There is a severe global shortage of midwives, and the situation worsens when qualified professionals leave their jobs because of inadequate working conditions. Hospitals have increasing difficulties in filling vacancies for midwives. In the case of Germany, midwives tend to give up birth assistance after an average of seven years working in delivery rooms, which are usually led by physicians. We aim to provide concrete recommendations on encouraging qualified professionals to work in maternity wards by examining the job preferences of midwives who currently do not provide such services. These insights shall help policy makers and hospital managers to fill vacancies more quickly and provide adequate care to more women. Discrete choice experiment. Online survey promoted through email and social media to midwives in Germany. 415 midwives participated; we examine the subgroup of 241 midwives who do not offer birth assistance. We obtain individual parameter estimates through a multinominal logit analysis with hierarchical Bayes estimation techniques, calculate importance weights, and simulate uptake probabilities of different hypothetical job offers that include birth assistance. Participants want to provide birth assistance but fiercely reject doing so under physicians' supervision. With a 15 % increase in income, however, 16 % would accept this least preferred setting. Forty-four percent, however, would choose to offer birth assistance if they could work in a midwife-led unit. An additional increase in income of 5 % (15 %) could even lead to uptake probabilities of 67 % (77 %). There is a common understanding that midwife-led care is a safe and effective option for healthy women. Policy makers are advised to further extend their initial support for such units to fill vacancies quicker and enable comprehensive healthcare for more childbearing women. Midwife-led units help counter shortages: Midwives want to provide birth assistance but reject doing so under physicians' supervision.

中文翻译：

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让助产士返回医院：一项离散选择实验


全球助产士严重短缺，当合格的专业人员因工作条件不足而离职时，情况会变得更糟。医院在填补助产士空缺方面越来越困难。以德国为例，助产士在产房平均工作七年后往往会放弃分娩援助，而产房通常由医生领导。我们的目标是通过研究目前不提供此类服务的助产士的工作偏好，为鼓励合格的专业人员到产房工作提供具体建议。这些见解将有助于政策制定者和医院管理人员更快地填补空缺，并为更多女性提供足够的护理。离散选择实验。通过电子邮件和社交媒体向德国助产士推广在线调查。 415名助产士参加；我们对不提供分娩援助的 241 名助产士进行了调查。我们通过采用分层贝叶斯估计技术的多项 Logit 分析获得个体参数估计，计算重要性权重，并模拟包括助产在内的不同假设工作机会的接受概率。参与者希望提供分娩帮助，但在医生的监督下强烈拒绝这样做。然而，随着收入增加 15%，16% 的人会接受这种最不喜欢的环境。然而，如果可以在助产士领导的单位工作，百分之四十四的人会选择提供生育援助。收入额外增加 5% (15%) 甚至可能导致采用概率达到 67% (77%)。人们普遍认为，助产士主导的护理对于健康女性来说是一种安全有效的选择。 建议政策制定者进一步扩大对此类单位的初步支持，以更快地填补空缺，并为更多育龄妇女提供全面的医疗保健。助产士领导的单位帮助应对短缺：助产士希望提供分娩援助，但拒绝在医生的监督下这样做。