I love my job. But it's physically, mentally, and emotionally draining": a cross-sectional survey exploring midwives' intentions of leaving the profession in Melbourne, Australia.

Background: Prior to the COVID-19 pandemic there were midwifery workforce deficits reported in Australia, but inadequate workforce data to identify retention and attrition in the profession. In the post-pandemic era, workforce deficits continue. This paper reports on midwives' intentions to leave the profession and explores reasons for and factors associated with having high intention to leave, to inform strategies that can address retention and attrition of midwives.

Methods: A cross-sectional survey with midwives was conducted in 2017 via an online survey in two maternity care sites in Victoria, Australia. Plans for remaining in or leaving the profession were explored along with reasons for leaving or intending to leave the profession. Other data collected included demographic and workforce characteristics and occupational stressors. Burnout was measured using the Copenhagen Burnout Inventory and job satisfaction using the Midwifery Process Questionnaire. Descriptive statistics, univariate, multivariate analyses, and content analysis were used for data analysis.

Results: Of the 326 respondents (326/508, 64%), over half had considered leaving the midwifery profession in 12 months prior to the study, 20% had thought about leaving frequently and 12% were planning on leaving in the next five years. The main reasons for leaving were not wanting to do shift work, feeling worn out, and experiencing work-related stress. Factors associated with a high intention to leave the profession were work-related burnout, poor job satisfaction and a high intention to leave the workplace. Age did not impact intention to leave but was influential on the reasons for leaving.

Conclusions: Pre-pandemic, midwives in Victoria, Australia had a high intention to leave the profession regardless of age. Approaches that address midwifery stress, burnout, and fatigue need to be considered, including developing options that offer employment that does not require shift work. To provide safe quality care that supports positive outcomes for women and their families, an appropriate midwifery workforce must be achieved and maintained. Understanding midwives' intentions to leave the profession is critical and requires ongoing attention given the workforce is likely to remain under significant stress until the major contributing factors are addressed.