Australian midwives' intentions to leave the profession and the reasons why.

There is growing body of evidence that suggests many midwives are unhappy and as a result are making decisions to leave the profession. Determine the incidence of midwives indicating their intention to leave the profession and explore the reasons for this decision including what might cause midwives to be dissatisfied. Data analysed was collected as part of the Australian arm of the Work, Health and Emotional Life of Midwives (WHELM) project. Descriptive statistics and latent content analysis was used to analysis the data set. Almost half (42.8%, n=443/1037) the midwives had considered leaving the profession in the preceding six months. The qualitative and quantitative data aligned with 'dissatisfaction with the organisation of midwifery care' and/or 'dissatisfaction with my role as a midwife' being the two commonest reasons behind the intention to leave. Early career midwives were most likely to consider leaving the profession (p=.05) due to dissatisfaction with their role. Almost half the midwives who had considered leaving the profession were most dissatisfied with managers (p=<.001). Midwives felt their ability to provide quality maternity care was constrained by a fragmented medicalised system that did not work for the women in their care or themselves. The results of this study add to a growing call for policy makers and health care providers to reorientate maternity services to enable women to build positive longitudinal relationships with midwives. Not only will this improve maternal and neonatal outcomes but provide a satisfying and sustainable way for working for midwives.

Harvie K ，Sidebotham M ，Fenwick J 《-》

A survey of burnout and intentions to leave the profession among Western Canadian midwives.

Midwives are at high risk for burnout and occupational stress. This has implications for workforce retention and quality of maternity care. We set out to understand how burnout and occupational stress are experienced by midwives in Western Canada, and whether burnout is linked to intentions to leave the profession and other factors. Midwives were invited to participate in the international WHELM (work, health, and emotional lives of midwives) survey through invitations via their professional organizations. The survey included demographic questions and emotional wellbeing scales such as the Copenhagen Burnout Inventory and the Depression, Anxiety, and Stress Scale. Of 158 midwives who participated, 51 (34.7%) had seriously considered leaving the profession, citing reasons such as the negative impact of an on-call schedule on personal life (n=84, 84.8%), as well as concerns about their mental (n=80, 80.8%) and physical health (n=57, 57.6%). Burnout scores were higher among midwives who planned to leave the profession, midwives with young children, those with higher caseloads and fewer days off. Quality of life was significantly lower among midwives who reported higher burnout scores. Midwives suggested many strategies to reduce stress, such as part-time work options, support for sick days/vacation coverage, more pay per course of care, more off-call career opportunities and initiatives to reduce bullying and interprofessional conflict. The current study identified occupational stressors that are unique to the caseload model. Findings from this study can inform policies and strategies to support the growth and sustainability of caseload midwifery in Canada.

Stoll K ，Gallagher J 《-》

Western Australia facing critical losses in its midwifery workforce: a survey of midwives' intentions.

the ongoing attrition of the midwifery workforce frustrates future workforce planning and the provision of maternity services in Western Australia. This project determined factors contributing to the intention of the midwives to move jobs and/or leave the profession. a cross-sectional survey approach was taken for this descriptive research utilising a self-administered questionnaire developed by the Nursing and Midwifery Office, Department of Health, Western Australia. public and private health sectors in Western Australia, April-May 2010. 1,600 midwives employed in the public and private health sectors throughout Western Australia were invited to participate: 712 responded (44.5%), one-fifth of the state's registered midwives. most midwives worked part-time in a clinical role in public hospitals. Almost half intended moving jobs within 5 years and/or leaving midwifery. Excluding midwives of retirement age, the most common reasons for intending to move jobs were family commitments, working conditions and role dissatisfaction. Those intending to leave midwifery cited work-life balance, career change and family commitments. Midwives thought addressing the following issues would improve midwifery retention: flexible work arrangements, remuneration, staffing and caseload, workplace culture, professional development and models of care. retaining the midwifery workforce requires attention to workforce practices particularly flexible work arrangements and workloads; models of care to strengthen midwives' relationships with clients and colleagues; and accessible professional development. a review of workplace practices at unit and institution levels is urgently required in Western Australia so that midwives can achieve work-life balance and practice to the full extent of their professional role. These changes are necessary to forestall premature retirement of skilled and experienced midwives from the profession and workforce churn.

Pugh JD ，Twigg DE ，Martin TL ，Rai T ... -  《-》

Novel solutions to the midwifery retention crisis in England: an organisational case study of midwives' intentions to leave the profession and the role of retention midwives.

Midwifery retention is a global issue, but less is known regarding what motivates midwives' intention to stay or leave within individual organisations. In 2021, NHS England funded maternity organisations to employ retention midwives. To date, the impact of these roles has not been evaluated. To explore the views of midwives regarding their intentions to leave or stay within one English organisation and to provide insights into the perceived impact of the role of retention midwives. An instrumental case study was carried out in one organisation. Data a mixed methods survey (n=67/91) and interview data (n=7). Quantitative data was analysed using descriptive and inferential statistics; qualitative data using thematic analysis. All data was synthesised together. The three themes included 'Values-based tensions: The eroding role of the midwife'; 'Discerning differences: Intentions to leave or stay'; 'Retention midwives: Activities and impact'. We found that there was a clear link between midwives' intention to leave or stay and their workplace roles; specialist midwives were more likely to stay, report satisfaction, autonomy, and feel a sense of contribution or effectiveness in their role compared to those in other roles. The retention midwives were making a positive difference to midwives' experience of the workplace. Midwives working within the same organisation have different experiences of their role and job satisfaction. Future work should consider applying the positive elements of the specialist roles to the wider midwifery workforce to enhance retention. The retention midwife role shows promise, but further evaluation is required.

Feeley C ，Stacey T 《-》

Work-related stress and intention to leave among midwives working in Swiss maternity hospitals - a cross-sectional study.

Peter KA ，Meier-Kaeppeli B ，Pehlke-Milde J ，Grylka-Baeschlin S ... -  《BMC HEALTH SERVICES RESEARCH》