clinical practice
clinical practice
Reigniting the flame
Why do Australian midwives have much higher levels of burnout than their counterparts in other countries?
Jennifer Fenwick interviewed by Dallas Bastian.
There is a high prevalence of personal and work-related burnout, depression, anxiety and stress among Australia’ s midwives, new research has found. Published in BMC Pregnancy and Childbirth, the study gathered responses from over 1000 nurses and measured them against the Copenhagen Burnout Inventory and the Depression, Anxiety and Stress Scale.
The authors found that almost two-thirds of midwives surveyed reported personal burnout, while over 40 per cent reported work-related burnout and about 10 per cent reported client-related burnout. About a fifth of midwives surveyed reported anxiety and stress symptoms, as well as moderate, severe or extreme levels of depression.
The research team said:“ Exploring levels of burnout, depression, anxiety and stress within the midwifery population is important to better understand and address the development of responses to the stressful nature of their work and workplace demands.”
Nursing Review sits down with study co-author Jennifer Fenwick, professor of midwifery at Griffith University and clinical chair at Gold Coast University Hospital, to find out what causes burnout and the factors affecting the mental health of midwives.
NR: What causes burnout and how would you characterise it when it comes to the work that midwives do? JF: That’ s not an easy question to answer. In the research that we did, we used a tool called the Copenhagen Burnout Tool, and it’ s kind of divided into three domains. It looks at personal burnout,
work burnout and client-related burnout. For midwives, what we’ re seeing is certainly work-related burnout, not client-related burnout. That’ s associated with the working environment, the way they provide care, and organisational issues. Issues around that are seemingly the reason that we’ re getting quite high levels of burnout in some groups of midwives.
What else did the survey reveal about the prevalence of burnout in Australia? What we were able to find out is that we have high levels of stress, anxiety and depression, which is associated with work-related burnout. We’ ve done some of this work internationally in New Zealand and in Sweden, and the survey is just about to run in the UK and Canada, and has also run in Sweden.
What we found between Sweden, New Zealand and Australia is that Australian midwives have much higher levels of depression, anxiety and stress than midwives in those other countries, and higher than what the normal population is. That was related to a large group of midwives suffering burnout.
We were able to look at different groups of midwives and we did find differences in midwives who worked slightly differently or who had different working patterns.
What we did find, here and in New Zealand, is that midwives that worked in what we call case-load models providing continuity of care to women – so they worked across their full scope of practice, providing pregnancy care, labour and birth care, and post-natal care up to six weeks – have much lower levels of stress, anxiety, depression and burnout than midwives who worked in what we call the traditional shift-based way, or core.
That certainly resonates with other work that’ s being done in Australia, and certainly overseas as well. What we think is potentially happening is when we ask midwives about satisfaction, what comes out is their frustration with the way care is organised, and the inability to form meaningful relationships with women.
Certainly that again matches the international literature that says when midwives can form what we call longitudinal relationships – that is, get to know women across the whole pregnancy – that
14 | nursingreview. com. au