Understanding midwifery workforce retention: An Australian cross-sectional study

Retention is a known challenge in international and Australian midwifery workforce.

Identification of drivers of workforce retention is essential to enable strategic planning for service delivery, consistent with workforce trends. Limited contemporary, midwifery-specific workforce data within Western Australia (WA) exists.

To explore midwives' perspectives of factors contributing to retention, and views on their working environment.

An anonymous cross-sectional survey was conducted with midwives within the largest maternity service in WA. Quantitative data were analysed using descriptive statistics and structural equation modelling. Qualitative data underwent content analysis.

A total 193 midwives participated. Modelling demonstrated that perceptions of workplace culture was positively associated with the probability of midwives feeling acknowledged by the organisation for their work (OR=6.61, p < .001), and with better midwifery retention (b=3.34, p < .001). Acknowledgement was not a significant direct predictor of retention (b=1.12, p = .150), thus, was not a significant mediator of the association between workplace culture and retention. Top three reasons influencing midwives' intention to stay were pay (89.6 %), patient ratios reflecting acuity (82.4 %) increasing the profile of the midwifery profession (80.8 %). Content analysis of midwives' perspectives on retention factors exposed three categories: Intraprofessional relationships; Valuing the workforce; Career satisfaction.

Midwives' perspectives on retention emphasise the need for transformational leadership, professional recognition, and workplace empowerment as key strategies for sustaining the midwifery workforce.

Findings provide novel insight into indicators of WA midwifery workforce retention. Recommendations for midwife-driven solutions provide direction to enable midwifery leadership to support sustainable midwifery workforce retention into the future.