Enabling and inhibiting factors in the transition to practice for newly qualified midwives: An integrative review

OBJECTIVE: This integrative review examines the factors that enable or constrain the transition to practice for newly qualified midwives. It identifies the core factors underpinning their successful transition to the profession. DESIGN: An integrated review of the empirical literature on the experience of transition to practice for newly qualified midwives. METHODS: Relevant literature was identified by database searches of CINAHL, Embase, Medline, PubMed, Scopus, and Trove. Search terms included 'midwife', 'transition to practice', 'transitional programs', 'new graduate', and 'newly qualified'. Studies were eligible for inclusion if they were published in English from 2000 to 2026 and presented empirical studies on the transition to practice experience of university-educated midwifery graduates. Studies focusing on nursing graduate experiences or transition programs in contexts where midwifery practice formed part of nursing transition pathways were excluded from this study. REVIEW METHOD: A five-stage integrative review methodology was used to collect, evaluate and present the evidence. The Mixed Methods Appraisal Tool (MMAT) was also used to evaluate the quality of the methodological studies. RESULTS: Database searches yielded 1161 papers, of which 26 met the inclusion criteria (qualitative n = 22; mixed methods n = 3; quantitative n = 1). The included studies were conducted in Australia (n = 11), Ireland (n = 2), New Zealand (n = 4), and the United Kingdom (n = 9). Four overarching themes and associated subthemes were identified: (1) program features (supernumerary time, clinical rotation), (2) workplace culture (institutional culture, midwives as gatekeepers), (3) workplace support (mentorship, preceptorship, clinical practice support, peer midwives), and (4) practice environment (fragmented hospital model, continuity of care model). Inhibiting factors were primarily linked to workplace culture and the fragmented hospital model within the practice environment. CONCLUSION: This integrative review distinguished key factors that enabled and/or inhibited the transition to practice experience for newly qualified midwives within high income countries. Program features, workplace support, and the practice environment both enabled and inhibited transition to practice. However, workplace culture was a significant barrier and requires further investment from key stakeholders to ensure cultural reform. SOCIAL MEDIA ABSTRACT: Enabling and inhibiting factors associated with transition to practice programs for new graduate midwives. @PetaWinters @ijn2026.