The early postpartum period is a critical time for first-time parents as they adapt to their new role. Perceived lack of social support is a risk factor for developing mental health problems. Insufficient or inappropriate professional support for both parents has been reported by many studies. Social support that appropriately meets parents' needs is an important protective factor for parents' wellbeing; however, little is known about the social support needs of both first-time parents.To describe both first-time parents' formal social support needs in the early postpartum period.Individual semi-structured interviews were conducted with first-time parents recruited on the postpartum ward of a Swiss university hospital. Thematic analysis was used to identify themes and sub-themes.Fifteen mothers and eleven fathers were interviewed. Twelve themes were identified. Mothers' themes were “experiencing postpartum changes,” “creation of a family unit,” “self-esteem,” “emotional needs,” “difficulty in communicating their needs,” and “the postpartum stay.” Fathers' themes were “to be included in care procedures on the postpartum ward,” “to be reassured,” “to anticipate their postpartum stay” and “to consider their need as non-priority.” Parental shared needs were: “to care for their newborn,” and “returning home.”Mothers' and fathers' needs differed. Mothers needed more emotional support than fathers and fathers considered themselves as the main support for their partner. Fathers wanted to be integrated in the care of their newborn. Transition to parenthood is a challenging time, especially for first time mothers and fathers –3 who haRisk factors contributing to maternal and paternal PMAD, such as CB-PTSD and/or depression include a history of mental illness, being primipara, operative birth/having complications during birth, negative subjective experience of birth , 17–19, Social support is a reciprocal exchange of resources or activities between at least two individuals, aiming to improve the health and wellbeing of the person receiving it. There are two sources of support: formal [healthcare providers (HCPs)] and informal , although most studies so far have not clearly distinguished these two types –23. BothEvidence shows that parents are often not satisfied with the formal social support they received in postpartum care , 35, 36,In summary, formal social support is important in the postpartum period, especially for first-time parents. Given the lack of distinction of formal and informal social support in previous studies, further research is needed to better understand both mothers' and fathers' formal social support needs during this particularly vulnerable period . This maThe objective of this study was to describe first-time parents' perceived formal social support needs in the early postpartum period.A qualitative descriptive study design using a phenomenological approach was used, as it is most suited to describing personal experiences of an event or situation . This apParticipants were recruited on two postpartum wards (one with single rooms and one with double rooms) of a Swiss University Hospital from June to September 2021. Purposive sampling was used, based on the following inclusion criteria: (a) primiparous women (over 18 years of age), and who gave birth to a healthy full-term newborn  by cesarean section or vaginal birth; and/or (b) their partner who is parent for the first time, over 18 years of age, was present during birth, and stayed on the postpartum ward. Exclusion criteria for both parents included insufficient knowledge of French, child's admission to the Neonatal Intensive Care Unit (NICU), stillbirth, or death of their child within the 24 h post-delivery. Due to information power and methodological guidance, we planned to recruit ~15 mothers and 15 fathers , 47. Parvia a secure online “face-to-face” platform (ZOOM). Interviews were held online for 57% of participants. Interviews were recorded using a separate digital recording device to safeguard confidentiality and subsequently transcribed verbatim. As little is known about formal social support needs of first-time parents in the early postpartum period, an interview guide with open-ended questions . Written informed consent was obtained from all participants. Transcripts were anonymised prior to data analysis. All audio-recordings were destroyed immediately after transcription. In order to protect participants' confidentiality, fictional codes were used to represent mothers and fathers quotes in the article. For example, F7 in the quotes represents participant seven of the fathers.Fifteen mothers and eleven partners who identified themselves as fathers participated, including eleven couples and four mothers participating alone. No same-sex couple took part in this study. All participants were employed (on maternity or paternity leave) when participating in the study. Every participant had a health insurance as it is mandatory in Switzerland. Regarding the participants' origin, the majority were Swiss. European participants were from Western Europe. Non-European participants were from Brazil, Indonesia and Senegal. n = 6): “experiencing postpartum changes,” “emotional needs,” “creating a family unit,” “self-esteem,” “difficulty in communicating their needs” and “postpartum stay,” fathers' needs (n = 4): “to be integrated during the postpartum stay,” “to be reassured,” “to anticipate their postpartum stay” and “to consider themselves as non-priority,” and shared parental needs (n = 2): “to care for their newborn” and “returning home.” N = 29) with illustrative verbatims.In total, 12 themes were identified and classified into three categories: mothers' needs  tear. For me it was really problematic [...]the biggest difficulty for me was 'this body'.” (M1)“They expressed various needs regarding breastfeeding. They wanted to have information on how to proceed , what it may imply for their body  and for their relationship with their newborn.I had a lot of questions regarding breastfeeding in fact. Because it was my first time and I didn't know exactly what to do.” (M14)“They also needed that HCPs recognized and acknowledged the normality of the particular mental state they were in.I'm telling you the first 48 h, just after the birth, […] I wasn't really there, I didn't realize. And then so I don't know, it was quite strange.”(M5)“After birth, mothers experienced an emotional roller coaster, including joy, fear, and sadness. They needed HCPs to acknowledge their emotions by reassuring them as often as required. Mothers reported being supported emotionally was important. They mentioned HCPs' caring, active listening, and use of reassuring words had a comforting effect.It's true that the caring after the violence of childbirth is just ultra-comforting and ultra-necessary. Because you're immersed in something completely unreal […] be surrounded by people who are really caring, who listen. Well, for me, that's really important.” (M12)“After birth, mothers stressed the importance of creating a family unit; for this, the partner's presence and having intimacy were essential. Mothers wanted to adjust to their new role together with their partner. One mother staying in a shared room mentioned the difficulty of being without her partner at night:The more difficult thing [is]…the absence of the father during moments when […] we would like to be together, to build it [parental role] together.” (M6)“One participant underlined the importance of intimacy by creating a bubble with their partner and newborn, where they could enjoy the first moments of their newborn's life together, despite the presence of HCPs or other people in the room.In terms of support and help... I would have needed to be alone with my partner and our daughter for a few moments.” (M4)“Mothers needed to feel confident in their new mothering role. Doing things by themselves helped mothers to develop their skills and confidence in their capacity to take care of their newborn.What helps for sure is to have your little one around the clock. In fact, you have no choice… but to be a parent at that time, because the child is there […]. Even if it's hard at first, it helps.” (M 9)“Some mothers needed to share their experience with other parents, in order to become more confident in their parenting role.Being with someone in the room, another mother, I found it helped because we had a live experience. Even if we're not going to compare ourselves, but the fact of having, next to you, a woman who is going through the same thing, […] allowed me to put some of my situations into perspective.” (M 12)“Some mothers experienced difficulties to communicate their needs to HCPs. This difficulty was related to their personality traits or values, such as not daring/wanting to disturb HCPs. Their expectations and preconceptions regarding the postpartum hospital stay also induced some difficulties in communicating their needs. For instance, they expected help to come automatically, without asking. Some mothers considered that HCPs should anticipate their needs and offer support accordingly. One mother reported not being at ease about asking for help, as she considered the hospital context to be highly hierarchical.I had the impression that it was very much expected that it was the patient who would say what he/she wanted. […]in this medical context it's hard to speak? […] indeed there's so much of hierarchy... it's not easy.” (M6)“This theme includes specific needs related to the hospital context and the ward's organization. Mothers expressed a need for continuity of care. They experienced a loss of reference points due to staff rotation, which was accentuated by their inexperience in their new parenting role. They mentioned not knowing whom to trust. Another need