Report makes 30 recommendations to tackle midwifery crisis

Australia’s midwifery workforce is in crisis, with a new report identifying widespread staffing shortages, and not enough midwives or current students in the pipeline to meet future needs.

Commissioned by the Nursing and Midwifery Board of Australia (NMBA) to help safeguard the profession and the women and babies who rely on it, the Burnet Institute-led ‘Midwifery Futures’ report provides more than 30 recommendations to address the crisis. NMBA works in partnership with the Australian Health Practitioner Regulation Agency (Ahpra) to regulate nurses, midwives and related students to protect the public.

The report has identified local staffing shortfalls, particularly in non-metropolitan areas, which would have a “catastrophic impact” if the already high rates of workforce attrition increase above expectations, Ahpra said in a statement.

Launched in Canberra, the final report takes in the views of more than 3000 midwives, 300 students and 70 educators as well as focus groups across the country in what is said to be the largest study of Australian midwives so far.

While Australian governments, employers, the higher education sector and professional bodies will need to consider the recommendations, NMBA Chair Adjunct Professor Veronica Casey AM said, “Midwives play a vital role in maternity care at the most precious time, but they now need urgent support to ensure they can continue to be everywhere they are needed.

“That not only means making sure that midwives have the right capabilities for their role, but ensuring there are the right numbers of midwives to meet demand.

“This Australian-first research presents a strong case for change to grow the midwifery workforce, support greater workforce flexibility and improve the available data to optimise midwifery workforce planning. The Board is focused on championing this change.

“With sustained commitment, investment and collaboration between Australian governments, employers, the higher education sector and professional bodies, we will be able to grow our midwifery workforce.

The Midwifery Futures project was funded by the NMBA, in collaboration with the Chief Nursing and Midwifery Officers of Australia and New Zealand, to review the current state of Australia’s midwifery workforce and generate the information needed to guide improvements.

The report also found that:

• While modelling shows a slight excess in future workforce numbers to 2030, a higher than current attrition rate would have a “catastrophic impact”.
• A third of respondents to the Midwifery Futures workforce survey were considering leaving the profession, including many well before retirement age due to their experiences of working as a midwife.
• Aboriginal and Torres Strait Islander Peoples are underrepresented in the midwifery profession, and the impact and ongoing presence of racism, intergenerational trauma, vicarious trauma, and colonisation present significant challenges.
   

The lead author of the study, Burnet Institute Professor Caroline Homer AO, said, “We can’t keep doing the same thing and expect different results. This is the moment to do something differently.

“We don’t have enough midwives or midwifery students to meet our future needs, and we need to support midwives to stay in the profession.”

The Midwifery Futures project made 32 recommendations to increase the visibility, governance and leadership of the profession, to scale up models of care, and to grow and support the midwifery workforce, including:

• universities, health services and policymakers to increase the number of midwifery students, starting as soon as possible, by at least 20% — leading to around 1560 students graduating in the next 2–4 years;
• universities and health services to implement quarantined places for Aboriginal and Torres Strait Islander midwifery students;
• where there is a maternity service, ensure that leadership is provided by midwives at government, employer, executive and clinical levels;
• the Australian Government to develop and implement midwifery continuity of care models as a defined care pathway, and fund midwives to work to their full scope;
• government, health services, industrial and professional bodies to strengthen workplace flexibility, provide adequate working conditions, and ensure midwives have more career pathway options including part-time and job-share opportunities.
   

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