Understand burnout in midwifery

Researcher and clinical midwife Robyn Matthews has been practicing for 16 years. Her work in large tertiary hospitals in Melbourne has provided a strong foundation for her research into the profession. 

Midwifery and professional satisfaction

Robyn has a keen interest in finding out what makes midwives happy at work and what makes them unhappy. She has studied job satisfaction and burnout for almost a decade and has some great insights into how we can support midwives to stay in the profession and feel satisfied with the vital work they do supporting women and babies. 

Measuring satisfaction and wellbeing

Robyn is currently working on a long-term study involving around 400 midwives and midwifery students who will participate in progressive surveys to follow their levels of satisfaction and overall wellbeing. 

“In our 2021 and 2022 surveys we found the levels of burnout were very high. Burnout includes both physical and emotional exhaustion originating from conditions of work and is a mental health condition in its own right,” Robyn explains. 

“Global studies have confirmed that levels of burnout among midwives is higher than other health professions such as doctors and nurses. We are not entirely sure why, but it could be because of the emotional investment midwives put into their jobs,” Robyn says. 

More likely to experience vicarious trauma

“Midwives are there for mothers and parents at the best and worst of times and more likely to experience vicarious trauma. If a woman loses a baby, the emotions at play can impact on the midwife as well.”

Strategies for preventing burnout

Robyn says while midwives are in a profession where there are a lot of factors that contribute to burn out, there are some good strategies available to tackle and ideally prevent burnout. 

“The tricky thing is to identify if you are heading for burnout and not coping. There are things we can do to tackle the causes of burnout,” she says.

“Let’s start on a personal level. You might check in with your colleagues and see if they have noticed anything in relation to the more sensitive aspects of your job. Are there things you can put in place like planning some annual leave if you feel things are getting overwhelming? Think about taking some time out and talk to your manager about it.”

Patient mix – balance not burnout 

It is also useful to think about the mix of patients being cared for and try to make sure there is a balance, Robyn says. 

“If you are looking after a lot of women who have pregnancy losses you could ask if you can shift your focus and make sure you look after your own mental health. You might even consider a preventative measure like changing midwifery roles if you feel you are on the way to burnout.”

Try ‘hot’ and ‘cold’ debriefing

Other things midwives could try on a personal level include self-advocating by speaking up and bringing their situation to the attention of their manager and debriefing with colleagues. “I would recommend hot and cold debriefing,” Robyn says. “Hot debriefing directly after a traumatic event or critical incident and cold debriefing in the days and weeks after the incident after the adrenaline has gone down.”

Support others and seek support

The research Robyn has conducted so far has found strong evidence that midwives who feel supported and adequately acknowledged for the work they do are less likely to experience burnout.

Manage each team member individually

“This is something that sounds simple but can be important. As a manager or colleague, you can make a big difference to how someone feels at work by letting them know they did a great job. Check on your colleagues and support them. This can be different for everyone, and we should be asking people what they need to feel supported.”

Preventing burnout in midwives – Robyn reflects

“The big question to consider in preventing burnout is looking at the whole profession and how we do midwifery. We need to look at what is causing midwives harm and leading to so many midwives experiencing burnout. 

We know that there is a strong correlation between burnout and midwives leaving the workforce. We assist midwives to stay in the profession if we look at the big picture and find ways to support our midwives so that they enjoy their work and feel satisfied and valued. 

There are many factors to consider and areas for improvement. This could be rethinking shift work and workloads, including how much physical work a midwife does on a shift and if that is a problem. There is also the long-term financial security for our midwives, many of whom work part time and might also take time off to have their own children. 

We need to think about how we can enable midwives to create good quality care while also supporting them to remain healthy and happy. We are very philosophically driven as a profession and while we would like to be paid more that is not a defining feature of the job. We are in these jobs because we want to support the mothers bringing new life into the world.

I see a role for the Nurse and Midwives National Health Program in relation to preventing burnout. Midwives need the opportunity to talk about their experiences. If this service is available for a midwife to call in those urgent moments when they can’t get support at work, it could make a real difference. 

It can also be better to talk to someone outside of work. That is  why clinical supervision is good because it is someone outside of your immediate workplace and they can give an outside perspective. These options provide someone who can focus on you and what you need.  

I would prefer to find a solution to prevent burnout all together rather than manage it. We need to go big picture and stop individualising the issue. It is a national and global problem and the profession itself needs to change. It will take an all of sector approach and there is no single solution but a range of things we can do.”