was to receive coherent information. When mothers had incoherent information, they felt unsettled. It also felt complicated to justify decisions that had been agreed with another HCP. This is illustrated in the following verbatim.The teams rotate a lot, which I understand, but in fact, we don't know who to trust, we don't know who has what information, I realized several times that when I rang the bell and asked for something, …people didn't know my medical records.” (M3)“Fathers in our study highlighted fundamental issues for which they required consideration and investment from HCPs. Father reported that the newborn's arrival had impacted in many ways, such as lack of sleep, hunger, and intense emotional experiences. As mothers, fathers also needed to be able to rest, underlining the importance of having a “proper” bed. They also mentioned feeling overwhelmed by the information they were given. They suggested that waiting a little while before receiving information or being able to ask for the same information again would be helpful.We hadn't slept for hours, both of us, and I had fallen asleep a bit during the period before the birth on a chair. It's not a real restorative night sleep […] when you haven't slept for 36 h and you're coming out of something emotionally important your brain may not be at 100%.” (F17)“Fathers needed to be present at all times with their partner and newborn. Fathers said they did not want to be treated as a “spare part” but rather to be integrated and involved into the postpartum care. If not, they reported worries regarding the separation with their partner and newborn.I think that the most intense moment, it's precisely that night when the baby cries a lot and when, he needs to breastfeed and at the same time, [while] he's breastfeeding, he doesn't eat, but... when he's not there he cries. Well, the fact that I couldn't be there at that moment, it's true that was difficult, with the idea of forming a team with the mother.” (F6)“Fathers needed to be reassured and informed on the health of their partner and their newborn, especially if they could not stay with them. Fathers reported concerns regarding breastfeeding. They also mentioned as essential that HCPs acknowledged verbally that everything was and will be going well.Personally, I would have liked someone to reassure us about breastfeeding and going home, because what I realized was that my wife had problems with breastfeeding […] We got a lot of different advice […] but nobody told us.... at home, it's going to be fine.” (F15)“The postpartum ward operated according to explicit and implicit rules. Knowing these rules helped fathers to have reference points. Fathers had many questions related to their stay e.g., how will the stay take place? for how long? Who will be coming to get me? When will the newborn be bathed? Fathers wanted to know how to act and who to contact if they had questions.I think it's more in terms of explaining the planning, of how it was going to happen[…] during the day. […] it's about the time, once they've left,... we don't actually know when they're going to come back.” (F1)“Fathers considered themselves as non-priority for getting support. To the contrary, they underlined their role to support their partner and wanted HCPs to help them in doing so.No, finally, I didn't really need support. I wasn't the one who gave birth. […] What could I need in terms of support? It's good news, it's a birth, it's a positive thing. […] I don't need any support myself […] I was just a mental and physical support, that's all.” (F13)“Fathers' personality traits also hindered them to ask for support . Finally, their expectations and preconceptions regarding hospital care provision also influenced their needs.I had the idea, that someone would look after our daughter […]. I don't know why I imagined that we would arrive in the room and that someone would be able to take care of the little one, so that my wife could rest.” (F10)“via various methods. Some parents found it helpful to have short written information leaflets. Others wanted that HCP demonstrated the care and provided the occasion to do the care with them, to be supervised.Following the birth of their child, parents had to discover what parenting was and how to care for their newborn. In this context, they had many questions. Parents often felt inexperienced, not knowing how to proceed with the newborn care. They also felt afraid or even helpless of not doing the right thing and how to respond to their newborn's needs. Therefore, parents needed to be supported in learning how to care for their newborn. This implied that HCPs gave them information There was the bath, […]. At that point, it was clear that they were going to explain to us how to do things, how to dress him, how to change him, so these were things that were important to us, because we didn't know.” (F14)“Parents needed to be verbally praised on the care they were providing for their newborn and have feedback.Maybe to say regularly that we are doing it (taking care of the baby) well. Like, “you're doing great.”(M11)“Mothers expressed a greater need for informational support regarding potential newborn's health complications, such as failure to thrive and tongue-tie. Being unfamiliar with these complications, they expressed a need to be properly informed and guided on how to care for their newborn in these particular circumstances.When she was born, she had tremors […]. They (HCPs) said ‘you need to monitor the evolution of your newborn's tremor.' Then you are stressed because you don't really know what you should look for. What's normal or not.” M7“The need to prepare for the return home was mentioned by both parents. They reported the importance of organizing the hospital discharge, wanting that HCPs discussed with them how it will be at home in order to better anticipate and manage this transition. Parents did not want to be rushed for hospital discharge, to the contrary they wished HCPS take time to recap the recommendations and do a sort of final briefing so that they can feel ready to go home, like one father who said:It's [information] repeated, but it's quite good that it's repeated, when we saw the doctor just before the discharge. He gave us a general briefing on all the things to do and not to do at home and gave us a good feedback on all the recommendations.” (F14)“This study explored the perceived social support needs of first-time parents in the early postpartum period with an understanding of the specific needs of not only the mothers and the fathers, but also needs shared by both parents.To be emotionally supported whilst adapting to postpartum physical changes was important to mothers. In line with other studies, mothers in our study expressed the need to have more support and attention for their emotional and physical changes , 49, 50.Receiving breastfeeding support was essential. In particular, mothers had questions regarding breastfeeding positions and how to proceed. Another study reported that breastfeeding was a main concern for first-time mothers, in particular regarding techniques .We also found that mothers experienced mixed emotions following the birth of their newborn; they needed that HCPs acknowledged these emotions and reassured them. In their study, Mcleish et al.  found thHaving privacy and their partner's presence was essential for mothers in order to create a family. Mothers mentioned the importance of having a single room, which was also appreciated in another study reporting higher care satisfaction when in a single room . MothersCaring for their newborn by themselves was important to mothers, as it gave them confidence. This was also reported in other studies , 54. MotMothers' difficulties to communicate their needs was also found in other studies , 54, 56.This study highlighted the importance of continuity of care. Mothers in other studies explained dissatisfaction about being taken care of by too many midwives, which resulted in inadequate transmission of information and poor continuity of care , 56. In Fathers wanted to be integrated into postpartum care during their stay, and wanted HCPs to recognize that, not only mothers but also fathers, feel exhausted, hungry, and overwhelmed with emotions. Other studies found that fathers were experiencing various physical needs and emotional needs due to a loss of sense of reality , 43, 59.Fathers needed to anticipate their postpartum stay, by having information on how the stay would unfold and who they should ask if they had questions. This was also reported by other fathers mentioning the need to clearly know who does what , 57 and In our study, fathers considered themselves as a support for their partner. Like in other studies, fathers considered their partners' needs as more important than their own , 25, 59.Shared themes were “to care for their newborn” and “returning home.” Both parents in our study expressed the need to learn how to care for their newborn. This need has been widely documented in postpartum research for both first-time parents , 52, 58.To prepare for discharge was a need for both parents. Being able to picture themselves in the future was important. Another study reported that it is essential for parents to be prepared to discharge .. This may be due to fathers favoring problem-focused coping approaches  for analysis is available. Requests to access the datasets should be directed to The studies involving human participants were reviewed and approved by the Ethics Committee for Research on Humans of the Canton of Vaud, Switzerland. The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.ES contributed to conception and design, participants' recruitment, data collection, transcription, analysis, and manuscript writing. MV participated in data analysis and manuscript writing. A-SR and AH contributed to the conception and design of the study, participated in discussions related to data analysis and manuscript review, provided critical feedback, and supervised the work of ES (Ph.D. candidate) and MV. A-SR and AH gave final approval of the manuscript's publication. All authors have read and approved the final manuscript.


