Secondary traumatic stress in iranian midwives: stimuli factors, outcomes and risk management

Maryam Hajiesmaello,Hedyeh Riazi,Roya Yavarian,Sepideh Hajian,Hamid Alavi Majd

doi:10.1186/s12888-022-03707-7

Abstract

BackgroundThe present qualitative study was conducted to explain the experiences of secondary traumatic stress (STS) and its related factors in midwives working in maternity wards.MethodsData were collected using semi-structured interviews with 11 midwives working in the maternity wards of hospitals in Urmia, Iran, through in-depth interviews with open-ended questions. Data were analyzed using the conventional content analysis approach.ResultsThe results of data analysis led to the extraction of three themes, seven main categories, and 18 subcategories. The first theme was “STS stimuli,” with the two categories of “Discriminatory approach to midwifery” and “The nature of the midwifery profession”. The second theme was “Traumatic outcomes”, which included the subcategories of “Psychological-emotional trauma”, “Physical trauma” and “Social trauma”. The third theme was “Risk management”, which had the two subcategories of “Reactive approach” and “Proactive approach”.Conclusions The results showed that, in addition to the traumatic nature of events that midwives experience during work as the secondhand victims, factors such as governance-organizational structure, unbalanced distribution of power, and poor supportive laws undermine their professional role and provide conditions conducive to STS. Therefore, avoiding traumatic situations and scientific and skill self-empowerment were the most important strategies adopted by the midwives in this study to prevent risky situations and cope with the consequences of STS. The participation of midwifery stakeholders in policy-making and adopting supportive legislation in redefining the position and role of midwives can play a major role in reducing STS and sustaining their role and position in maternal care.

Highlights

Midwifery has a history as old as humanity, and a midwife is a professional and responsible person who, with the cooperation of women, provides the needed care and support during pregnancy, childbirth and the postpartum period and the care needed for the newborn and child[1]
STS is an occupational threat to healthcare providers caring for injured patients [2]
The participants were selected via purposive sampling with maximum variation of demographic characteristics and a high potential for providing rich information. They were selected from the maternity wards in teaching, nonteaching, and private hospitals and a birth center with midwife-centered services in Urmia

Summary

Introduction

Midwifery has a history as old as humanity, and a midwife is a professional and responsible person who, with the cooperation of women, provides the needed care and support during pregnancy, childbirth and the postpartum period and the care needed for the newborn and child[1]. STS is an occupational threat to healthcare providers caring for injured patients [2]. Occupational accidents in midwifery include emergencies, and violent behavior by other healthcare providers, including physicians, and any disrespectful behavior by pregnant women and their families [2, 4]. A hallmark of the midwifery profession is that it entails high levels of empathy with the woman in labor, as midwives establish a very close contact with these women; midwives have the power to experience what the mother is experiencing, and this distinguished attribute exposes midwives to STS [6]. The present qualitative study was conducted to explain the experiences of secondary traumatic stress (STS) and its related factors in midwives working in maternity wards

Methods

Results

Discussion

Conclusion