Factors that contribute to midwives staying in midwifery: a study in one area health service in New South Wales, Australia.

OBJECTIVE The Australian health workforce is experiencing workforce shortages like many other countries. Managing retention is one important element of workforce planning. Determining the drivers of retention in midwifery can assist workforce planning. The objective of this study was to determine the factors that contribute to the retention of midwives, that is, why do midwives stay? DESIGN A descriptive design was undertaken in two phases. Phase one used focus groups to adapt a questionnaire used in the 'Why Midwives Stay' study in England for the Australian context. Phase two used the questionnaire to collect qualitative and quantitative data. SETTING One area health service in New South Wales, Australia. PARTICIPANTS 392 midwives employed in the area health service either full-time, part-time or on a casual basis were invited to participate and 209 (53%) responded. FINDINGS The majority of respondents were women aged 23-69 years (mean age 42 years). Just over half had received their midwifery qualification through the hospital-based system which was usual prior to 1994 reflecting the age of the cohort. The top three reasons for staying in midwifery were 'I enjoy my job', 'I am proud to be a midwife' and 'I get job satisfaction'. Job satisfaction was received when midwives felt that they made a difference to women, had positive interactions with women in their care and saw women happy. The motivation to keep going was achieved through having a positive outlook; having job satisfaction, and, having work colleagues with a sense of belonging. IMPLICATIONS FOR PRACTICE The findings have implications for the organisation of care, models of care, and management systems. Health services and departments of health need to consider these issues especially in an environment of workforce shortages. Addressing the way care is arranged and how staff are supported may lead to higher retention rates, thus reducing costs.