Existing research has documented the dynamics of increased news consumption alongside – paradoxically – increased news avoidance during the Covid-19 pandemic, highlighting its adverse effects on mental health and emotional wellbeing. However, for methodological and theoretical reasons, research still lacks specifics on what types of negative psychological responses were directly triggered by pandemic news, how prevalent they were in the population, how they manifested in daily life, and what could be the alternatives to them. Further, the almost exclusive focus on negative effects has led to a relative negligence of the positive sides of pandemic news. This study takes a mixed-method approach to address these gaps, combining 59 interviews and a follow-up survey with a representative sample of 2,015 adults across the UK. We found that pandemic news consumption, driven primarily by the need for personalised surveillance in an uncertain situation, oscillated in parallel with its severity and associated lockdown restrictions. The influx of repetitive bad news triggered many negative feelings besides general pandemic anxiety – namely fear, despair and moral outage (anger and disgust). This led to various alterations of daily routines, including news avoidance. Such adverse effects were offset by the reassurance, happiness and hope that the news did, at least occasionally, brought to audiences during the pandemic. Participants suggested several potential “good news” categories that point to the need for constructive news forms that not only inform but also inspire, motivate and/or empower people in personal or collective ways. The manifold disruptions caused by Covid-19 have affected news consumption in ways not seen before. As people turned to the media to gratify cognitive, affective and socially integrative needs amidst the sheer disruption of the pandemic, early research has documented the ambivalence between the need to monitor an evolving crisis and the protection of mental and emotional health, which led to a rapid fluctuation of news consumption . News avThis study thus takes a more nuanced approach to add depth to current knowledge of pandemic news consumption and its effects on psychological wellbeing. In seeking to explain the fluctuations of Covid-19 news consumption over a one-year period of three national lockdowns, it employs a mixed-method examination of both negative and positive dimensions in the relationship between personal surveillance of pandemic news, mental and emotional states, and news avoidance. Based on 59 in-depth interviews and a survey with 2015 citizens across the UK, we examine and interlink three different foci: (a) the pervasive negative news environment’s effects on users’ psychological wellbeing, with a focus on the specific characteristics of news-induced feelings and behaviours (including multiple forms of news avoidance); (b) the positive psychological effects of pandemic news consumption and their potential contribution to mitigating news avoidance; and (c) alternative types of pandemic news that users perceived as helpful for them to offset its adverse effects.News, as an uncertainty reduction means, is often considered to be a lifeline in times of crises – and the pandemic is no exception. In the UK’s first lockdown week in March 2020, for example, virtually every online user (99%) accessed news at least once a day  – a factWithin these rapid changes is consumers’ reconfiguration of how they consume the news to deal with the pandemic and its disruptions. Here, the theoretical framework by The first takes the form of an information-utility approach, in which users implement an active information-oriented search strategy to survey the environment, to make sense of the unexpected crisis, and to grasp what public health measures are in place for them to follow. All this is to serve the purposes of reducing uncertainty  and/or iSuch information-utility approach, however, might work in the opposite manner: instead of helping users to cope with stresses, news could generate more stress among users . In the These factors converge to give rise to the second practice of resilience, which is the opposite of news seeking: news avoidance. Here, limiting or abandoning exposure to news – either for a short or long term – helps users to achieve resilience through two closely related processes: (i) avoidance can lower the chance for users to experience the distress and anxiety caused by uncertainty; and (ii) avoidance can help users to escape the subjective experience of bad feelings caused by the predominantly negative nature of Covid news. This is, of course, not peculiar to the pandemic: the abundance of negative news has long been a key driver of worrying news avoidance in Western countries , particuindifference (due to the perception of the pandemic being far away); shock  as the outbreak arrived; Corona fatigue  as the virus advanced; and the becoming of a new normal. Of these, they found shock and fatigue to be the most critical: they demanded users to fundamentally adapt news habits – including a reduced or more controlled consumption of news – so that they were informed without letting their news intake overwhelm their information- and emotion-processing capacities. In a Dutch survey, The link between pandemic news avoidance and its negative psychological effects has been established across the world. In the UK, two-thirds of those who avoided Covid-19 news cited its “bad effect on my mood” and 33% the feeling that “there is too much news” as reasons . In the situated news avoidance . In Germany, MentalHealth.org, a major health charity in the UK, advised its followers to “find a balance” in news consumption to reduce stress. Likewise, the National Health Service recommended its users to “limit the time [you] spend watching” news and to “(turn) off breaking-news alerts on your phone” .From Australia, In sum, pandemic news consumption oscillates between phases of intensity and laxity and between news seeking and news avoidance, and this has much to do with its negative effects on users’ psychological wellbeing. Several things, however, require more attention before we reach a balanced, more nuanced understanding of what pandemic news does to the audiences’ mental and emotional state.First, the evidence base for the negative effects of pandemic news on psychological wellbeing needs to be expanded in several aspects. For one thing, most research so far tends to describe such effects through catch-all terms – such as ill mental health, emotional drain and bad mood – but lacks details on specific feelings. Often, descriptions do not go far beyond common mental and emotional states that the pandemic-wounded public would have experienced, with or without news consumption, such as despair, anxiety and fear. Other possible negative feelings directly triggered by news per se – e.g., moral outrage (such as anger) or pity towards what is reported in the news – have not been studied in detail. For another, the vast majority of studies approach the negative psychological effects of pandemic news from a qualitative perspective, stopping at describing their existence in small and non-representative samples, with no external validity to generalise their magnitude in the broader population. Even the contribution of negative news-induced emotions to news avoidance has been established mainly through interpretation of qualitative interviews rather than through rigorous statistical testing, except for RQ1What were the most prevalent negative psychological responses to pandemic news and how did they contribute to its avoidance in the UK population?Second, as scholars have focused on the negative psychological effects of Covid-19 news, they tend to overlook the other side of the coin. If news seeking is a resilience strategy in times of crisis, then it must have some positive effects on users’ mental and emotional state. However dark the pandemic situation was, for instance, some people might at least sometimes find news a source of joy, assurance or hope for very personal reasons. Further, it is reasonable to expect that such positive reception might reduce users’ tendency to reduce or avoid pandemic news. So far, however, there is little evidence of this. We ask:RQ2What were the most prevalent positive psychological responses to pandemic news and how did they relate to news avoidance in the UK population?Third, although the abundance of negative Covid-19 news has been identified as a key cause of news avoidance, no study has asked audiences what they think could be the alternatives. Given that the pandemic was a pro-longed catastrophic crisis, what type of “good news” did audiences think the media could provide to offset the abundance of bad news? We ask:RQ3In what ways did UK audiences think the media could make pandemic news more positive?This study is part of a larger project that investigated how UK audiences experienced Covid-19 news and what they expected the media to do to help local communities recover from the pandemic. The data came from the early stage of the project, which combined in-depth interviews and a survey with UK news users.gender , age groups ; ethnicity (10% from minority groups); and regions . As one aim of the broader project was to explore how the news could assist local communities to recover from the pandemic, we intentionally included 20 “community