A national shortage of midwives, coupled with the increasing complexity of maternal health issues
and the rising age of childbearing women, has resulted in the role of the midwife being an
increasingly challenging one. Many midwives experience emotional distress, low morale, and job
dissatisfaction and are making the decision to leave the profession as a result. Recruiting and
retaining resilient individuals who can survive and thrive in complex and demanding working
environments in the NHS has been widely suggested as a key strategy for improving retention in
the midwifery profession. However, limited evidence exists on the influence of resilience on
midwives’ career experiences, choices, and trajectories, particularly during the early phases of
stress and job dissatisfaction.
This thesis presents a Grounded theory (GT) study which explored the influence of resilience on
midwives’ and student midwives’ career-related decisions. Thirty-six participants from the North
of England took part in individual semi-structured interviews. Data were collected and analysed
following Charmaz’s (2014) Constructivist Grounded theory approach and constant comparative
methods.
The substantive Grounded theory (GT), ‘Time to change’ was developed comprising four core
concepts: ‘Fitting in’, ‘Being valued,’ ‘Feeling in control’ and ‘Getting the balance right’. Central to
the theory was the importance of confidence, experience, and perceived support on fluctuating
levels of resilience, and midwives’ subsequent ability to make career related decisions including
changes in role, work-life balance, and the decision to remain in the profession.
Findings from the study indicate that participants perceived resilience, alongside a number of
other influences, had a significant role to play in midwives’ and student midwives’ career related decisions.
The findings provide novel insight into the influence of resilience in midwifery
that has relevance for the profession and the potential to inform midwifery policy, practice, and education for the future.
