MIDWIVES’ turnover poses a significant global health challenge, with approximately two out of every five worldwide intending to leave the profession, a new first-of-its-kind systematic review and meta-analysis has found.
Researchers called for urgent policy action to enhance working conditions, strengthen leadership, and address systemic inequalities to retain the essential workforce.
Study Significance
Midwives are paramount to the safeguarding of mothers and newborns, as well as to achieving the Sustainable Development Goals in sexual, reproductive, maternal, newborn, and adolescent health.
Authors reported that factors tied to burnout, job dissatisfaction, and intention to leave include a lack of recognition, limited autonomy, heavy workloads, and the COVID-19 pandemic.
Until the study, there had been no global quantification of turnover intention in the relevant population.
39% Intention to Leave
Researchers searched databases from January 2020 to August 2025 for observational studies reporting the prevalence of turnover intention among midwives worldwide.
Overall, 27 studies analysing a total of 17,427 midwives were included.
The pooled prevalence of intention to leave the profession stood at 39%.
Rates were also subject to substantial geographic variation.
There were significantly lower rates of intention to leave in Europe, at 27.7%, compared to other regions.
Low- and middle-income countries saw intention to leave rates almost twice as high as those in high-income countries, at 52.6% and 33.8%, respectively.
Call for Urgent Reform
The findings come amid indications of a wider crisis, across global healthcare systems, in retaining professionals.
Urgent reform is necessary for the wellbeing of midwives and safety of mothers and newborns.
From a research perspective, authors said that future studies must move from documenting issues towards analysing potential solutions, like mentorship programmes, supervision models, and policy reforms, with a view to elevating midwifery’s status and autonomy.
Researchers reported that addressing contributing factors to intention to leave is a “moral imperative to ensure the health of current and future generations”.
Reference
Zarei E, Khabiri R, Stoll K. Global prevalence of midwives’ turnover intention: a systematic review and meta-analysis. Women Birth. 2026;39(3):102190.
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