leaders” in the sample. These were basically ordinary citizens who were playing or had played some formal or informal role in communities – e.g. support workers, mother and baby group leaders, Brownie/scout leaders, school governors, community sports coaches, local club committee members, local business leaders etc.59 members of the public were interviewed between 15 February and 3 March 2021. The sample was recruited by a professional research firm, to ensure proportionate representation relative to the UK population in terms of Interviews lasted 45–60 min and were conducted over Zoom. Each was semi-structured in three sections: (a) general news consumption in pre-pandemic times; (b) pandemic news use experience and expectations; and (c) the psychological empowerment potential of solutions journalism (SOJO) in general and in the context of the pandemic. Participants were not told about these specific topics in advance. For this paper, we use data from the first two sections, when participants had not been introduced to the SOJO concept and therefore were not potentially primed towards it in their responses.inter alia, their uses of Covid-19 news, its impact on mental and emotional states, how it shaped their pandemic experience and what they expected from journalism in the exit from the pandemic.The findings of the interviews were fed into the design of a national survey on pandemic news experiences. The questionnaire gathered information to quantify and scale the phenomena observed in the interviews, especially the psychological effects that emerged frequently in the interviews, as well as to explore other relevant issues that have been raised in the literature on crisis news consumption. Respondents were specifically asked about, The survey was administered by Opinium, a professional research firm. Opinium recruited participants from a panel of about 40,000 UK citizens who signed up to take part in its surveys on a range of subjects in exchange for small incentives. Participants were not told about the survey’s subject when they were invited to prevent response bias. The final sample included 2015 qualified respondents, which were demographically representative of the UK’s adult population.throughout the pandemic. While we did not collect time-series data, this study did specifically ask audiences to reflect on how their news uses changed across the waves. Inevitably, all self-reported data like these depend on audiences’ ability to recall. As such, all interviewers were trained to use probing or clarifying questions wherever necessary to encourage deep reflections on the chronological order of news consumption changes since the first lockdown. During data analysis, we cross-checked and eliminated any actual or potential inconsistencies in interviewees’ responses. Overall, despite their subjective nature, we are confident that the interview data had reached a very high level of authenticity and trustworthiness.It is noteworthy that both qualitative and quantitative data were collected after the UK had gone through three national lockdowns and various local ones. The survey itself was live from 22 to 24 March 2021 – exactly 1 year after the UK went into the first lockdown. This is a crucial difference from previous research, which has examined pandemic news consumption within early single waves of the virus outbreak rather than across different waves. As Audio recordings of interview data were transcribed verbatim and analysed in NVivo using a process of inductive thematic analysis. This provided for the contextual development of key instances and themes across the transcripts grounded in existing literature. Colleagues within the wider project team acted as “critical friends” in the analytic process, providing reflective “sound boards” as multiple themes were identified and contextualised. All interviewees’ names here are pseudonyms. As for survey data, this paper will use descriptive analysis to scale-up what we found in the in-depth interviews. All percentages reported below would have a sampling error of ±2%. For the relationships between news avoidance and its negative and positive psychological effects, we conducted multivariate regression analyses with statistical controlling for age and gender (more below).Previous research found a clear oscillation in news consumption within the first wave of the pandemic. With the usual caveat about the nature of self-reported data, we found that audiences’ perceived changes in news consumption across multiple waves followed a similar “inverted bell curve” pattern. In general, participants reported higher levels of news consumption – both in terms of use frequency and time spent – than pre-pandemic times, with some developing new habits . Following a steep increase in the first lockdown (March 2020), however, engagement with news reduced along with easing restrictions over the summer months, and then rose again, to some extent, in the autumn and winter, when rising infection cases and deaths forced the UK into lockdowns again.personalised surveillance – i.e. the overwhelming lockdown-induced need to monitor the pandemic in relation to how it affected their own daily routines and concerns. As people sought to understand the evolving situation, detailed local/national statistics – especially transmission rates, hospital admissions, deaths and, later, vaccination rates – and updates on lockdown restrictions were in high demand. Even when they looked beyond local/national contexts, it was often about places with which they have personal connections. Due to this personalised surveillance drive, news consumption went up and down in parallel with the severity of the pandemic and its alternate waves. Embedded in this process are the contradictory effects of surveillance on users’ psychological wellbeing.Some participants attributed their up-down-up pattern to the extra amount of free time afforded by lockdowns. For the most part, however, they linked it to what we would call the drive for You just heard from the five news articles exactly the same thing [and you wanted to shout], “Please shut up and leave me alone, I don’t feel like it.” … So, [it’s like] you put a barbed wire around and really can't move.Heavy news consumption out of the personalised surveillance drive in an uncertain, rapidly evolving situation took a heavy toll on the psychological wellbeing of many participants. First, for some interviewees, news per se could not offer them a sense of control, especially during the early days, when nobody could be certain about anything. Second, in line with previous research, there was the pervasive feeling of information overload. Interviewees frequently lamented about fatigue caused by the sheer volume and intensity of, to use one interviewee’s word, “samey” news about Covid-19. This fatigue was worsened by the very negative focus of Covid-19 news: all but a few interviewees felt that while repeated exposure to the same news was bad, it was repeated exposure to the same bad news – especially the influx of case numbers, death statistics and lockdown uncertainties – that triggered much worse psychological distress. One participant, Nikki, compared this to a barbed wire around her daily life:Projecting these into the general population, our survey shows that a large majority of the UK population experienced this overload of bad news, with two-thirds agreeing that “news about Covid-19 is rather repetitive” and more than half (53%) agreeing “there is not enough news around the good things that happen during Covid-19” . In addiThe range of emotions that emerged out of this “barbed wire” was wide. Throughout the interviews, we found that despair and anxiety were the most frequently mentioned responses to Covid-19 news. To a lesser extent, some interviewees reported instances when they “got mad” or “felt sick” of the behaviours of some people in the news – from the ordinary people who refused to wear masks in a supermarket, to the powerful few who acted against pandemic standards . In the survey , a largeIn the first lockdown, watching the news was really negative for me, and it did not help in any way, shape or form … I spent three or four months reading the news and then it got to a point where I just I didn't go out anymore. I didn't walk the dog every day. I stayed in bed, I wasn't eating properly, I went into a slump.This manifested in a range of symptoms that were laid bare in interviewees’ accounts, including obsession by a “bleak outlook on the future” (Rohan), sleep deprivation (Helen), “not wanting to go outside” (Nigel), various alterations of regular activities and even the inability to function normally. One of the most sober accounts came from Chloe, who went through to a slump period that saw her unable to get out of bed:Some had to resort to mental medication. Nina, for example, took the antidepressant Fluoxetine for the first time in her life, to calm herself from the stresses that she attributed substantially to her “focusing so much on the Covid-19 situation on the news”.I remember I got halfway down the article to the one line that basically says social distancing will just become non-existent. I started to have a mini panic attack because, after the past year of not being near anyone or not hugging my parents and my grandparents, [it was scary to think] suddenly in a few months’ time I would be able to do that … And I started crying. I was worried about it, and then I saw things like Leeds festival coming … I can't even describe how much anxiety I had and how scared I was … just terrified of the fact that we're going back to square one. (Rebecca)Before moving on, it should be noted that such personal accounts cannot be attributed solely to the influx of negative news. In fact, they cannot be removed from