96 | Chapter 5 were shortages of staff at work, not being satisfied with the quality of care that they can give and being dissatisfied with working conditions and workload.2 In addition, within the group of UK midwives who considered leaving the midwifery profession, there were higher levels of burnout, depression, anxiety and stress in comparison to the midwives who did not consider it.2 Turnover is often defined as the voluntary termination of membership to an organisation by an employee of that organisation.2 Common reasons for leaving are dissatisfaction due to a lack of time to deliver appropriate care, shortage of staff and a high workload.9 Moreover, studies show that midwives feel demoralised, disempowered, and overwhelmed by the medicalisation of birth, as well as a lack of autonomy.2,11,12 Despite this research on intentions to leave and the reasons for turnover, little is known regarding the reasons of community midwives in the Netherlands to leave the workforce. This study adds specific new knowledge and insights based on a maternity care system in which midwives work as autonomous medical professionals. This study focuses on elements such as the strong relation between the intention to leave and actual turnover and on the possibility that a midwife’s performance could already be different once they intend to leave. The aim of this study is to identify the rate and reasons of intention to leave and to explore the actual reasons for leaving the midwifery profession in the Netherlands. The following research questions will be answered: 1. What is the rate of intention to leave among community midwives? 2. What are the reasons for intending to leave among community midwives and do these reasons differ between newly qualified midwives and experienced midwives? 3. Why do community midwives really leave the profession? PARTICIPANTS, ETHICS AND METHODS To answer our research question, we used a mixed method sequential explanatory design: quantitative data was enriched with in-depth information to gain broad knowledge. The study consists of two parts: 1. A quantitative survey study of a sample of practising community midwives in the Netherlands to identify the rate and reason for the intention to leave. 2. A qualitative study consisting of in-depth interviews with community midwives who left the midwifery profession.
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