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:
- high rates of intervention in childbirth
- lack of autonomy
- high institutional expectations
- clashing of midwifery and obstetric views and practices
- unmanageable workloads.
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.