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Research uncovers the effects of traumatic childbirth on midwives and obstetricians

April 11, 2016

When complications arise in the delivery room that lead to traumatic childbirth, clinicians providing care may feel upset and experience secondary traumatic stress. A new study published in Acta Obstetricia et Gynecologica Scandinavica, a journal of the Nordic Federation of Societies of Obstetrics and Gynecology, found that feelings of blame and guilt dominate when midwives and obstetricians struggle to cope with the aftermath of a traumatic childbirth, but such events also made them think more about the meaning of life and helped them become better midwives and doctors.

Medical mistakes primarily affect patients and relatives, but healthcare professionals can also be profoundly affected. When errors occur, and even when problems arise that may not have been avoided, clinicians often feel personally responsible for negative outcomes experienced by patients.

To get a sense of how traumatic childbirth impacts healthcare professionals' mental health and their professional and personal identities, Katja Schrøder, RM, MSc Health, of the University of Southern Denmark, and her colleagues asked Danish obstetricians and midwives to complete a survey and participate in interviews.

A total of 1237 professionals responded, of which 85 percent stated that they had been involved in a traumatic childbirth, where the infant or the mother suffered severe and possibly fatal injuries related to labor and delivery. Although blame from patients, peers, or official authorities was feared (and sometimes experienced), inner struggles with guilt and existential considerations were more prominent. Feelings of guilt were reported by 49 percent of respondents, and 50 percent agreed that the traumatic childbirth had made them think more about the meaning of life. In addition, 65 percent felt that they had become a better midwife or doctor due to the traumatic incident.

"To our knowledge, this is the largest study to investigate obstetric healthcare professionals' experiences with traumatic childbirth. Self-blame and guilt appear to dominate when midwives and obstetricians struggle to cope with the aftermath of a traumatic childbirth, which was a consistent finding regardless of time since the event," said Ms. Schrøder. "This could indicate that although the current patient safety programs have promoted a more just and learning culture with less blaming and shaming after adverse events, the personal feeling of guilt remains a burden for the individual healthcare professional." She added that existential considerations such as thinking more about the meaning of life and experiencing personal development opportunities of an emotional or spiritual nature have not been previously investigated in this context, and they seem to play a profound role in the aftermath of these events.

The findings may be helpful for efforts aimed at providing adequate support to healthcare professionals in the aftermath of traumatic childbirth, which will benefit not only professionals but also patients because the physical and emotional state of clinicians impacts upon the quality and the safety of patient care.
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Full citation: "Blame and Guilt - A Mixed Methods Study of Obstetricians' and Midwives' Experiences and Existential Considerations after Involvement in Traumatic Childbirth." Katja Schrøder, Jan Stener Jørgensen, Ronald F. Lamont, and Niels Christian Hvidt. Acta Obstetricia et Gynecologica Scandinavica; Published Online: April 11, 2016 (DOI: 10.1111/aogs.12897).

URL Upon Publication: http://doi.wiley.com/10.1111/aogs.12897

Author Contact: Marianne Lie Becker, of the University of Southern Denmark's press office, at mlbecker@health.sdu.dk or +45 65502888.

About the Journal

Acta Obstetricia et Gynecologica Scandinavica is the official scientific journal of the Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). It is a clinically oriented journal that covers all aspects of obstetrics, gynecology and reproductive health, including perinatology, gynecologic endocrinology, female urology and gynecologic oncology. The journal is published in English and includes: editors´ messages, editorials, Acta commentaries, Acta reviews and original articles under the main categories of investigation, pregnancy, birth, fertility, infection, gynecology, gynecologic urology, oncology and surgery. The journal is published by Wiley on behalf of the NFOG. For more information, please visit http://wileyonlinelibrary.com/journal/aogs.

About Wiley

Wiley is a global provider of knowledge and knowledge-enabled services that improve outcomes in the areas of research, professional training and practice, and education. Through the Research segment, the Company provides scientific, technical, medical, and scholarly journals, magazines, databases and websites. The Talent Solutions & Education Services segment provides services, technology, insights and content that support learners and institutional partners in business and higher education to improve effectiveness by developing knowledge and skills. In Knowledge and Learning, higher education institutions, faculty and students benefit from Wiley's print and digital content, online program management services and course management tools.

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