Abstract
Background/Objectives: Midwifery workforce sustainability faces critical challenges including high burnout and turnover rates threating the service quality and the maternal health outcomes. While self-leadership and self-compassion represent promising psychological resources, their roles relative to organizational factors remain underexplored. This study examined associations between self-leadership, self-compassion, and workforce outcomes (job satisfaction, turnover intention, performance) among Turkish midwives. Methods: A cross-sectional survey was conducted with 346 midwives working in diverse healthcare settings across Turkey from May 2021 to April 2022. Data were collected through an online self-report questionnaire using validated scales for self-leadership and self-compassion as well as measures of job satisfaction, turnover intention, and job performance, and including demographic and organizational items. Descriptive statistics, one-way ANOVA (with Eta-squared [η(2)] calculated to determine effect size), and correlation analyses were conducted, followed by hierarchical multiple regression and binary logistic regression to examine predictive relationships, with organizational factors entered before psychological resources. Results: Self-leadership and self-compassion demonstrated a moderate positive correlation (r = 0.342, p < 0.01). Self-leadership strongly predicted job performance (OR = 2.497, p = 0.001), particularly through natural reward strategies emphasizing intrinsic motivation (OR = 1.970, p < 0.001). However, neither psychological resource significantly predicted job satisfaction or turnover intention when organizational factors were included. Work schedule, healthcare setting, professional position, and income emerged as primary predictors of satisfaction and retention. Work experience predicted increased psychological distress (OR = 1.073, p = 0.003). Conclusions: Psychological resources demonstrate domain-specific effects on workforce outcomes in midwifery: self-leadership strategies strongly enhance job performance, whereas job satisfaction and turnover intention are influenced primarily by organizational conditions. These findings highlight the need for multi-level strategies to support the sustainability of the midwifery workforce.