Predictors of intention to leave and actual turnover among midwives — A three-year nationwide longitudinal study in Swedish healthcare

Objectives: This study explored midwives' intentions to leave their position or the profession, actual turnover, and salary satisfaction over a three-year period. It also examined differences between primary and hospital care and identified predictors of turnover. Methods: A longitudinal survey was conducted with 478 midwives in 2020 and 2023. Measures included intention to leave, salary satisfaction, and actual turnover. Predictors were analysed using linear and logistic regression models. Results: By 2023, 39% of midwives expressed an intention to leave the profession. Intention to leave their current position decreased slightly over time, while salary satisfaction increased. Significant predictors of intention to leave included baseline intention (β = -0.698, p < .001), salary satisfaction (β = -0.128, p < .001), and professional experience (β = -0.113, p < .001). Turnover was higher in primary care (OR = 2.83, p < .001). Salary satisfaction was also linked to actual turnover. Care setting did not predict intention to leave. Conclusion: Efforts to improve working conditions and ensure fair compensation are key to retaining midwives and maintaining quality care for mothers and newborns.