OBJECTIVE: to explore the retention and attrition of pre-registration midwifery students. DESIGN: an exploratory, comparative design that enabled the comparison of a 3-year and a 78-week midwifery programme. The methodology was designed into two main phases using both quantitative and qualitative methodology. SETTING: a university in the South West of England. PARTICIPANTS: 36 questionnaires were sent to students who had left the programmes during 2001-2003. A purposive sample of 16 student midwives formed two separate focus groups. The participants were selected from current 3-year and 78-week midwifery programmes. FINDINGS: midwifery attracts highly motivated students. In order for this motivation to continue through an emotional and demanding programme of study, their motivation needs to be nurtured and retained. The findings of this study clearly illustrate that in only a few cases can one over-riding reason be given for students withdrawing from midwifery programmes. IMPLICATIONS FOR PRACTICE: there is often a complexity of 'personal reasons' and an accumulation of clinical and theoretical demands as to why students leave. Although there were realistic expectations of the programmes, the lived experiences of these expectations created anxiety and tension. It is therefore imperative that clinicians and academics work in harmony to plan and offer a programme of adequate mentorship and support for student midwives. This should also acknowledge the uniqueness of the different programmes that lead to qualification as a midwife.