the context of the stress, turmoil and uncertainty caused by the pandemic. In such times, there was evidence that even positive developments could become a cause of ill mental health. One respondent, for instance, described how Boris Johnson’s announcement of the roadmap to the new normal a few weeks before the interview had a “massive, massive, massive, massive” effect on her anxiety:news dosing strategy  of the total variance in pandemic news resistance. Individually, all but one of the six feelings – anxiety  – contributed significantly to that resistance. Of the five significant contributors, interestingly, disgust was a negative one – the more often people felt disgusted by the action of people in the news, the less often they resisted the news during the pandemic. This suggests that even in the face of psychological distresses, news audiences would, out of moral outrage, still keep up with the news to monitor the deeds of those they thought were not behaving properly in relation to the pandemic situation. Age and gender were statistically significant contributors to news resistance in their own right, with females and younger people showing higher frequencies of pandemic news switch-off.To gain a deeper quantitative insight, we conducted a regression analysis  for newsEven the slightest small news about the pensioners who got their first jabs, the planning for holiday … gives me a sense of safety. Not safety – I should say it gives me a sense of being in control.Although feelings about the negative effects of Covid-19 news on public mood were overwhelming, it is important not to lose sight of the fact that there were positive perceptions. As noted, uncertain and unsettling times like the pandemic prompt people to look out to things that are near and dear to their heart – at least to assess the situation, to know what to do, and to have a sense of security that they are on top of the situation. This is where the positive values of news – particularly its reassurance effect – comes in. As Nigel put it: “I don’t know whether they would even have helped me prepare because nothing really helps prepare you for this, but I think knowing was a little bit more, better than just not being aware.” For some, the simple fact of having access to news was a reassurance. Hannah, for example, said that the news has definitely made her pandemic experience better because “knowing what is happening around me and seeing the trends” made her feel in control of the situation, rather than “just imagining scenarios in my head”. As she explained:In our survey, there was an equal divide in responses to “news about Covid-19 helps to clear my thinking” (30% agreeing and 30% disagreeing). However, the majority (53%) agreed – and 9% disagreed – that “news about Covid-19 reassures me that I’ve been doing the right thing” . FurtherSome in-depth interviewees found other positives than cognitive reassurance, particularly happiness and hope, from the news they consumed. This was increasingly the case when news about the rollout of vaccines, new treatments and other things became more prevalent. Such “cheerful news”, in an interviewee’s words, “obviously got a bit of a psychological emotional effect on all of us” because it provided “the hope (that) perhaps there's a light at the end of the tunnel” (Mandy). When we brought these into the survey, six in ten sometimes/often/very often felt “happy about what is reported in the news” and three-quarters (76%) at least sometimes felt from news that “things would get better out there” .p < 0.001). The news-induced feelings of hope and happiness were significantly negative determinants of news resistance. The “sense of control over my life” was also negative but not statistically significant. In other words, there was enough evidence to say that the more frequently people felt positive from pandemic news, the less frequently they abandoned it. Note that the effects of age and gender remain unchanged from those in the previous model for negative emotions.Did positive emotions help reduce news avoidance? Our regression of the frequency of news resistance on the frequencies of feeling happiness, hope and a sense of control, with control for age and gender, provided a firm yes to that question. As seen in What, then, could the media do to make pandemic news more positive, or at least, less negative? Although in-depth interviewees acknowledged that negativity is unavoidable in the pandemic, many argued that the media could create more positive pandemic news by restraining themselves from old habits. In particular, they saw the abundance of negative Covid-19 news as an exacerbation of the inherent imbalance between positive and negative stories in everyday news. Evident in their accounts is the perception that there were positive stories around the pandemic that the media could but chose not to tell. Christopher, for instance, said that he abandoned TV as his main source because it “keeps repeating the same story (that just pushes) one angle”. For him, this is not unintentional. “The [mainstream] outlets would draw a very grim picture of the whole thing,” he said. “Well, the cases are rising, but how often do we hear about people recovering?”The media have been quite critical of public bodies … They've been very critical about the NHS, … about the reporting of numbers, … about the vaccine. I think they could definitely put a more of a positive spin on it, but (they’ve chosen to be) more negative. (Toby)When participants were asked to recommend ways to make pandemic news more positive, their perceptions of what is positive vary from one to the next. Some might strike hard at the very pillars of journalism, such as the following suggestion that the media should be less critical and deliver a “positive spin” on certain things:more emphasis on events that lift the public mood. This is different from asking journalists to put a “positive spin” on events, facts and figures: it means bringing to light the positive things that have come from the pandemic. Chloe, for example, wanted to see the benefits that lockdowns bring. One example she did not “see reported much in the UK is the environmental benefits that we've had”. Others shared the above Christopher’s demand for positive people-centred stories:I'd like to see more stories regarding people beating Covid-19. Because I think that people have had enough with the negatives, they need hope to know that people are actually recovering from it. (Nigel)I remember watching and reading one story about a volunteer at a vaccine centre. I didn't look out for it, as that was not the reason I logged in, but I read it and thought ‘oh, that was nice to hear about.’ There have to be hundreds, maybe thousands, of these volunteers but we're not hearing about. It would be nice to hear a couple more of their stories, like ‘a day in the life of’ stories could be nice. (Greg)Most recommendations, however, fall into two categories. First, there was a strong call for When Captain Tom's story came out it was … a very positive story and literally a ray of hope for us. (Hannah)I think the more positive news you get the more you can cope with it … Positive stories do help. Like Captain Tom, that boosted everyone's morale, didn't it? I think stories like that make people think that whatever was happening with the virus and with lockdown, (everyone) could do something positive. (Irene)One of the most oft-mentioned examples was stories about the 100-year-old Sir Tom Moore’s effort to raise millions of pounds for NHS charities:In line with this, nearly half (48%) of survey respondents agreed – and only 15% disagreed – that they “would like to see more news about those who deal well with pandemic challenges” .a shift from an excessive focus on Covid-19 problems to more attention to how people overcome these problems. Even simple advice on how to cope with the situation could help. Christine – who, “at one point in the second lockdown, … just felt like losing the will to live a little bit” – commented on how some advice in the news empowered her to escape depression:They give you good ideas on what to do. ‘Make sure you get outside’ and things like that, so I have watched that kind of news. And I took on board some of the things that people have said to do.Second, there was a desire to see If there are problems somewhere, what's happening? What's the way out? So, the NHS is overwhelmed what's the way out? How do we build a new hospital? Are we putting in applications into build new hospitals or we're recruiting more staff? … So, it might be bad news now, but is there anything beyond that … to put a smile on our faces … as well as the facts?Beyond lifestyle advice, others called for something that resemble the core values of what has come to be known as constructive, solutions-oriented journalism (SOJO), a journalism practice that breaks from traditional focus on problems in society to a balance between problems and solutions to problems . TypicalThis research has shown a multifaceted picture of the functions and impacts of Covid-19 news in the daily life of a pandemic-wounded public. On the one hand, people relied heavily on the news as a lifeline to keep themselves informed, assured and, where possible, empowered in the face of extreme uncertainties. On the other, they found an abundance of repetitive bad news that led them to experiencing, intensively or extensively, many mental and emotional wellbeing problems. Inherent in the search for information utilities in pandemic news – primarily for personalised surveillance purposes – is the ambivalence between anxiety and security, with the motive to seek information being characterized by deep ambiguity, uncertainty and, hence, distress. By combining two rich sets of qualitative and quantitative