Australian midwifery workforce in crisis, report finds

23 Oct 2024

Modelling outlines midwifery gaps and options to boost workforce

Australia’s midwifery workforce is in crisis, with an in-depth analysis of the profession revealing there are not enough midwives or students to meet future needs.

The Midwifery Futures modelling has identified widespread 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.

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 research includes more than 30 recommendations to address a midwifery crisis that is also impacting other areas of the world.

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 the Board was pleased to have taken a major step in long-term planning for the birth of future generations.

‘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,’ Adj Prof Casey, said.

‘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 focussed 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.

Launched in Canberra today, the final report takes in the views of more than 3,000 midwives, 300 students and 70 educators as well as focus groups across the country in the largest study of Australian midwives so far, which found:

• Australia’s midwifery workforce is in crisis and there are not enough midwives or current midwifery students in the pipeline to meet the future needs, especially if midwives are not supported to stay in the profession
• there are widespread localised staffing shortfalls, particularly in non-metropolitan areas.
• while modelling shows a slight excess in future workforce numbers to 2030, a higher than current attrition rates 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.

Lead author of the study, Burnet Institute Professor Caroline Homer AO said urgent action was needed to boost midwifery students by a fifth.

‘Australian midwifery is in crisis. People in the sector already know this,’ Prof Homer 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, to grow and support the midwifery workforce, including:

• universities, health services, and policy makers 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 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, employers, executive and clinical levels.
• the Commonwealth Government 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 strengthen workplace flexibility, adequate working conditions, and ensure midwives have more career pathway options including part-time and job share opportunities.

The final report of the Midwifery Futures project is available on the Midwifery Futures Project website.

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