BACKGROUND:
Midwives play a critical role in achieving global goals for sexual and reproductive health, yet midwifery shortages are a growing concern worldwide.

OBJECTIVES:
This study aimed to analyse work and health-related factors associated with midwives’ intentions to leave their current position or the profession entirely.

METHODS:
A nationwide web survey was conducted among Swedish midwives in 2020 (n = 5076) and repeated in 2023 (n = 4398). The analyses included cross-sectional data (n = 3696) and prospective data (n = 531/406) from participants responding at both time-points. Uni- and multivariable logistic regressions examined associations between variables including: possibilities for development, quality of work, role conflict, recognition, self-rated health, and burnout, and two outcomes: intention to leave current position and intention to quit midwifery.

RESULTS:
Cross-sectional analyses showed that 56% of midwives had an intention to leave their current position. Higher quality of work, recognition, and development opportunities were associated with lower intention to leave the current position, while role conflict and burnout increased the likelihood. In prospective analyses (n = 531), quality of work, recognition, and lower burnout at baseline predicted lower intention to leave at follow-up. When excluding those already intending to leave at baseline (n = 406), only quality of work remained a significant predictor. Regarding intention to quit midwifery,42% of midwives had thought of quitting midwifery altogether. Recognition and development opportunities were protective factors, while burnout increased the risk. Prospectively, recognition and self-rated health at baseline predicted lower intention to quit among those not already intending to leave.

CONCLUSIONS:
Quality of work, recognition, and health are key factors in midwives’ retention. Recognition, in particular, emerges as a simple yet powerful factor—a humble but meaningful wish from a professional group essential to global health systems.

KEY MESSAGE:
To retain midwives, healthcare systems must improve working conditions and meaningfully acknowledge their professional contributions. Poster session 1 (Group A)