Author Identifier
Rosebeth Kagoce: https://orcid.org/0000-0002-7510-2269
Date of Award
2026
Keywords
Job satisfaction, retention, intention to leave, workforce, attrition, workplace, workforce, accoucheur, midwife, registered midwife, intention to stay
Document Type
Thesis
Publisher
Edith Cowan University
Degree Name
Master of Midwifery (Research)
School
School of Nursing and Midwifery
First Supervisor
Dianne Bloxsome
Second Supervisor
Sara Bayes
Abstract
Midwives play a crucial role in global healthcare, making a significant contribution to reducing maternal and newborn mortality and morbidity. Despite their vital role, shortages in the midwifery workforce and ongoing challenges in retaining midwives, remain a major global concern. The World Health Organization has repeatedly emphasised the risks associated with workforce attrition, highlighting that poor midwifery retention could adversely affect maternal and neonatal health outcomes. These challenges are compounded by an ageing workforce, persistent issues such as burnout, exhaustion, and low job satisfaction. While substantial evidence exists regarding why midwives leave the profession, there is limited understanding of the organisational factors that encourage midwives to remain, particularly within the Western Australian (WA) context.
This study identifies organisational strategies that encourage midwives to stay in the profession in the WA context. Using naturalistic inquiry aligning with qualitative descriptive methodology, between June and August 2024, 82 midwives working across various health sectors in WA participated in an online survey. The data collected was analysed using Braun and Clarke’s six-step thematic analysis, which revealed that although midwives love their jobs, organisational factors influence their decisions to stay or leave the profession.
The findings suggest that organisations must move beyond reliance on midwives’ intrinsic motivation and professional commitment and instead implement structural and cultural strategies that actively promote retention.
Examples of these strategies include, but are not limited to:
1. Fostering a supportive workplace culture by promoting teamwork and strengthening collegial relationships.
2. Providing fair and competitive remuneration structures that recognise experience and advanced practice.
3. Ensuring safe staffing levels and manageable workloads, including workforce planning that aligns staffing with patient acuity and limits excessive workloads. Such essential and vital measures will both support midwives’ wellbeing and promote safe, high quality maternity care and reinforce professional satisfaction.
4. Providing flexible and equitable rostering practices necessary to support work-life balance, including self-rostering and part-time options with fixed days, implemented organisation-wide rather than selectively. Consistent access to flexibility may aid retention across different life stages and career paths.
5. Strengthening leadership capability through investment in leadership development programmes that emphasise supportive, relational, and visible leadership could improve morale and trust.
6. Improving interdisciplinary collaboration within maternity multidisciplinary teams, such as creating organisational strategies that promote respectful communication, shared decision-making, and clear role definitions between midwives and the obstetric multidisciplinary team. Regular structured opportunities for interdisciplinary engagement may reduce workplace tension and enhance professional autonomy, thereby supporting retention.
Collectively, these six strategies highlight the need for comprehensive, organisation-wide approaches that address workplace culture, staffing conditions, leadership quality, remuneration, and flexibility. Implementing such strategies may foster a sustainable workplace environment that enables midwives to remain in the profession in the long term. Recommendations emerging from this study include the need to investigate how specific organisational models, such as midwifery-led continuity-of-care, team-based care, or flexible rostering systems, influence retention and wellbeing.
Future research should focus on how these organisational models, such as midwifery-led continuity-of-care, team-based care, and flexible rostering systems, affect midwives’ retention and wellbeing, while recognising that these impacts may differ across various career stages. Furthermore, examining the experiences of early-career, late-career, and casual midwives separately, could clarify whether organisational strategies require tailoring rather than a one-size-fits-all approach. Future research should also focus on identifying organisational barriers that impede the implementation of optimal staffing levels, effective workload management, and meaningful recognition frameworks. Longitudinal studies would be valuable in assessing the long-term impacts of organisational strategies and in providing insights into how midwives’ intentions to stay or leave the profession change over time. Finally, comparative research across WA, other Australian jurisdictions, and international contexts may also reveal which organisational strategies are transferable and which are influenced by local systems and constraints.
Access Note
Access to this thesis is embargoed until 3rd June 2027
Recommended Citation
Kagoce, R. K. (2026). Developing strategies to support midwives to stay in the profession: Qualitative descriptive study. Edith Cowan University. https://doi.org/10.25958/kfhr-3p13