data, this research adds depth to previous research that has found how news emphasizing negativity can lead to disillusion and disinterest in matters of civic interest, and, ultimately, provoke a civic disengagement with social and political matters .Perhaps one of the most telling parts of the data are the sober personal testimonies on how the adverse impacts of news consumption manifest the way people altered their daily activities and routines during the pandemic . Such psychological discomfort and disorders laid bare the very real and dramatic impacts of negative news on the fabric of society. They speak to a larger issue often expressed about the mental and emotional effects of the 24-h news cycle of unfinished stories. In this cycle, news outlets must keep reporting, even with little new information, while the public gets increasingly bored, fatigued, desensitised, stressed and sometimes despaired . Our mixed-method data show that most users, being ceaselessly exposed to a prolonged repetition of bad news around Covid-19, would sooner or later reach a point of informational saturation, emotional drain and mental distress. Amidst a general climate of uncertainty and anxiety, we saw fear, anger, disgust, despair and cognitive overload emerging both as the most prevalent psychological responses to pandemic news content and as direct triggers of the alteration of regular daily activities, including the partial or total abandonment of news. The regression data show a clear contribution of these news-induced emotions to news resistance, especially among younger females. In short, news resistance – and the lesser forms of news avoidance (news dosing and media substitution) – could be seen an essential part of living in a precarious and threatening situation, serving as a resilience-building strategy against psychological disturbances.It would be a critical mistake, however, to think of pandemic news exclusively in terms of its negative psychological effects. This study breaks from previous research into pandemic news consumption by paying close attention to its positive aspects. It was clear from both the interview and survey data that news was at least an occasional source of reassurance, happiness and hope for the majority of audiences during the pandemic. The regression analysis further shows that such positive psychological experiences did help to prevent people from tuning out the news. This echoes the argument by : 8 that This study thus highlights the urgent need for journalists and media executives to take lessons from their heavily negative pandemic coverage to reconsider the important but often overlooked function of news as a force to inspire, motivate and empower the public. This invites a fundamental shift from traditional occupational ideologies that prioritise negative news – i.e. the type of “if it bleeds, it leads” mindset – to a balance of the negative and the positive. Of course, the pursuit of bad news to inform and enlighten the public is integral to journalism’s watchdog role and its professional reputation. However, over the years this conditioned journalists towards an overemphasis of reporting the negative at the expense of the positive. In this particular case, while the pandemic’s unprecedented disruptive and destructive scale might make it hard for journalists to be positive in news reporting, the suggestions from our interviewees did point to ample space for improvement. Audiences do not always speak the same language as journalists but, as the interviews demonstrate, they did see many ways in which pandemic news can be made more positive.In relation to this,


The purpose of this research project was to investigate midwives’ job satisfaction in Australian maternity care settings.A mixed methods pilot study using the convergent parallel design, and a mixed-methods approach was used for this study. The Nursing Workplace Satisfaction questionnaire was used to collect data online via social media platforms, and consisted of Likert Scale responses, and both closed and opened ended questions.The quantitative results noted an overall positive result to participants’ job satisfaction, however there were areas that participants reported as problematic. These areas were delved into further via the results of the qualitative data which highlighted eight themes that explored the participants’ perception of the worst things that impacted upon their job satisfaction, and also the best things which impacted in relation to their current jobs.This study revealed factors including staff shortages, being time-poor, missing basic human rights like meals and comfort breaks which were linked to midwives’ dissatisfaction with their jobs in Australia. The study also identified that midwives valued being of service to women, and that this factor was a driving force in job satisfaction. However, healthcare organizations are struggling to retain midwives, which is resulting in global workforce shortages5. According to The State of the World’s Midwifery Report (2021) these shortages are expected to worsen over the next few years following the global COVID-19 pandemic6 due to burn-out and loss of life8, and as the midwifery workforce ages9. The average age of a midwife in Australia is 48.8 years, with 55.6% of the working population being over 50 years of age10. Despite efforts to improve the midwifery shortage in Australia, the problem still exists and is worsening5. It is therefore imperative that healthcare agencies explore midwives’ job satisfaction as it has been associated with staying in the midwifery profession11, and has an impact upon cost effectiveness to organizational, neonatal and maternal health outcomes12.Providing quality, safe maternity care is dependent upon the provision of a highly skilled midwifery workforce14. It appears an individual’s perception of job satisfaction has changed over time, along with varying definitions, e.g. job satisfaction now includes factors such as work environment, organizational demands, and professionalism, with the personal job satisfaction of midwives included as one of the constructs16. Some argue this lack of clarity is due to job satisfaction being a multi-faceted entity, including factors such as work environment and leadership styles, rather than a singular element18.Operationalizing the concepts and assessing the job satisfaction of midwives is a complex issue, as this can relate to numerous variables including working hours, leadership style, organizational structure, women and neonatal outcomes, or it may be limited to the specific function of a job or personal characteristics19 viewed job satisfaction as a human need, which was fulfilled by the individual’s occupation, whilst others perceive it as everything that is good about their job. Castaneda and Scanlan20 concluded that job satisfaction relates to three specific areas, firstly, autonomy . Secondly, providing care , and interpersonal relationships 20. Liu et al.21 state that job satisfaction relates to the ‘happiness, or enjoyment that an employee feels when doing his or her work’, which encapsulates the areas identified by Castaneda and Scanlan20. Recent studies have been conducted to address the gaps in research exploring the relationship between midwives’ job satisfaction17, quality of work life15 measurements of wellbeing of midwives and reasons to stay in midwifery22. Results published from these studies reveal that there is a positive and significant correlation between the intent to stay or not in the profession and job satisfaction.Maslow23. Over time, job satisfaction tools appear to have changed focus, to include work environment, organizational demands, and professionalism, rather than the personal job satisfaction of the midwife. Some argue this is due to job satisfaction evolving and now including different aspects of the work environment, and also encompassing leadership styles24, rather than a single entity. Previous studies have identified different factors that may also contribute to job satisfaction, such as positive self-appraisal14. Thus, whilst many factors appear to contribute to extrinsic job satisfaction, intrinsic satisfaction seems to rely on self-reflection, positive self-appraisal, self-recognition and a sense of competency14. Moreover, if the correct tools are not used, then findings will undoubtedly be flawed, and this important aspect of a midwife’s work will be underestimated or underreported.From a slightly different perspective, researchers need to be clear of the variables they wish to explore and ensure that they are using the correct tool prior to commencing their research studies due to the blurring of inclusivity of this phenomenonThis pilot study aimed to investigate midwives’ job satisfaction in maternity care settings by posing the question ‘what does job satisfaction consist of for midwives in Australian maternity care settings?’ and using the previously validated Nursing Workplace Satisfaction questionnaire as the tool to collect data for the study.A mixed-methods pilot study using the convergent parallel design, and a mixed-methods approach was used. The quantitative and the qualitative components were conducted sequentially. Both the quantitative and qualitative data were utilized to enhance the description and understanding of midwives’ job satisfaction in maternity care settings. The Nursing Workplace Satisfaction questionnaire and two open-ended qualitative research questions were used to collect data in this study: ‘Can you tell us about the best things about your job?’ and ‘Can you tell us about the worst things about your job?’