title: Occupational exposure to maternal death: psychological outcomes and coping methods used by midwives working in rural areas.
abstract: OBJECTIVE
  to explore the psychological outcomes of occupational exposure to maternal death and the coping methods used by midwives working in rural areas.
  
  
  BACKGROUND
  maternal deaths are common in rural areas of developing countries because of the shortages of human and other resources needed for maternity services. When maternal deaths occur, midwives often experience emotional distress while striving to perform their work. This may have a negative impact on their well-being.
  
  
  METHODS
  Descriptive design. A self-administered questionnaire in the English language, comprising the Death Distress Scale and Brief COPE Scale, was used to collect data from 238 midwives working in two rural districts of Uganda.
  
  
  RESULTS
  the majority of participants were female (81%) and had a diploma in midwifery (36%). Mean age and years of professional experience were 34 [standard deviation (SD) 6.3] years and three (SD 1.3) years, respectively. The majority of participants (94%) had witnessed a maternal death. The results from the Death Distress Scale showed that the majority of midwives who had witnessed a maternal death had moderate to high death anxiety (93%), mild to moderate death obsession (71%) and mild death depression (53%). Most midwives coped with their distress using methods such as active coping, venting, positive reframing, self-distraction and planning.
  
  
  CONCLUSIONS
  midwifery educational programmes and work settings need to understand the importance of maternal death from the midwives' perspective and their ability to cope with this detrimental experience.
  
  
  CONCLUSIONS
  there is a need for midwifery practice settings to provide respite care, education on coping with death experiences and counselling after traumatic experiences in order to maintain the well-being of midwives. As occupational exposure to maternal death can have a negative effect on the well-being of midwives, this can affect their professional quality of life and clinical practice.
authors.affiliation: College of Nursing, Sultan Qaboos University, P.O. Box 66, AlKhod, Muscat, Oman. Electronic address: suubiracs@gmail.com.
authors.forename: Rhoda Suubi
authors.initials: RS
authors.lastname: Muliira
authors.affiliation: College of Nursing, Sultan Qaboos University, P.O. Box 66, AlKhod, Muscat, Oman; PHC Community Based Clinic, The Adelaide Tambo School of Nursing Science, Tshwane University of Technology, Pretoria, South Africa.
authors.forename: Mathie C
authors.initials: MC
authors.lastname: Bezuidenhout
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D063130:Maternal Death / Q000523:psychology*; D008427:Maternal Health Services; D008875:Middle Aged; D009721:Nurse Midwives / Q000523:psychology*; D016273:Occupational Exposure / Q000706:statistics & numerical data; D011247:Pregnancy; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000401:mortality* / Q000523:psychology*; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult
keywords: Coping; Maternal death; Midwives; Psychological well-being