title: Midwives׳ experiences of workplace resilience.
abstract: BACKGROUND
  many UK midwives experience workplace adversity resulting from a national shortage of midwives, rise in birth rate and increased numbers of women entering pregnancy with complex care needs. Research evidence suggests that workplace pressures, and the emotional demands of the job, may increase midwives׳ experience of stress and contribute to low morale, sickness and attrition. Much less is known about midwives who demonstrate resilience in the face of adversity. Resilience has been investigated in studies of other health and social care workers, but there is a gap in knowledge regarding midwives׳ experiences.
  
  
  OBJECTIVE
  to explore clinical midwives׳ understanding and experience of professional resilience and to identify the personal, professional and contextual factors considered to contribute to or act as barriers to resilience.
  
  
  METHODS
  an exploratory qualitative descriptive study. In Stage One, a closed online professional discussion group was conducted over a one month period. Midwives discussed workplace adversity and their resilient responses to this. In Stage Two, the data were discussed with an Expert Panel with representatives from midwifery workforce and resilience research, in order to enhance data interpretation and refine the concept modelling.
  
  
  METHODS
  the online discussion group was hosted by the Royal College of Midwives, UK online professional networking hub: 'Communities'.
  
  
  METHODS
  11 practising midwives with 15 or more years of 'hands on clinical experience', and who self-identified as being resilient, took part in the online discussion group.
  
  
  RESULTS
  thematic analysis of the data identified four themes: challenges to resilience, managing and coping, self-awareness and building resilience. The participants identified 'critical moments' in their careers when midwives were especially vulnerable to workplace adversity. Resilience was seen as a learned process which was facilitated by a range of coping strategies, including accessing support and developing self-awareness and protection of self. The participants identified the importance of a strong sense of professional identity for building resilience.
  
  
  CONCLUSIONS
  this study provides important new insights into resilience within UK midwifery, of relevance to the wider profession. Some findings echo those of other resilience studies; however, there are new insights such as the importance of professional identity which may be relevant to other health care workers. Through understanding more about resilience, it may be possible to facilitate positive adaptation by midwives and ameliorate the effects of workplace adversity.
  
  
  CONCLUSIONS
  This study indicates that resilience is a complex phenomenon, which warrants serious consideration from clinical midwives, managers, educators and researchers.
authors.affiliation: School of Health Care Sciences, Cardiff University, Cardiff, UK. Electronic address: HunterB1@cardiff.ac.uk.
authors.forename: Billie
authors.initials: B
authors.lastname: Hunter
authors.affiliation: School of Health Care Sciences, Cardiff University, Cardiff, UK.
authors.forename: Lucie
authors.initials: L
authors.lastname: Warren
mesh_terms: D002055:Burnout, Professional / Q000517:prevention & control*; D006801:Humans; D007400:Interprofessional Relations; D008880:Midwifery; D036301:Qualitative Research; D055500:Resilience, Psychological; D017132:Workplace / Q000523:psychology*
keywords: Emotion; Midwives; Resilience; Stress; Workforce