Work Situation of Midwives in Spain: Perception of Autonomy and Intention to Leave the Profession: A Cross-Sectional Study

Background: Developed countries report specific issues regarding the declining midwifery workforce, and their shortage could have serious consequences for women’s sexual and reproductive health. The aim was to understand the perception of autonomy among midwives working in Spain, as well as factors related to their intention to leave the profession and their work environment. Method: A descriptive and cross-sectional study using an online questionnaire. Population: midwives working in Spain in any field (clinical, research, teaching, or management). Results: A sample of 1060 midwives was obtained. Of these, 53.7% (n = 569) feel autonomous in their work, 92.4% (n = 978) perceive that their profession frequently suffers from external interference, 46.6% (n = 494) have experienced sexist behaviors at work, and 53% (n = 561) have considered leaving the profession in the last year. Midwives with less than 10 years of experience (57.7%), those aged 31–45 years (59.8%), those with temporary contracts (38.3%), and those working in hospital care (71.9%) show a higher rate of considering leaving the profession (p < 0.001). Conclusions: Considering the current midwifery workforce crisis in Spain, it seems urgent to improve the working conditions of midwives to ensure the continuity and quality of women’s sexual and reproductive healthcare.