The wellbeing of our midwives is in crisis. Australian midwives are overworked and under-supported. We are exposed to risk and asked to work in ways that contradict the midwifery ethos of placing ‘woman at the centre’ of her care.
At the height of the pandemic, I had my own experience of burnout. The good news is that it’s possible to reclaim your health and feel well again. I was able to change my work type within the profession I love and recover my sense of wellbeing.
Burnout is a syndrome caused by chronic and prolonged stress. Gordon Parker, head of UNSW's school of psychiatry and founder of the Black Dog Institute, explains:
“Burnout is over-represented in dutiful, reliable, caring people (such as) health professionals and teachers… part of its tragedy (is) that burnout is over-represented in good people."
Burnout can happen to anyone, and can look different for different people. Common symptoms include:
Social withdrawal, anxiety and depression are common responses to burnout. If you are experiencing burnout, you may find it difficult to enjoy activities that you previously found meaningful. You may experience feelings of hopelessness and care less about the things that once were important to you.
Burnout can also lead to the development of post-traumatic stress disorder. A recent study by the Rosemary Bryant AO Research Centre found that 15% of nurses and midwives are experiencing PTSD: “The higher the burnout, the higher the proportion of people with post-traumatic stress scores above the clinical cut-off.”
Prolonged burnout often leads to physical illness, as described by Deryn, a midwife who participated in the study Burnout: Lessons from the Lived Experience of Case Loading Midwives:
“I kept getting sick, but I didn’t recognise that I needed to take time off because of burnout. I saw it as needing time out because I was sick. Gastric problems, headaches, feeling unwell, exhaustion, all those related symptoms.”
Burnout is real, debilitating, and potentially dangerous. Check out these resources to learn more:
The cost of the current crisis in our profession is high. Many midwives are experiencing poor mental health and burnout. Many are planning to leave. A 2022 LaTrobe University survey of Victorian midwives found:
A combination of heavy workloads, skill shortages, staff deficits and bullying have resulted in midwives feeling stressed, overwhelmed and fatigued.
A participant in the study Giving of the self and Midwife burnout explains:
“I do think midwives go home carrying about ’I wonder how that baby is’. ’Is that baby okay that I delivered’? You know, if you have a difficult delivery. And I think that’s obviously a difference from general to midwifery. So, I think that people do carry stuff a bit more than others in relation to that”. — Ali, Midwife
Burnout has always been prevalent in the midwifery profession but has been worsened by the additional strain and heightened emotions of the pandemic.
Midwifery is ‘high involvement’ work due to the emotionally demanding nature of the care needed. At the centre of our ancient occupation is a wellness perspective with a strong emphasis on woman-centred care. As modern practitioners, we are now also expanding our practice to support birthgivers of other genders alongside the tradition of woman-centred care.
But midwifery is challenged by factors that interfere with the midwife-woman relationship. We face an enduring dilemma of woman-centred vs fragmented-care as well as:
Surging rates of IVF pregnancies, advanced maternal age, and pre-existing chronic health conditions increase the chance of adverse outcomes in childbirth, placing even more stress and pressure on midwives.
Burnout can also be exacerbated by an experience known as ‘moral distress’. When midwives are forced to work in environments that do not support their personal ethos, and there are competing moral commitments, a type of psychological suffering can ensue. As discussed earlier, being ‘with woman’ is a crucial element of midwifery care, and a vital aspect of a midwife’s value system. When midwives cannot be ‘with woman’ due to heavy workloads, moral integrity can feel compromised and put them at heightened risk of burnout. Check out mental health nurse Tayla Vella’s blog on how to handle moral distress.
Midwives accompany people through some of the most important, challenging, and vulnerable moments of their lives. It’s natural that it’s sometimes difficult to shake that off at the end of the day.
In 2021, after working through the pandemic and multiple lockdowns in Victoria, I resigned from my position as a midwife in a busy birthing suite unit. The job had been rewarding but I felt that a change would help my health and wellbeing.
I had been considering this for some time but felt paralysed about my decision, as I loved aspects of my job. However, I suspected I was beginning to burn out as a result of the pressures placed on me from COVID, and I knew that preventative action was better than waiting until my health deteriorated.
One of the symptoms of burnout is a loss of self-agency. In the moment I decided to resign, I knew I was taking back my sense of self agency and control. I left and am now working for both the Nurse and Midwife Health Program of Victoria and Nurse and Midwife Support providing support to nurse and midwives as a counsellor, where my work/life balance and stress levels are much better.
Preventing and recovering from burnout is possible. With the right support and strategies, you can reclaim your health and feel well again.
Sometimes when we feel stuck, it seems like no other routes are possible, but the truth is that you have options. Midwives are highly trained, in-demand professionals with a number of transferrable skills. Whether you think you just need to change your employer, or change your whole career path, there are many paths available to you. Give us a call and talk over ideas for how you’d like your professional life to change — we’re here free, confidential, 24/7 on 1800 667 877 or by email.
You can also check out our podcast episode: Career transition: Your career matters!
Clinical supervision is a way for midwives and their managers to prevent burnout. It is a “professional development activity which focuses on reflective learning…supervision is a collaborative relationship to review and improve practice together.”
Julie Sharrock explains how career supervision works in her blog: Clinical supervision: what is it about?
A study is underway to examine the impact of group supervision on burnout amongst midwives. The authors hypothesise that regular group supervision will reduce rates of burnout and improve the perception of workplace culture. Find out more: Group Clinical Supervision for midwives and burnout: a cluster randomized controlled trial
We’ll keep you updated on the results!
You can avoid professional burnout by putting these self-care practices into play:
With the right support and strategies you can recover from burnout, reclaim your health and feel well again. A ‘back to basics’ wellbeing approach can really help.
Gordon Parker of the UNSW School of Psychiatry studied 1,000+ people who had experienced burnout and found that the best way to recover is to:
Burnout IS treatable, and you can recover from it. With the right kind of support, and lifestyle interventions, it’s you can regain your wellbeing.
“I’m now far more optimistic in suggesting that even in those who seem to have lost their elasticity, they can no longer work, they may have been in bed for extended periods of time, they actually can get back and get back their full vitality. So in fact, it’s an optimistic story in terms of management.”
– Gordon Parker
The study by Latrobe University found that overall midwives enjoy their job and want to keep doing it. Employers may be able to retain this vital workforce by putting proactive strategies in place.
There is hope. Support is available to you if you’re worried about or experiencing burnout. For more information on how to move from surviving to thriving, check out our podcast with Sam Eddy, mental health first aider, workplace coach and educator for a first-hand account of recovery.
And remember, Your Health Matters!
If you need to talk about burnout, the Nurse & Midwife Support team is here for you — free, confidential, 24/7. Give us a call on 1800 667 877 or email us