.25. The study was conducted online through the Qualtrics™ online platform. Social media platforms such as Twitter and Facebook were used to recruit participants. These were closed group midwifery forums, and participants were asked to share the link to the study with their own midwifery networks. Questionnaire completion time was estimated to be approximately twenty minutes, although it was not mandatory for participants to answer all questions; an in-depth information sheet was provided to help motivate participants.The Nursing Workplace Satisfaction questionnaire was reproduced with kind permission from Greg Fairbrother26. Viechtbauer et al.26 suggest that if a problem exists, using a 5% probability will detect its existence, and using a confidence level of 95% will identify the problem. This study used a 5% probability and a confidence level of 89% to determine that 43 participants was adequate for this pilot study. As Sauro and Lewis27 note, using a confidence level greater than 80% is sufficient when the aim is to obtain general feelings from a group of participants.The unit of analysis for this study were registered midwives working in maternity care settings in Australia. Forty-four respondents completed the anonymous questionnaire via an online platform. As this study was a pilot study, a statistical formula was used to determine the sample size requiredPermission to undertake the study was obtained from the University Human Research Ethics Committee. An information sheet was available to participants, outlining the purpose of the study. The completed questionnaires were anonymous and unable to be identified. A formal consent form was signed by each participant before commencement of the questionnaire. On completion of the study, the data were stored securely as per the university’s policy for research data management.The Nursing Workplace Satisfaction questionnaire included 18 statements using a 5-point Likert scale with choices ranging from strongly agree to strongly disagree. Open-text qualitative questions provided respondents the opportunity to comment on what was the best components of their job and what were the worst. It consists of intrinsic questions which focused on how the individual enjoyed their job, if it gave them satisfaction and meaning. It sought to explore if participants thought their job gave them an opportunity to show what they were worth, and if they were enthusiastic about their present job. The questionnaire also explored extrinsic factors such as did they perceive they had enough time to deliver good patient care to women, enough support from colleagues, and the busyness of the environment or feelings of isolation or lack of confidence as a clinician, and the final domain focused on the relational aspects of job satisfaction which include the perception of making friends amongst their colleagues, and feeling like they belong, and liking the people they work with.25 and found suitable for use in a midwifery context.The tool has been validated in the nursing professionParticipants had six weeks to complete the online survey. Participation was voluntary and participants were made aware, via the provided information, that they had the right to withdraw at any time without prejudice or need for justification. As the surveys were anonymous, any information submitted was not able to be returned to the participants as the collected data were de-identifiable.28, occur at the same time within the research process, and weigh equally within interpretation of the collective results29. In line with this approach, the quantitative data were analyzed via the QualtricsTM platform, and the qualitative data were analyzed using content analysis. Qualitative content analysis was organized by the researchers examining the data for patterns of themes from the thoughts and perceptions of the respondents30. There were two open-ended questions with free text boxes for midwives to provide their own experiences/perceptions when answering. After analysis of the quantitative data which fell into three domains, content analysis of the qualitative data identified five subthemes relating to the worst things that impacted upon job satisfaction, and three subthemes describing the best thing impacting upon job satisfaction.Data were collected online via social media. To ensure that an in-depth understanding occurred, a convergent parallel approach was taken as part of the mixed-methods design. This approach necessitates that the quantitative and qualitative variables denoted as QUAL + QUANForty-four participants completed either all or parts of the survey. The survey focused on three domains: Intrinsic, Extrinsic and Relational .25.The intrinsic domain consisted of questions 1-6; extrinsic domains were captured by questions 7, 8, 9, 11, 12, and finally the relational domain was captured by questions 15– 18 of the Nursing Workplace Satisfaction questionnaire25 state that question 10 is addressed by question 7 as both capture workplace feelings, and questions 13 and 14 form stand-alone questions which do not fall into an extrinsic domain.Questions 10, 13 and 14 were removed as Fairbrother et al.Overall, the intrinsic findings were positive towards how much the participants enjoyed their job. However, when asked the question: ‘in the last year, my work has grown more interesting’ (question 5), 19 participants disagreed (n=35). The least favorable was the extrinsic domain which relates to doing your job and especially question 8: ‘I have enough opportunity to discuss patient problems with colleagues’ with 17 participants (n=34) disagreeing.The relational domain relates to the people the participants work with, and was viewed as favorably by participants, with 20 responses (n=36) agreeing with question 18: ‘I feel that my colleagues like me’.Question 13: ‘I feel confident as a clinician’ highlighted those participants that felt confident as clinicians, with 24 respondents (n=35) reporting either fully agree or agree to this question.Finally, question 14: ‘I like the way my ward is run’ was highlighted by 32 participants who answered the question; 9 participants partly agreed with this view, 14 disagreed and 9 definitely disagreed.25 suggest that question 10 be removed at the results stage, as it is viewed that this information is captured by question 7. Twenty-eight participants (80%) disagreed or definitely disagreed with the question that they ‘have enough time to deliver good care to patients’, which compares favorably with the findings of question 10 which seeks to find out if participants would ‘function better if it was less busy on the ward’, to which 35 (92%) participants either fully agreed or agreed, which therefore validates Fairbrother et al.25.Fairbrother et al.The qualitative results revealed five subthemes describing the worst things that impacted upon job satisfaction, and three subthemes describing the best thing impacting upon job satisfaction in the participants’ current jobs.Subtheme 1: ‘We are desperately short of staff.’The midwifery respondents described a shortage of staff was one of the worst things impacting upon job satisfaction. They identified that ‘staff ratios’, ‘a lack of staff’ and ‘being constantly understaffed’ were having serious consequences in their roles, with one midwife stating: ‘it is now dangerous on some of the wards’ (AS21).‘Poor retention of staff’ was also highlighted, as were ‘being on call’ and ‘being on call 24 hours’, which led to ‘not being able to switch off, causing burn-out’.Subtheme 2: ‘Shift work isn’t working for many of us.’Respondents identified that shift work contributed to dissatisfaction with midwifery jobs, describing: ‘inflexible work hours’ being ‘not life-style friendly for midwives or women’ (AS12), and that rosters and long shifts did not fit in with young families.Subtheme 3: ‘Management don’t care.’The impact of management was identified as a factor in midwives’ job satisfaction, with ‘micro-managing’ and ‘lack of support from management’ being a common response. Statements of ‘management doesn't care’, ‘bad management’ and ‘a lack of respect from the hospital management and managers’ (AS6), were also identified. Many respondents also stated that ‘management make decisions without consulting the staff’(AS27).Subtheme 4: ‘We have no time.’Time-related issues attracted the most comments from the midwifery respondents and appeared to be a major factor in job dissatisfaction. ‘Lack of time to do the job properly’, an ‘increase in women/patient numbers’ and ‘not having enough time to make a difference to women’ were some of the most common responses; ‘babies not in patient ratios’, ‘pushing on the clock unnecessary interventions’ and ‘not giving care you should give’ were also cited. Many respondents said they were ‘time poor’ and complained about the ‘lack of time spent with women’. Two respondents said they felt ‘unsafe’ because they were ‘overworked’ on many shifts, and that they were ‘not able to provide the best evidence-based care due to time constraints’ (AS6), and ‘unable to provide the necessary support to women because of being time poor’ (AS23).Many respondents stated that ‘I don't have enough time on the wards to give women the time they deserve’ (AS9) and ‘not being able to give women continuity and time they should have due to staffing/care model constraints’ (AS32).Subtheme 5: ‘We are missing our basic rights.’Most respondents described ‘not getting breaks’, and ‘missing meals’ whilst on shift. This was seen as an important issue in being dissatisfied with their current jobs. The midwives stated a ‘lack of relief for unexpected leave’ or ‘long periods of planned leave’ left them feeling ‘physically exhausted’. One respondent described ‘feeling constantly blamed and feeling gutted that we constantly have to beg and justify basic rights such as lunch breaks and toilet breaks. I'm exhausted picking up other's work’ (AS 31).Subtheme 1: ‘Midwifery models of