Midwives' experiences of high stress levels due to emergency childbirths in Namibia Regional Hospital

Many midwives throughout the world experienced high stress levels when they deal with emergency childbirths. Midwifery professionals experience certain unique stressors, such as midwives being responsible for the care of women when they are giving birth. Complications of childbirth may occur during labour leading to the life of the baby and the mother being threatened. Situations such as this leave midwives experiencing high levels of stress for which they often do not have effective coping mechanisms. When the stress is not managed, it may lead to burnout. When burnout occurs the midwives present with physical and psychological symptoms of stress, grief for the loss and lack of motivation, which results in staff turnover and a fear of working in a maternity ward. Consequently, patient care may be compromised as some midwives became apathetic and develop unacceptable attitudes toward their patients. Such behavior led to poor work performances, maternity services that are not woman-friendly and women seeing the maternity ward as a place where they are treated in rude and unfriendly manner which increased the chances of adverse childbirth outcomes. The aim of the study was to explore and describe the experiences of midwives who have to cope with stress associated with emergency childbirths. This information was used to develop the guidelines to help midwives to cope with the high stress associated with emergency childbirths. The researcher used a phenomenological, qualitative approach. The study was explorative, as little was known on this topic in the Namibian context and it was also descriptive and contextual. Purposive and convenient sampling was used to select the research sample. The research population was all the midwives working in the maternity ward of a Namibian regional hospital, who met the inclusion criteria. Data gathering was done using semi-structured interviews. Once data saturation occurred, interviewing stopped. The interviews were audio-taped and transcribed verbatim. Tesch’s eight steps of data analysis were followed to create meaning from the data collected. An independent coder assisted with the coding process to ensure the trustworthiness of the findings. Literature control was done after data collection to support and strengthen the study’s findings. Trustworthiness, as suggested by using Lincoln & Guba’s model of trustworthiness, included truth-value/credibility, applicability/transferability, consistency/dependability and neutrality/conformability was implemented. Ethical principles of beneficence, non-maleficence, autonomy and justice were ensured by obtaining permission to conduct the research from relevant authorities and from University structures, obtaining consent from the participants before the interviews, voluntary participation and right to withdraw from the study, privacy, confidentiality and dissemination of the results. Three main themes and sub-themes were identified namely: Midwives experienced significant stressors associated with emergency childbirth situations. Midwives experienced mixed emotions about dealing with emergency childbirth situations Midwives shared their views regarding their support needs associated with emergency childbirth situations. Recommendations for nursing education, clinical midwifery and for further research were made. Four guidelines were developed based on the study findings as well as literature related to these findings, to help the midwives to cope with high stress levels associated with emergency childbirths