Midwives are increasingly confronted with social and economic hardship in the families they care for. One midwife gives an example: “The effectiveness of breastfeeding counselling is limited when the refrigerator is empty and the breastfeeding mother has nothing to eat at the weekends.”

The ZHAW study shows that making sure families are provided for and building appropriate support networks is very time-consuming for the midwives and requires a great deal of flexibility. Midwives respond to emergencies around the clock, seven days a week and spend many hours working on finding solutions. The leaders of the ZHAW study therefore find it all the more incomprehensible that this service is not recognised.

“This additional work is nowhere near covered by the flat rates paid for home visits. In this respect there is a difference between midwives and other professionals in early intervention, who are paid by the hour,” says Jessica Pehlke-Milde.

The health-promoting and preventative work of midwives is increasingly gaining in importance, as is the collaboration between midwives and professionals in the social sector. Midwives participate in various networks and work closely with parent counselling services. At the end of the postpartum care period, home visits are sometimes carried out with members of both professions in order to ensure the continuity of care and to maintain the families’ trust.

“However, there are grey areas where the work of the various care and service providers overlaps. All too often, collaboration is hampered by resentment between professions or ill-defined areas of responsibility,” says Pehlke-Milde. However, there are also many good examples of collaboration. In particular, midwives with strong networks appreciate the exchanges within their professional group and other networks, which they believe benefit the families and children they care for.

In order to provide competent care and support to socially disadvantaged families, midwives need to expand their range of care services, especially in the psychosocial area. This is why training and further education should integrate these requirements in their assessment, communication and network activities.

According to the ZHAW study, midwives working in cities provide care to many more socially disadvantaged families and have stronger networks. In rural areas, midwives are confronted with few cases that urgently require additional assistance, but in these cases mostly have no access to help at all. There is a lack of contacts and networks for families around the time of the birth.

“The period of time after the birth of a child can be challenging,” say the ZHAW researchers. This is why they recommend that parents who are overwhelmed or exhausted should have easy access to support and counselling services. Central points of contact for anonymous counselling which are open at all times, including weekends and holidays, could provide support for midwives and families in emergencies.