RESEARCH PAPER
Reports of work-related traumatic events: A mixed-methods study
 
More details
Hide details
1
Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
2
Antwerp University, Belgium
3
AMC Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
4
Women's coaching practice
CORRESPONDING AUTHOR
Yvonne Fontein-Kuipers   

Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
Publish date: 2018-12-31
Submission date: 2018-09-18
Final revision date: 2018-12-04
Acceptance date: 2018-12-09
 
Eur J Midwifery 2018;2(December):18
KEYWORDS
TOPICS
ABSTRACT
Introduction:
There is limited evidence of the effect and impact on midwives of being involved or witnessing traumatic work-related events. We categorised midwives’ selfreported traumatic work-related events and responses to an event and explored the impact on the midwives’ professional and personal life.

Methods:
A sequential explanatory mixed-methods study, consisting of a questionnaire and semi-structured interviews for midwives who practised or who had practised in the Netherlands or Flanders.

Results:
In total, 106 questionnaires were completed. We categorised various workrelated traumatic events: witnessing birth trauma/complications (34%), death (28.3%), (mis)management of care (19.8%), events related to the perceived social norm of maternity services’ practitioners (9.5%), events related to environmental and contextual issues (5.6%) and to (mis)communication (2.8%). Sharing the experience with colleagues, family and friends, a supervisor or the woman involved in the event, was the most common response. In all, 74.5% of the participants still experienced the influence of work-related events in day-to-day practice and 37.5% still experienced the effects in their personal life. The scores of three participants (3.2%) indicated the likelihood of post-traumatic stress. Twenty-four interviews were conducted. Four themes emerged from the content analysis: 1) Timeline, 2) Drawing up the balance of relations with others, 3) Fretting and worrying, and 4) Lessons learned.

Conclusions:
Various work-related traumatic events can impact on midwives’ professional and/or personal life. Although not all midwives reported experiencing (lasting) effects of the events, the impact was sometimes far-reaching. Therefore, midwives’ experiences and impact of work-related traumatic events cannot be ignored in midwifery practice, education and in supervision or mentoring.

 
REFERENCES (35)
1.
ICM 2017. International definition of the midwife. Revised and adopted at Toronto Council meeting, International Confederation of Midwives https://internationalmidwives..... Accessed July 16, 2018.
 
2.
Fontein-Kuipers, Y, den Hartog-van Veen H, Klop L, Zondag, L. Conflicting values experienced by Dutch midwives – Dilemmas of Loyalty, Responsibility and Selfhood. Clinical Research in Obstetrics and Gynecology. 2018;1(1).
 
3.
Fontein-Kuipers Y, de Groot R, van Staa A. Woman-centered care 2.0.: Bringing the concept into focus. European journal of Midwifery. 2018;2(May). doi:10.18332/ejm/91492
 
4.
Rice H, Warland J. Bearing witness: Midwives experiences of witnessing traumatic birth. Midwifery 2013;29(9):1056-1063. doi:10.1016/j.midw.2012.12.003
 
5.
Ullström S, Andreen Sachs M, Hansson J, Øvretveit J, Brommels M. Suffering in silence: a qualitative study of second victims of adverse events. BMJ Qual Saf. 2014;23:325-331. doi:10.1136/bmjqs-2013-002035
 
6.
Wahlberg Å, Andreen Sachs M, Johannesson K, et al. Post‐traumatic stress symptoms in Swedish obstetricians and midwives after severe obstetric events: a cross‐sectional retrospective survey. BJOG. 2017;124(8):1264-1271. doi:10.1111/1471-0528.14259
 
7.
Scott SD, Hirschinger LE, Cox KR, et al. Caring for our own: deploying a systemwide second victim rapid response team. Jt Comm J Qual Patient Saf. 2010;36(5):233–240. doi:10.1016/s1553-7250(10)36038-7
 
8.
De Schepper S, Vercauteren T, Tersago J, Jacquemyn Y, Raes F, Franck E. Post-Traumatic Stress Disorder after childbirth and the influence of maternity team care during labour and birth: A cohort study. Midwifery. 2016;32:87-92. doi:10.1016/j.midw.2015.08.010
 
9.
Hollander MH, van Hastenberg E, van Dillen J, van Pampus MG, de Miranda E, Stramrood CAI. Preventing traumatic childbirth experiences: 2192 women’s perceptions and views. Arch Womens Ment Health. 2017;20(4):515-523.doi: 10.1007/s00737-017-0729-6
 
10.
Evers R, Zomer S, Baas M, Stamrood CA, van Pampus MG, Dijksman LM. Ingrijpende gebeurtenissen op de werkvloer [Profound events on the work floor]. Tijdschrift voor Verloskundigen. 2015;40(4):6-12.
 
11.
Fontein-Kuipers Y, Rietveldt B, Mestdagh E. Traumatische ervaringen voor studenten vroedvrouwen tijdens hun stages [Traumatic experiences of student midwives during clinical practice]. Tijdschrift voor Vroedvrouwen.2018. 24(2):85-90.
 
