Bower, Heather (2023) Why do midwives stay?: a mixed-methods study of the factors influencing newly qualified midwives in London to remain in post. EdD thesis, University of Greenwich.

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Abstract

Background:
Midwives are leaving midwifery in greater numbers than in previous years. Newly qualified midwives (NQMs) are the group most likely to leave. Most research has explored why midwives leave rather than why they stay. This research seeks to understand which factors enable NQMs to stay in midwifery, focusing on London, with the aim of retaining this important group of midwives in the midwifery profession.

Methods:
A pragmatic, mixed-methods approach was used to explore why NQMs choose to stay in midwifery. The research was conducted in two phases. Phase one was a survey, sent to all midwives (n = 1502) in four London Trusts with a 16.3% (n = 248) response rate. Participants were asked to complete two scales, the Connor-Davidson 10-point Resilience Scale and the Bower Midwife Wellbeing Scale, developed for this research. Survey data were analysed using SPSS-27. From the survey, eleven NQMs self-selected to be interviewed (phase two) using the findings from the scales as a basis for questioning. Interviews were recorded and transcribed, and interview data were analysed using Applied Thematic Analysis.

Results:
The survey found that the Bower Midwife Wellbeing Scale demonstrated a significant predictive ability in being able to identify midwives who were more likely to have thought of leaving in the last six months. The higher the mean score of the scale, the less likely the midwives were to have thought of leaving (their post/midwifery), so were more likely to stay.

The interviews identified three themes: head above water, cultural conflicts and professional identity. The factors most likely to enable NQMs to stay were those that improved their professional identity, such as job satisfaction and continuity of care. Factors that were least likely to enable them to stay were a poor workplace culture, such as a bullying culture and lack of staff.

Integrating the results from the survey and the interviews, factors that both improved and diminished personal and professional resilience were identified. NQMs with a higher Bower Midwife Wellbeing score were more likely to stay in midwifery.

Recommendations:
The Bower Midwife Wellbeing Scale, developed for this research, has the potential to predict NQMs who are more likely to stay in midwifery as they score higher on the scale. By predicting those who are more likely to leave, it is proposed that interventions, such targeted support, can prevent attrition. The research also identifies adverse workplace conditions that need to be addressed if NQMs are to stay.

The relevance of the research for education is that high personal resilience enables NQMs to cope better with adverse workplace conditions (improving their professional resilience). Personal resilience can be developed through educational interventions, and it is recommended that this is addressed in pre-registration midwifery education programmes. Further research into testing the Bower Midwife Wellbeing Scale is also recommended, to be able to identify those NQMs who are more likely to stay.

Item Type:	Thesis (EdD)
Uncontrolled Keywords:	Midwifery, midwifery practice, midwifery profession, wellbeing, personal resilience,
Subjects:	R Medicine > RG Gynecology and obstetrics R Medicine > RT Nursing
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > School of Education (EDU)
Last Modified:	02 Sep 2025 11:04
URI:	https://gala.gre.ac.uk/id/eprint/50974

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