title: Exposure to traumatic perinatal experiences and posttraumatic stress symptoms in midwives: prevalence and association with burnout.
abstract: BACKGROUND
  Midwives provide care in a context where life threatening or stressful events can occur. Little is known about their experiences of traumatic events or the implications for psychological health of this workforce.
  
  
  OBJECTIVE
  To investigate midwives' experiences of traumatic perinatal events encountered whilst providing care to women, and to consider potential implications.
  
  
  METHODS
  A national postal survey of UK midwives was conducted.
  
  
  METHODS
  421 midwives with experience of a perinatal event involving a perceived risk to the mother or baby which elicited feelings of fear, helplessness or horror (in the midwife) completed scales assessing posttraumatic stress symptoms, worldview beliefs and burnout.
  
  
  RESULTS
  33% of midwives within this sample were experiencing symptoms commensurate with clinical posttraumatic stress disorder. Empathy and previous trauma exposure (personal and whilst providing care to women) were associated with more severe posttraumatic stress responses. However, predictive utility was limited, indicating a need to consider additional aspects increasing vulnerability. Symptoms of posttraumatic stress were associated with negative worldview beliefs and two domains of burnout.
  
  
  CONCLUSIONS
  Midwives may experience aspects of their work as traumatic and, as a consequence, experience posttraumatic stress symptomatology at clinical levels. This holds important implications for both midwives' personal and professional wellbeing and the wellbeing of the workforce, in addition to other maternity professionals with similar roles and responsibilities. Organisational strategies are required to prepare midwives for such exposure, support midwives following traumatic perinatal events and provide effective intervention for those with significant symptoms.
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK. Electronic address: Kayleigh.sheen@liverpool.ac.uk.
authors.forename: Kayleigh
authors.initials: K
authors.lastname: Sheen
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Spiby
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Pauline
authors.initials: P
authors.lastname: Slade
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000209:etiology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D008880:Midwifery; D011247:Pregnancy; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*
keywords: Burnout; Midwives; Posttraumatic stress; Trauma