working.’The midwifery respondents described working within midwifery models of care, increased their satisfaction in their current jobs. Many respondents identified ‘continuity of care and the variety of the work’, ‘positive outcomes with minimal interventions’, ‘the teamwork on the ward’, ‘working with women’, ‘working in a woman-centered care way’, and ‘working in the continuity model’ as some of the best things about their roles. Every participant responded with at least one of the responses recorded.Subtheme 2: ‘Providing midwifery care is our priority.’Midwifery respondents were overwhelmingly clear in that prioritizing midwifery care had a positive impact upon job satisfaction. The participants made a series of similar comments about how providing care was a rewarding aspect of their role; this included ‘working with the women to provide quality care’, ‘the families I care for each day make my job worthwhile’ (AS19), ‘I am passionate about being a midwife and providing quality midwifery care’ (AS7) and ‘I enjoy caring for new mothers’.Subtheme 3: ‘Being of service to women.’This theme that emerged from the collected data, contained the largest volume of comments from participants. Midwives were unanimous that being of service to the women they provided care to, was the best indicator of their job satisfaction. Every respondent described aspects of the role that made their job enjoyable, with one stating that‘building relationships with women and their support persons and assisting them to achieve as close to their birthing goals as possible makes me stay in my job’ (AS12),‘being able to make the most vulnerable time of someone's life a fulfilling and empowering time’ (AS34),‘the precious moments where I can give good advice, empower a woman to make her own informed choices is so rewarding’ (AS14),and ‘building rapport with women and making their pregnancy/birth/postnatal experience better’ (AS5).Many respondents identified ‘helping a woman to have the birth she wanted’ (AS17), ‘advocating for the woman’, and ‘making a difference to women and their families’ as important factors of satisfaction in their jobs.25, are noted as being positive within this study. Moreover, intrinsic factors which encompass self-worth, and a sense of achievement are vitally important not only to explore job satisfaction but are predictors of an individual’s job performance. Participants within the current study reported that their job gave them job satisfaction, which is a positive finding, as it is well documented that perceptions of poor job satisfaction increase the likelihood of burnout amongst staff32. Self-worth is another intrinsic factor that is explored within this study, whereby participants were asked if they felt their ‘job gave them opportunities to show what they were worth’. Interestingly, findings were again positive, which is important, as Maslach and Leiter33 identify that when there is any form of mismatch relating to the main areas of a person’s work, such as their perceived control over their job, or performance, and if the warning signs are not recognized or addressed in a timely manner, burnout can ultimately occur.The results from this study revealed that the overarching concept of providing care, building relationships, advocating for women, helping women to achieve the birth they desired, and making a difference for women, equated to being of service to women, which ultimately appeared to be the main factor for job satisfaction for midwives. Intrinsic factors such as self-reflection, positive self-appraisal, self-recognition, and a sense of competency25. Within the current study, the extrinsic domain has been negatively reported, for example, when asked if participants were ‘given enough opportunity to discuss patient problems’. The midwifery profession focuses on providing women-centered care, having a women focused approach is fundamental to all that midwives do. Frawley et al.34 have also reported negative findings relating to extrinsic domains, suggesting that midwives perceived they were time-poor, and this resulted in them not having time to do things well, or adequately address parents’ concerns.Extrinsic factors such as support from colleagues, workloads, or training, are all aspects that can impact on job satisfaction35. Overwhelmingly, participants of the current study (100%) agreed with this view, strengthening the findings of Thapa et al.36 in a study where they explored the health of nurses and midwives in the workplace, whereby collegial support and teamwork were viewed by participants as inspiring, and crucial, not only to their own health, but for job satisfaction. This substantiates the view of the need, and necessity to nurture and grow an effective workplace relationship and culture35.The relational domain explores the dynamics of the team with whom participants work, their relationships and teamwork, and wider network. Having effective social interaction and relationships are crucial to sustaining a motivational momentum and engagement37. There are not many jobs that do not recognize the importance of being able to take breaks, instead of working continually to the end of a shift. In recent studies, midwives consistently did not have the ability to take meal breaks due to staff shortages38, and nurses’ and midwives’ experiences of urinary symptoms at work were found to primarily relate to delayed voiding39. These studies, and the results from this study, suggest that the missing of meals and comfort breaks are directly related to a workplace culture that puts women or patients first, and deters self-care of those providing care to others.Eight determinants relating to job satisfaction for midwives were revealed in the qualitative section of this study. The everyday issues impacting upon job satisfaction appeared to stem from a shortage of staff, inflexible shifts, a lack of support from management that caused midwives to be time-poor, unable to have the time to provide the care that women required and that the midwives’ basic needs regarding meal/comfort breaks were being ignored. In the United Kingdom (UK), a campaign by the Royal College of Midwives called ‘Caring For You’ in 2016, aimed to improve the health and safety of midwives, which included the importance of taking meal/comfort breaks40 is affecting the job satisfaction of midwives. In the UK, a recent study suggested that there was a shortage of 3500 full time midwives, and skills, experience and confidence were being lost due to the aging midwifery workforce retiring41. In Australia, a recent study identified that the midwifery workforce was impacted by shortages and attrition, which had bearing upon the ability to be a midwife and also negatively affected workplace culture42. It has been predicted that the world is facing a shortage of about 0.9 million midwives, according to the latest State of the World’s Midwifery (SoWMy) report, which was released on the International Day of the Midwife in 202143. Therefore, the issue of continuing staff shortages has been shown to negatively impact on midwives’ daily working experience44, forcing midwives to provide quick, basic care, rather than focusing on quality midwifery care that forms job satisfaction for most midwives.The current global staff shortage in all areas of clinical midwifery practiceBeing of service to women, in providing woman-centered care and having time to support women, appears to withstand the impact of other factors that have bearing upon midwives’ satisfaction with their jobs. By being of service to women, midwives are choosing to engage without expectation or reciprocation, which is linked to the midwifery fundamental belief of being ‘with woman’. As a profession, midwifery has a deep-seated service to women and their families which becomes embedded within midwifery curricula via continuity of care experiences and the foundational belief of woman-centered care. Therefore, this core concept that is conceived in midwifery education and training, remains as a major incentive within midwifery job satisfaction.This study was conducted within Australia and therefore, may not be generalizable to midwives working in other countries. The results also need to be interpreted with caution in regard to other global settings, given the study was conducted solely in Australia, and so may not necessarily be transferrable. As there were only 44 respondents in this pilot study, job satisfaction attitudes may not be generalizable for the Australian midwifery population. This study was undertaken in 2021 during the COVID-19 pandemic, where lockdowns, illness, and the changes to the provision of maternity care may have impacted upon midwives’ time to participate in the study and their attitudes to job satisfaction. We intend to undertake a larger study including international midwives, hoping to explore whether the current issues for midwives are the same as those reported here. The planned study will enable both the context of the COVID-19 pandemic and the views of midwives from multiple organizations to be explored.Exploring midwives’ job satisfaction is an important area of study due to the predicted global shortfall of midwives in the midwifery workforce. This study revealed factors both within the qualitative and quantitative data which linked midwives’ satisfaction with their jobs in Australia, and identified that midwives valued being of service to women, which became evident within the intrinsic factors analysis of the questionnaire, and within the open-ended long answer questions, and, furthermore, this was a driving factor in their job satisfaction. With the looming global shortage of midwives, the satisfaction of midwives in the workforce needs to be a priority to avoid a future crisis in the midwifery workforce.