Voices of Midwives working in Family Physician Program Regarding Their Challenges and Blessings: A Qualitative Study

Background aim: Midwives, as a part of the healthcare team, have a remarkable role in providing health to families and societies. Midwives have a prominent role in the family physician plan (FPP); therefore, the lack of proper attention to their challenges results in a decline in their efficiency and quality of care. Therefore, this study was performed with the aim of investigating the midwives’ perceptions and experiences about the challenges of working in the FPP. Methods: This qualitative study was conducted on 23 midwives recruited in the healthcare centers of Mashhad, Iran, in 2015. The study population was selected using the purposive sampling technique. Data collection was performed through semi-structured in-depth interviews. The interviews were transcribed verbatim and analyzed using conventional content analysis approach. The trustworthiness of the research findings was checked with the evaluative criteria developed by Lincoln and Guba. Results: The analysis of the data led to the extraction of two themes, namely professional struggles and internal reflection, each of which was further divided into several categories and subcategories. Professional struggles included such subcategories as professional autonomy (challenges related to the referral system and challenges related to insurance), professional role ambiguity (professional imposed conditions, professional incardination, Distortion of trust in midwives), professional commitment (affective commitment, continuing commitment), internal challenges (destruction of preconceived, insufficient motivation, stressors) and internal satisfaction (welfare satisfaction, environmental satisfaction, organizational satisfaction, serving the women). Conclusion: As the findings of the present study indicated, listening to the voices of midwives provided vital information about their challenges and blessings. These results can provide valuable guidelines for the managers to recognize the challenges of midwives in the FPP and plan for solving their organizational problems to enhance their efficiency in the fulfillment of organizational goals.