Planning for the future of the Australian midwifery workforce: the Midwifery Futures workforce model.

Abstract

Objective Quality maternity service provision relies on having a robust midwifery workforce. Although previous models suggested future growth of the workforce, this is at odds with recent reports of staffing shortfalls and difficulties in recruitment. We developed an updated model to provide long-term projections of supply and demand for the Australian midwifery workforce. Methods A dynamic stock and flow model was built from baseline data from 2022, with projections through to 2030. It was assumed that 79% of the midwifery workforce would provide clinical care, working 20h per week to meet a workload of 40 pregnancies per full-time equivalent midwife per year. Results If recruitment and attrition remain stable, both headcount and full-time equivalent numbers of midwives will increase by 2030, exceeding demand. The average annual workload per full-time equivalent midwife would fall to 34 pregnancies. However, if voluntary attrition rose by 10%, there would be a rapid and devastating decrease in numbers. The average workload for a full-time equivalent midwife would rise to 66 pregnancies per year by 2030. Conclusions The Midwifery Futures model demonstrated the sensitivity of the Australian midwifery workforce to a small change in attrition. Preventing midwives' exit from the workforce by improving their experiences in the workplace and increasing access to midwifery continuity roles would build workforce resilience. Minimising attrition, enhancing midwives' engagement, and matching student intake to attrition can assist in maintaining a robust Australian midwifery workforce.