Exploring Midwives' and Nurse-Midwives' Professional Identity and How Midwifery May Be Best Represented in the Public Realm: A Global Convergent Parallel Mixed-Methods Study.

Aims: With respect to midwives and nurse-midwife populations (1) measure and (2) explore professional identity and (3) explore how the midwifery profession may be best represented in the public realm.

Design: Convergent Parallel Mixed-Methods Design.

Methods: A web-based survey was used to collect data from 860 midwives and nurse-midwives from 102 countries between February and July 2022. Qualitative data were analysed inductively via reflexive thematic analysis. Statistical analysis was performed using SPSS.

Results: Nurse-midwives had a statistically significant higher professional identity score than midwives. Subthemes included pride and passion in midwifery and nurse-midwifery; motivational religiosity; celebrating role diversity and a call for the separation of nursing and midwifery. Subthemes outlining barriers to the development of a healthy professional identity related to lack of professional recognition in society and lack of respect from other professions. Subthemes related to the representation of midwifery included (1) imagery (e.g., real midwives) and (2) mediums (e.g., statues). Diminished professional identity and the conflation of midwifery with nursing were negatively associated with the recruitment and retention of midwives.

Conclusion: This is the first study to measure and investigate the professional identity of midwives and nurse-midwives concomitantly and explore how midwifery may be best represented in the public realm. Public monuments highlighting both the art and science of midwifery along with the separation of midwifery from the nursing profession and enhanced role diversity may boost the professional identity of midwives overall.

Implications For The Profession: Midwives' professional identity, status and recognition in society are key to improved perinatal outcomes, recruitment and retention. Findings will inform interventions designed to enhance the professional identity and public representation of midwives worldwide.

Impact: This research demonstrates midwives diminished professional identity. Findings will be used to bolster the midwifery profession to improve perinatal outcomes, along with the recruitment and retention of midwives to the benefit of childbearing people and their families worldwide.

Patient Or Public Contribution: Global webinars were used to engage midwives and nurse-midwives in shaping the design and direction of this research.

Reporting Method: The Good Reporting of a Mixed Methods Study (GRAMMS) checklist was used to guide reporting.