Background: International qualified midwives comprise 13% of the Australian midwifery workforce. Despite their important role in the Australian midwifery system, understanding of their transitional experiences is limited.

Aim: To explore the transitional experiences of internationally qualified midwives into the Australian midwifery system.

Methods: This study used a mixed methods sequential explanatory design. The mixed methods study was underpinned by the philosophical assumption of “Pragmatism” with the focus on the consequences and meanings of the experiences and challenges of internationally qualified midwives in Australia. In phase one, an e-survey study was conducted with 66 internationally qualified midwives who were recruited via a nonprobability sampling strategy. Descriptive statistics, non-parametric Mann-Whitney U test and content analysis analysed the data. The results from the phase one developed a structured interview schedule for phase two. Descriptive qualitative phase aimed to further explore the gap that became apparent in the quantitative phase and to develop a deeper understanding of transitional experiences of internationally qualified midwives. A nested sample was drawn through the e-survey from participants who gave permission. A total of 11 internationally qualified midwives were interviewed. Thematic analysis was adopted to derive the findings. Data from both phases were integrated.

Results:
The findings consist of four recurrent themes: “Differences in midwifery practice’ and ‘Cultural incongruence’ represent the differences internationally qualified midwives experienced. The third theme, ‘Bias/Discrimination’ characterises how their diversity was valued and respected. The forth theme ‘Mixed emotions’ represent how their feelings were navigated between positive and negative emotions during their transitional process

Conclusions: International qualified midwives in this study struggled with a different culture-base work environment, complicated by different midwifery practice in Australia, lack of autonomy in their practice and experienced discrimination. Despite evidence of challenges, these midwives also appeared willing to learn to adjust to Australian workforce. However, this transitional process requires opportunities and support to facilitate their transition to
occur. Multiple strategies to optimise their transitional experiences are recommended which fall within the cultural awareness and enhanced support.