Experiences of workplace adversity among midwives in labour wards of tertiary hospitals in northern Nigeria

Abstract

Background/Aims Midwifery has been described as an emotionally charged profession. It can be even more demanding as a result of the staff shortages and lack of resources often encountered in low- and middle-income countries. In Nigeria, there are high maternal and infant mortality rates, shortages in the midwifery workforce and a high prevalence of stress among midwives. The aim of this study was to explore midwives' experiences of workplace adversity and resilience in tertiary hospitals in northern Nigeria. Methods This study used a constructivist grounded theory approach. Data were collected via in-depth face-to-face interviews and field notes. A total of 34 interviews were conducted in two phases, with purposive and theoretical samples of midwives across two tertiary institutions in northern Nigeria. The iterative process of grounded theory methodology was used for data analysis. Results Significant adversity was caused by a severe lack of human and material resources, leading to an excessive workload. The nature of the work was characterised by high numbers of obstetric emergencies and attending to traumatic births. Conclusions Midwives working in tertiary hospitals in northern Nigeria experience workplace adversity fuelled by high caseloads, workforce shortages, a lack of basic equipment and consumables, an unsupportive working atmosphere and attending traumatic births. More investment in Nigerian maternity services is needed to improve quality of care provision, reduce adversity in the midwifery workforce and enhance staff retention.