12.
Davies S, Coldridge L. ‘No Man׳ s Land’: An exploration of the traumatic experiences of student midwives in practice. Midwifery. 2015;31(9):858-864. doi:10.1016/j.midw.2015.05.001
 
13.
Coldridge L, Davies S. "Am I too emotional for this job?" An exploration of student midwives' experiences of coping with traumatic events in the labour ward. Midwifery. 2017;45(2):1-6. doi:10.1016/j.midw.2016.11.008
 
14.
Beck C, Gable R. A mixed methods study of secondary traumatic stress in labor and delivery nurses. J Obstet Gynecol Neonatal Nurs. 2012;41(6):747–60. doi:10.1111/j.1552-6909.2012.01386.x
 
15.
Beck C, LoGiudice J, Gable R. A Mixed‐Methods Study of Secondary Traumatic Stress in Certified Nurse‐Midwives: Shaken Belief in the Birth Process. Journal of Midwifery & Women’s Health. 2015;60(1)16-23. doi:10.1111/jmwh.12221
 
16.
Sheen K, Spiby H, Slade P. What are the characteristics of perinatal events perceived to be traumatic by midwives? Midwifery. 2016;40:55-61. doi:10.1016/j.midw.2016.06.007
 
17.
Leinweber J, Creedy D, Rowe H, Gamble J. Responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. Women and birth. 2017;30:40-45. doi:10.1016/j.wombi.2016.06.006
 
18.
De Roose M, Tency I, Beeckman D, Van Hecke A, Verhaeghe S, Clays E. Knowledge, attitude, and practices regarding miscarriage: A cross-sectional study among Flemish midwives. Midwifery. 2018;56:44-52. doi:10.1016/j.midw.2017.09.017
 
19.
Morse JM, Niehaus L. Mixed method design: Principles and procedures. Walnut Creek, CA, USA: Left Coast Press Inc.; 193.
 
20.
Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 3rd Ed. Los Angeles: SAGE; 2018.
 
21.
Schoonenboom J, Johnson RB. How to construct a mixed methods research design. Kölner Zeitschrift für Soziologie und Sozialpsychologie. 2017;69(Suppl 2):107-131. doi:10.1007/s11577-017-0454-1.
 
22.
Guest G. Describing mixed methods research: An alternative to typologies. Journal of Mixed Methods Research.2013;7:141–151. doi: 10.1177/1558689812461179.
 
23.
Beck TC. Birth trauma: in the eye of the beholder. Nursing Research. 2004;53(1):381-390.
 
24.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Ed text revised. DSM-IV-TR. Washington: American Psychological Association; 2000.
 
25.
Moser A, Korstjens I. Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis. European Journal of General Practice. 2017;24(1):9-18. doi:10.1080/13814788.2017.1375091.
 
26.
Polit DF, Beck CT. Nursing research: Generating and assessing evidence for nursing practice. 10th ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2017.
 
27.
Polit DF, Beck CT. 2006. Essentials of nursing research methods, appraisal, and utilization. Philadelphia, PA Williams & Wilkins; 2006.
 
28.
Symon A. Litigation and changes in professional behaviour: a qualitative appraisal. Midwifery. 2000;16(1):15-21. doi: 10.1054/midw.1999.0193
 
29.
Healy S, Humphreys E, Kennedy C. Midwives’ and obstetricians’ perceptions of risk and its impact on clinical practice and decision-making in labour: An integrative review. Woman and Birth. 2016;29(2):107-116. doi:10.1016/j.wombi.2015.08.010
 
30.
Baas M, Scheepstra K, Stramrood C, Evers R, Dijksman L, van Pampus M.Work-related adverse events leaving their mark: a cross-sectional study among Dutch gynecologists. BMC Psychiatry. 2018;18(1). doi:10.1186/s12888-018-1659-1.
 
31.
Sheen K, Spib, H, Slade P. The experience and impact of traumatic perinatal event experiences in midwives: A qualitative investigation. International Journal of Nursing Studies. 2016;53:61-72. doi: 10.1016/j.ijnurstu.2015.10.003
 
32.
McDonald G, Jackson D, Wilkes L, Vickers MH. Personal resilience in nurses and midwives: Effects of a work-based educational intervention. Contemporary Nurse. 2013;45(1):134-143. doi:10.5172/conu.2013.45.1.134
 
33.
Hunter B, Warren L. Midwives’ experiences of workplace resilience. Midwifery.201 4;30(8):926-934. doi:10.1016/j.midw.2014.03.010.
 
34.
Magistretti CBM, Downe S, Lindström B, Berg M, Tritten Schwarz K. Setting the stage for health: Salutogenesis in midwifery professional knowledge in three European countries. International Journal of Qualitative Studies on Health and Well-Being. 2016;11(1):33155. doi:10.3402/qhw.v11.33155
 
35.
Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res Ther. 2000;38(4):319-345. doi:10.1016/s0005-7967(99)00123-0
 
eISSN:2585-2906