Midwifery members want staffing ratios with enough qualified midwives to keep patients safe and retain experienced staff.

Staff shortages in maternity services must not be addressed by significantly diluting midwifery positions. Midwives must comprise a substantial majority of maternity staff during any workforce rebuilding or transition period.

These were the views of a large majority of NSWNMA midwifery members who responded to a statewide survey conducted by the Association in order to guide its ongoing discussions with the Ministry of Health.

There are two main unresolved issues currently in negotiations: night duty ratios and the skill mix for the 1:3 ratio being rolled out in postnatal wards.

The survey shows staff numbers and skill mix are major concerns. Two-thirds (67.4 per cent) of respondents experienced staffing levels they considered unsafe on every or most shifts they worked; 60 per cent reported working with a skill mix they considered unsafe on every or most shifts.

Unplanned Leave

The survey also examined how unplanned leave is managed. Almost 85 per cent said unplanned absences were mostly or sometimes replaced by classifications other than midwives.

“While these arrangements may provide short-term staffing relief, ongoing concerns remain about workload distribution and the impact upon specialised maternity care delivery,” the survey report says.

Skill Mix

Midwives were also asked about acceptable skill mix arrangements during any workforce rebuilding or transition period. The model favoured by 44 per cent of respondents was a workforce comprising 90 per cent midwives and 10 per cent other classifications. A further 26 per cent supported an 80 per cent midwife / 20 per cent other classifications model.

“There is a clear need to preserve specialised expertise while allowing limited flexibility to support workforce sustainability during periods of recruitment and workforce growth,” the survey report says. “Importantly, support for a 90/10 model reflects a view that workforce shortages should not be addressed through significant dilution of midwifery positions.

“Instead, respondents are in favour of rebuilding workforce capacity while maintaining the integrity of the midwifery profession and the specialised care it provides.”

Night shift

Night shift staffing was a key issue for respondents. Asked whether the Association should maintain its claim for a 1:3 ratio on night shift, 81.3 per cent of respondents said yes.

Of those supporting 1:3 on night shift, 80.6 per cent expressed strong support rather than moderate support.

Retention crisis

More than four in five respondents (83.5 per cent) reported either having considered leaving their role or actively planning to leave due to workload and staffing pressures. Of particular concern, 22.3 per cent were actively planning to leave.

When asked whether a 1:3 staffing ratio would make them more likely to remain in midwifery, more than half (56 per cent) said “Yes, definitely”.  A further 33.2 per cent said a 1:3 ratio would somewhat influence their decision.

About the survey

The Association conducted the statewide survey of midwifery members working in the public health sector in May 2026. It received a total of 882 responses from local health districts covering metropolitan and regional maternity services.

The survey captured a mostly experienced workforce. Almost half (49 per cent) of respondents had more than 10 years of midwifery experience, and a further 19.1 per cent had between six and 10 years. More than half (53.7 per cent) of respondents were employed part-time.