Factors impacting Western Australian midwives' intention to stay: A mixed methods study

PROBLEM: Midwifery workforce sustainability remains a critical concern for maternity services. Existing literature predominantly focuses on burnout and attrition, offering limited insight into what influences midwives' decisions to remain within specific workplaces. BACKGROUND: Midwives consistently report strong professional commitment alongside growing workforce instability. National data indicate that uncertainty about current roles does not necessarily reflect disengagement from the profession. Understanding workplace-level influences on retention is therefore essential for targeted workforce strategy. AIM: To examine how workplace stress and satisfaction with the practice environment are associated with Western Australian midwives' intention to stay in their current job and in the profession. METHODS: A cross-sectional survey of midwives employed in Western Australian maternity services was conducted. Validated instruments assessed satisfaction with the practice environment, workplace stress, and intention to stay. Quantitative data were analysed descriptively, and open-ended responses were examined using categorical content analysis. FINDINGS: Midwives demonstrated strong commitment to the profession, with greater uncertainty about remaining in their current workplace. Positive perceptions of local leadership and collegial relationships contrasted with dissatisfaction at organisational level, particularly regarding governance participation and resource adequacy. Decisions to stay were shaped by whether practice environments enabled alignment with professional values. CONCLUSION: Retention is primarily influenced by site-level organisational conditions rather than professional disengagement, highlighting modifiable levers for strengthening workforce stability in maternity services.