Traumatic Experiences and the Midwifery Profession: A Cross‐Sectional Study Among Dutch Midwives

• Published in: Journal of midwifery & women's health Vol. 64; no. 4; pp. 435 - 442
• Main Authors: Kerkman, Tessa, Dijksman, Lea M., Baas, Melanie A.M., Evers, Ruth, Pampus, Maria G., Stramrood, Claire A.I.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-07-2019; John Wiley and Sons Inc
• Subjects: Anxiety; Birthing centers; Births; Clinical assessment; Colleagues; Critical incidents; Cross-sectional studies; depression; Medical personnel; Mental depression; Midwifery; Midwives; Nursing; Occupational stress; Original Research; Original Research and Reviews; Peer tutoring; Post traumatic stress disorder; posttraumatic stress disorder; Primary care; Questionnaires; Response rates; second victim; secondary traumatic stress; Side effects; support; Symptoms; Traumatic life events; Work; Netherlands; anxiety; midwifery; second victim; secondary traumatic stress; depression; support; posttraumatic stress disorder
• ISSN: 1526-9523; 1542-2011
• DOI: 10.1111/jmwh.12946

Introduction
Traumatic events that occur in a clinical setting can have long‐lasting adverse effects on persons who are affected, including health care providers. This study investigated the prevalence of work‐related traumatic events, posttraumatic stress disorder (PTSD), anxiety, and depression among Dutch midwives. Additionally, differences between midwives working in primary care (independently assisting births at home and in birthing centers) and midwives working in secondary or tertiary care (hospital setting) were examined. Finally, this study investigated the support midwives would like to receive after experiencing a work‐related adverse event.
Methods
A descriptive, cross‐sectional online survey of Dutch midwives was conducted. The respondents completed a questionnaire about demographic and work‐related events, as well as the Trauma Screening Questionnaire and the Hospital Anxiety and Depression Scale.
Results
The estimated response rate was 23%, with 691 questionnaires eligible for analysis. Thirteen percent of respondents reported having experienced at least one work‐related traumatic event. Among these, 17% screened positive for PTSD, revealing an estimated PTSD prevalence of 2% among Dutch midwives. Clinically relevant anxiety symptoms were reported by 14% of the respondents, significantly more often among midwives working in primary care (P = .014). Depressive symptoms were reported by 7% of the respondents. The desired strategies to cope with an adverse event were peer support by direct colleagues (79%), professional support from a coach or psychologist (30%), multidisciplinary peer support (28%), and support from midwives who are not direct coworkers (17%).
Discussion
Dutch midwives are at risk of experiencing work‐related stressful or traumatic events that might lead to PTSD, anxiety, or depression. Midwives working in primary care reported higher levels of anxiety compared with their colleagues working in a clinical setting (secondary or tertiary care). Most midwives preferred peer support with direct colleagues after an adverse event, and some could have profited from easier access to seeking professional help. It could be speculated that midwives would benefit from increased awareness about work‐related traumatic events as well as implementation of standardized guidelines regarding support after a traumatic event.