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Traumatic deliveries increase midwives’ risk of PTSD: research

The events midwives witness and participate in on the job may increase their vulnerability to post traumatic stress disorder (PTSD), new research suggests.

The study, led by Dr Julia Leinweber at Griffith University, found almost a fifth of the midwives surveyed met the criteria for probable PTSD as laid out by the Diagnostic and Statistical Manual of Mental Disorders, edition 4.

The team surveyed midwives across all types of healthcare settings, aiming to get a sense of their feelings of competence during stressful moments.

Co-author professor Jenny Gamble, from the Menzies Health Institute Queensland, said events that midwives may encounter in their day-to-day lives include the death or injury of a mother or baby during birth, abusive care by family members or simply care that is not undertaken in a sensitive way.

“Midwives, unfortunately, often say that they feel powerless to intervene to change the way care is [applied] by other healthcare providers, or they may feel pressured to make a decision by another professional,” Gamble said. “Alternatively, they may feel that the mother’s expressed wishes are overridden by organisational requirements of the hospital during the birth. If a midwife feels that she can’t do anything about these situations, [they] can produce feelings of stress, which can escalate.”

Gamble said there is growing evidence that exposure to birth trauma places midwives at risk of PTSD, which can increase perceptions of risk and affect midwives’ beliefs in the normality of childbirth.

“There is also the knock-on effect of workforce retention issues,” she said, and added that more awareness of trauma in the birth setting is required.

“Healthcare organisations at the primary level need to be more supportive of the risks of stress in the birth setting and provide an environment for midwives that enforces trauma-informed care and practice,” she said.

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