): e0201710. doi: 10.1371/journal. pone.0201710.
11. Marshall B, Cardon P, Poddar A, Fontenot R. Does Sample Size Matter in Qualitative Research? A Review of Qualitative Interviews in is Research. J Computer Information Systems. 2013; 54(1): 11-22.doi: 10.1080/08874417.2013.11645667.
12. Krueger R, Casey MA. Focus group: a practical guide for applied research. 4th ed. Thousand Oaks: SAGE, 2009, p. 216.
13. Edward K, Welch T. The extension of Colaizzi’s method of phenomenological enquiry. Contemp Nurse. 2011 Oct; 39(2): 163-71. doi: 10.5172/ conu.2011.163.
14. Tufford L, Newman P. Bracketing in Qualitative Research. Qual Soc Work. 2012; 11(1): 80-96. doi:10.1177/1473325010368316.
15. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 Dec; 19(6): 349-57. Epub 2007 Sep 14.
16. Cull J, Hunter B, Henley J, et al. “Overwhelmed and out of my depth”: Responses from early career midwives in the United Kingdom to the Work, Health and Emotional Lives of Midwives study. Women Birth 2020 Nov; 33(6): e549e557. doi: 10.1016/j.wombi.2020.01.003. Epub 2020 Jan 21.
17. Pawlak M. Ways of walking, speaking and listening: Nursing practices and professional identities among Polish nurses in Norway. Nurs Inq. 2021 Dec; 28(4): e12418. doi: 10.1111/nin.12418. Epub 2021 May 7.
18. Bloxsome D, Bayes S, Ireson D. “I love being a midwife; it’s who I am”: A Glaserian Grounded Theory Study of why midwives stay in midwifery. J Clin Nurs 2020 Jan; 29(1-2): 208-220.
doi: 10.1111/jocn.15078. Epub 2019 Nov 10.
19. Spina E. La professione ostetrica: mutamenti e nuove prospettive. Cambio: rivista sulle trasformazioni sociali. 2014; 4 (7): 53-63. https://doi. org/10.13128/cambio-19233.
20. Ministry of Health. Certificato di assistenza al parto (CeDAP) Analisi dell’evento nascita - Anno 2020. 2021.
21. Zanardo V, Tortora D, Sandri A, Severino L, Mesirca P, Straface G. COVID-19 pandemic: Impact on gestational diabetes mellitus prevalence. Diabetes Res Clin Pract. 2022 Jan; 183: 109149. doi: 10.1016/j.diabres.2021.109149. Epub 2021 Nov 19.
22. Kahveci B, Melekoglu R, Evruke IC, Cetin C. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth. 2018 Aug 22; 18(1): 343.
https://doi.org/10.1186/s12884-018-1984-x.
23. Giusti A, Maggini M, Colaceci S. The burden of chronic diseases across Europe: what policies and programs to address diabetes? A SWOT analysis. Health Res Policy Syst. 2020 Jan 29; 18(1): 12. doi: 10.1186/s12961-019-0523-1.
24. Giovannini N, Cetera GE, Ercolino C, et al. MYNd&CO (Mindfulness, Yoga, Nutrition, development & Coaching, and Osteopathy) randomized controlled trial for a positive psychophysical experience in pregnancy and after birth: a study protocol. Acta Biomed 2021; 92(S2):
e2021032. doi: 10.23750/abm.v92iS2.11259.
25. Colaceci S, Chapin EM, Zambri F, et al. Verba volant, scripta manent: breastfeeding information and health messages provided to parents in the neonatal discharge summary in the Lazio Region, Italy. Ann Ist Super Sanita. 2020 Apr-Jun; 56(2): 1429. doi: 10.4415/ANN_20_02_03.
26. Cernigliaro A, Palmeri S, Casuccio A, Scondotto S, Restivo V; In Primis Working Group. Association of the Individual and Context Inequalities on the Breastfeeding: A Study from the Sicily Region. Int J Environ Res Public Health. 2019 Sep 20; 16(19): 3514. doi: 10.3390/ ijerph16193514.
27. Dell’Omodarme C, Bocci G, Troiano G, et all. Midwives in England and in Italy: two realities compared. Ann Ig. 2018 Jan-Feb; 30(1): 14-20. doi: 10.7416/ai.2018.2191.
28. Shojaeimotlagh V, Valizadeh S, Hasankhani H, Bozorgomid A. Psychological Needs, Satisfaction and Intention to Migrate in Iranian Nurses: A Qualitative Content Analysis. Iran J Public Health 2018 Aug; 47(8): 1201-8.
29. Anderson G, Zega M, D’Agostino F, et al. MetaSynthesis of the Needs of Women Cared for by Midwives During Childbirth in Hospitals. J Obstet Gynecol Neonatal Nurs 2021 Jan; 50(1): 6-19. doi: 10.1016/j.jogn.2020.10.005. Epub 2020 Nov 17.
30. Colaceci S, Corsi E, Berardi F, Coscarella P, Mariotti M, Ramacciati N. Soddisfazione materna ed evento nascita: una web-based survey [Maternal satisfaction and birth: a web-based survey]. Prof Inferm. 2020 Jun-Sep; 73(3): 181-7. Italian. doi: 10.7429/pi.2020.733181.
31. Massimi A, Marzuillo C, Di Muzio M,et al. Quality and relevance of master degree education for the professional development of nurses and midwives. Nurse Educ Today. 2017 Jun; 53: 54-60. doi: 10.1016/j.nedt.2017.04.012. Epub 2017 Apr 14.
32. Stokes F, Iskander R. Human Rights and Bioethical Considerations of Global Nurse Migration. J Bioeth Inq. 2021 Sep; 18(3): 429-39. doi:
10.1007/s11673-021-10110-6. Epub 2021 Jul 5.
33. Bloxsome D, Ireson D, Doleman G, Bayes S. Factors associated with midwives’ job satisfaction and intention to stay in the profession: An integrative review. J Clin Nurs 2019 Feb; 28 (3-4): 386-99.
doi: 10.1111/jocn.14651. Epub 2018 Sep 4.
34. Federazione Nazionale degli Ordini della Professione Ostetrica (FNOPO). Ostetrica di famiglia e di comunità. ‘Sentinelle’ della salute Bio- psico-sociale dell’universo donna e famiglia. 2020. Available on: http://www.fnopo.it/custom/ fnopo/writable/news/fnopo%202020%20modello%20ostetrica%20famiglia%20comunita’. pdf [Last accessed: 2022 April 20].
35. Ministry of Health. Linee di indirizzo per la definizione e l’organizzazione dell’assistenza in autonomia da parte delle ostetriche alle gravidanze a basso rischio ostetrico (BRO). 2017. Available on: http://www.salute.gov.it/ imgs/C_17_pubblicazioni_2836_allegato.pdf [Last accessed: 2022 April 20].
36. Siyam A, Zurn P, Rø, OC, et al. Monitoring the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel. Bull World Health Organ. 2013 Nov 1; 91(11): 816-23. doi: 10.2471/BLT.13.118778.
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