The Hesitance of Nurses to Apply for Midwifery Specialization: Explorative Qualitative Study

Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, stress and burnout, lack of opportunity for training, lack of management support, financial issues and lack of recognition and compromised autonomy. Purpose: To explore the reasons behind nurses’ hesitance to apply for midwifery specialization. The objectives of this study were to understand the challenges that lie in front of Omani nurses and the motivational factors to apply for a midwifery programme. Method: Exploratory qualitative study was conducted at the largest tertiary hospital in Oman. Purposive sampling was applied for participant recruitment. Face-to-face interviews and focus group discussions were used as data collection methods. The study included general nurses, nurses in charge working in the maternity unit as well as nurses whose applications were accepted for midwifery education. Qualified midwives were excluded. The data collection process yielded twenty-five nurses. The interview protocol highlighted the impact and perception of the midwifery specialization on nurses’ careers. Thematic analysis was employed for data analysis. Results: Three over-arching major themes were identified. These are 1) nurses’ perceptions about the nature of work in maternity wards, the nurses have positive perception toward working in maternity wards and labor room because of working exclusively with female patients and their babies 2) factors influencing the decision to study midwifery specialization, work overload, stress, lack of support from administration were the most common reason behind the nurses not to apply for midwifery specialization and 3) support and recommendations required for midwives, the nurses mentioned that their identity, promotions and support from the administration will encourage them to apply for midwifery specialization. Conclusion: One of the main reasons that hindered nurses from applying to midwifery specialization is the false belief that midwives cannot work outside the delivery suite (DS). The second reason was the stress that midwives encounter at DS, and this was perceived by general nurses who did not work at DS. These challenges could be mitigated by leadership support, midwifery profession identity, as well as financial recognition for the midwives.