Burnout, job satisfaction, and intention to leave among midwives in Western Switzerland: The role of caseload and hospital-based practice models

Background: Burnout and job dissatisfaction among midwives compromise healthcare quality and workforce retention. Practice models, such as hospital-based versus caseload models, may influence midwives’ well-being and warrant further exploration. Aim: To examine the association between midwifery practice models (caseload vs. hospital) and burnout, job satisfaction, and the intention to leave the profession among midwives in Western Switzerland. Method: A cross-sectional survey was conducted with 392 midwives, using the Copenhagen Burnout Inventory to assess personal, work-related, and patient-related burnout. Multivariable logistic regression explored associations between practice models and burnout levels, job satisfaction, as well as retention in the profession. Main results: Hospital midwives were over nine times more likely than caseload midwives to experience moderate to high work-related burnout (OR = 9.18, p < .001) and were 80 % less likely to report above average job satisfaction (OR = 0.21, p < .001), considering differences between socio-demographic and practice-related factors between the two groups of midwives. Nearly half of all hospital-based participants expressed an intention to leave compared to one in three caseload midwives. Higher burnout and lower job satisfaction were linked to intentions to leave the profession. Discussion and conclusion: Caseload models may protect midwives’ well-being and promote job satisfaction and retention. These findings highlight the critical need for practice model changes and structural reforms in hospital midwifery, incorporating caseload principles, to support sustainable maternal and child healthcare in Western Switzerland and retain a resilient midwifery workforce.