Novel solutions to the midwifery retention crisis in England: an organisational case study of midwives’ intentions to leave the profession and the role of retention midwives

Abstract

Problem/Background: Midwifery retention is a global issue, but less is known regarding what motivates midwives’ intention to stay or leave within individual organisations. In 2021, NHS England funded maternity organisations to employ retention midwives. To date, the impact of these roles has not been evaluated. Aim: To explore the views of midwives regarding their intentions to leave or stay within one English organisation and to provide insights into the perceived impact of the role of retention midwives. Methods: An instrumental case study was carried out in one organisation. Data a mixed methods survey (n=67/91) and interview data (n=7). Quantitative data was analysed using descriptive and inferential statistics; qualitative data using thematic analysis. All data was synthesised together. Findings: The three themes included ‘Values-based tensions: The eroding role of the midwife’; ‘Discerning differences: Intentions to leave or stay’; ‘Retention midwives: Activities and impact’. Discussion: We found that there was a clear link between midwives’ intention to leave or stay and their workplace roles; specialist midwives were more likely to stay, report satisfaction, autonomy, and feel a sense of contribution or effectiveness in their role compared to those in other roles. The retention midwives were making a positive difference to midwives’ experience of the workplace. Conclusion: Midwives working within the same organisation have different experiences of their role and job satisfaction. Future work should consider applying the positive elements of the specialist roles to the wider midwifery workforce to enhance retention. The retention midwife role shows promise, but further evaluation is required.