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Midwives’ mental health during the COVID19 pandemic

Identifying as a midwife is a source of joy and purpose for most midwives, but many midwives describe their midwifery work as challenging. Researchers from the Transforming Maternity Care Collaborative have been co-ordinating the Work, Health, and Emotional Lives of Midwives (WHELM) project. The project has identified high levels of burnout, depression, anxiety, and stress in Australian midwives (Creedy, et al., 2017) and also internationally (Cull, et al., 2020; Dixon, et al., 2017, Pezaro, et al., 2016, Stoll & Gallagher, 2019). Many midwives with high levels of burnout planned to leave midwifery practice, creating the potential for a significant shortfall in the number of qualified midwives available to provide safe maternity care.

This research was conducted prior to the arrival of the novel coronavirus pandemic that has transformed the maternity care workplace. Concerns have been raised regarding the potential for the pandemic to have a significant impact on the mental wellbeing of health professionals (Pfefferbaum & North, 2020). Recent research has shown high levels of anxiety among doctors, midwives, and nurses working in maternity services (Uzun, et al., 2020). Rapid and significant changes to the workplace have been required, particularly in places with large numbers of cases. Whether there will be further waves of infection is unpredictable. It is therefore highly likely that midwives’ emotional coping resources are under pressure.

It is important that we continue to measure the emotional health of midwives. To do that we need tools which are fit for purpose and have been used previously so there is a secure baseline to measure against. The WHELM team have developed, tested, and deployed such tools for a number of years (Pallant, et al., 2015; 2016), and are therefore well placed to provide advice this area.

Previous research from the WHELM consortium has demonstrated that a key protector of midwives’ mental wellbeing is working in a midwifery continuity of carer model (Sidhu, et al., 2020). Prioritising a shift away from traditional, fragmented models of maternity care to midwifery continuity of care is likely to enhance the sustainability of maternity care services through this and any future significant external challenges.

You can access the most recent paper from the WHELM consortium for free for a limited time – here.

References

Creedy, D. K., Sidebotham, M., Gamble, J., Pallant, J., & Fenwick, J. (2017). Prevalence of burnout, depression, anxiety and stress in Australian midwives: a cross-sectional survey. BMC Pregnancy and Childbirth, 17, 13.

Cull, Hunter, Henley, Fenwick, Sidebotham. (2020). “Overwhelmed and out of my depth”: Responses from early career midwives in the United Kingdom to the Work, Health and Emotional Lives of Midwives study. Women and Birth, 33(6), e549-557.

Dixon,L., Guilliland,K., Pallant,J., Gilkison,A., Sidebotham,M., Fenwick,J.,McAra-Couper,J. (2017).The emotional wellbeing of New Zealand midwives: comparing responses between employed, self-employed (case loading) and midwives who do both. New Zealand College of Midwives Journal, 53, 5-14

Pallant, J. F., Dixon, L., Sidebotham, M., & Fenwick, J. (2015). Further validation of the Perceptions of Empowerment in Midwifery Scale. Midwifery, 31(10), 941– 945.

Pallant, J. F., Dixon, L., Sidebotham, M., & Fenwick, J. (2016). Adaptation and psychometric testing of the Practice Environment Scale for use with midwives. Women and Birth, 29(1), 24– 29.

Pezaro, S., Clyne, W., Turner, A., Fulton, E. A., & Gerada, C. (2016). ‘Midwives Overboard!’ Inside their hearts are breaking, their makeup may be flaking but their smile still stays on. Women and Birth, 29(3), e59– 66.

Pfefferbaum, B., & North, C.S. (2020). Mental health and the Covid-19 pandemic. New England Journal of Medicine, in press. https://doi.org/10.1056/NEJMp2008017

Sidhu R, Su B, Shapiro K & Stoll K. (2020). Exploring prevalence of and factors associated with Burnout in Midwifery: A Scoping Review. European Journal of Midwifery, 4(February), 4.

Stoll K & Gallagher J. (2019). A survey of burnout and intentions to leave the profession among Western Canadian midwives. Women and Birth, 32(4): e441-e449.

Uzun, N, Teki̇n, M, Sertel, E, Tuncar, A. (2020). Psychological and social effects of COVID-19 pandemic on obstetrics and gynecology employees. Journal of Surgery and Medicine, 4(5), 355-358. DOI: 10.28982/josam.735384