uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Post-traumatic stress symptoms in Swedish obstetricians and midwives after severe obstetric events: a cross-sectional retrospective survey
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Skane Univ Hosp, Dept Obstet & Gynaecol, Malmo, Sweden..
Karolinska Inst, LIME Med Management Ctr, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Gynecological endocrinology. Akad Hosp, Dept Obstet & Gynaecol, Uppsala, Sweden.
Show others and affiliations
2017 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 124, no 8, p. 1264-1271Article in journal (Refereed) Published
Abstract [en]

Objective: To examine post-traumatic stress reactions among obstetricians and midwives, experiences of support and professional consequences after severe events in the labour ward.

Design: Cross-sectional online survey from January 7 to March 10, 2014.

Population: Members of the Swedish Society of Obstetrics and Gynaecology and the Swedish Association of Midwives.

Methods: Potentially traumatic events were defined as: the child died or was severely injured during delivery; maternal near-miss; maternal mortality; and other events such as violence or threat. The validated Screen Questionnaire Posttraumatic Stress Disorder (SQ-PTSD), based on DSM-IV (1994) 4th edition, was used to assess partial post-traumatic stress disorder (PTSD) and probable PTSD.

Main outcome measures: Partial or probable PTSD.

Results: The response rate was 47% for obstetricians (n = 706) and 40% (n = 1459) for midwives. Eighty-four percent of the obstetricians and 71% of the midwives reported experiencing at least one severe event on the delivery ward. Fifteen percent of both professions reported symptoms indicative of partial PTSD, whereas 7% of the obstetricians and 5% of the midwives indicated symptoms fulfilling PTSD criteria. Having experienced emotions of guilt or perceived insufficient support from friends predicted a higher risk of suffering from partial or probable PTSD. Obstetricians and midwives with partial PTSD symptoms chose to change their work to outpatient care significantly more often than colleagues without these symptoms.

Conclusions: A substantial proportion of obstetricians and midwives reported symptoms of partial or probable PTSD after severe traumatic events experienced on the labour ward. Support and resilience training could avoid suffering and consequences for professional carers.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 124, no 8, p. 1264-1271
Keywords [en]
midwives, obstetricians, perinatal, post-traumatic stress disorder, survey
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-328980DOI: 10.1111/1471-0528.14259ISI: 000403938600031PubMedID: 27562912OAI: oai:DiVA.org:uu-328980DiVA, id: diva2:1140536
Funder
AFA InsuranceAvailable from: 2017-09-12 Created: 2017-09-12 Last updated: 2018-04-11Bibliographically approved
In thesis
1. Second Victims in Swedish Obstetrics
Open this publication in new window or tab >>Second Victims in Swedish Obstetrics
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The term “second victim” implies that healthcare providers can be pro-foundly affected by severe events in which a patient is badly injured or dies. The patient is the first victim. This thesis investigates the magnitude, riskfactors and consequences of becoming a second victim in Swedish delivery care.

We examined self-reported exposure to severe events in a survey among 1459 midwives and 706 obstetricians. A severe event was defined as severe injury or death to a mother or child or other stressful events, such as threats or violence, during delivery. Of the midwives and obstetricians who responded, 71% and 84%, respectively, had experienced one or several severe events during their career. Post-traumatic stress symptoms following the perceived worst event were measured. Fifteen percent of the midwives and obstetricians reported symptoms equivalent to partial post-traumatic stress disorder (PTSD), and 5% of the midwives and 7% of the obstetricians reported symptoms commensurable with PTSD. Increased risk was correlated with emotions of guilt, and negative experience or support from friends. Professionals with partial PTSD left delivery care significantly more often than their less traumatised colleagues.

Experiences of severe events were, furthermore, investigated, using qualitative content analysis, leading to an overarching theme “acting in an illusory system of control and safety”. This reflected how midwives and obstetricians retrospectively identified factors that had contributed to the course of events leading to such detrimental consequences. The process that the midwives and obstetricians followed in the aftermath of a severe event, were investigated using a Grounded Theory analysis. A core category, “regaining of a professional self-image”, was constructed. Six main categories illustrated an erratic pathway which might lead to full regaining, reconsidering, reconstructing professional self-image or deciding to leave the profession, depending on level of regained professional self-image.

In summary, the majority of midwives and obstetricians will experience severe obstetric events that might affect them, sometimes severely. The vulnerability that healthcare professionals are exposed to should not be underestimated and preparedness in terms of collegial support, as well as an awareness in the workplace of how badly affected employees might be, is important.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 94
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1446
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-344021 (URN)978-91-513-0284-3 (ISBN)
Public defence
2018-05-08, Auditorium minus, Gustavianum, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2018-04-17 Created: 2018-03-05 Last updated: 2018-04-17

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records BETA

Wahlberg, ÅsaBergh Johannesson, KerstinHallberg, GunillaJonsson, MariaSkoog Svanberg, AgnetaHögberg, Ulf

Search in DiVA

By author/editor
Wahlberg, ÅsaBergh Johannesson, KerstinHallberg, GunillaJonsson, MariaSkoog Svanberg, AgnetaHögberg, Ulf
By organisation
Obstetrics and Reproductive Health ResearchPsychiatry, University HospitalGynecological endocrinologyClinical ObstetricsReproductive Health
In the same journal
British Journal of Obstetrics and Gynecology
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 182 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf