A meta-ethnographic synthesis of midwives' and nurses' experiences of adverse labour and birth events

Introduction: Health professionals are frequently exposed to traumatic events due to the nature of their work. While traumatic and adverse labour and birth events experienced by women are well researched, less attention has been given to mid-wives’ and nurses’ experiences of these events and the impact it has on their lives. Aims and objectives: To undertake a meta-ethnographic study of midwives’ and nurses’ experiences of adverse labour and birth events. Methods: Scopus, CINHAL PLUS, MEDLINE and PUBMED databases were searched using subject headings and keywords. The search was limited to papers published in peer-reviewed journals from 2004–October 2016. Quality appraisal was undertaken using the Critical Appraisal Skills Programme tool. Inclusion criteria: Papers had to be qualitative or have a substantial qualitative component. Studies were included if they primarily focused on midwives’ or nurses’ perspectives or experiences of complicated, traumatic or adverse labour and birth events. Analytic strategy: A meta-ethnographic approach was used incorporating methods of reciprocal translation guided by the work of Noblit and Hare (1988, Meta-Ethno-graphy: Synthesizing qualitative studies (Vol. 11). Newbury Park: Sage publications). Findings: Eleven qualitative studies were included in the final sample. Four major themes were (i) feeling the chaos; (ii) powerless, responsible and a failure; (iii) “It adds another scar to my soul”; and (iv) finding a way to deal with it. Conclusion: Midwives and nurses feel relatively unprepared when faced with a real-life labour and birth emergency event. While many of the midwives and nurses were traumatised by the experience, some were able to view their encounter as an opportunity to develop their emergency response skills. Relevance to clinical practice: Witnessing and being involved in a complicated or adverse labour and birth event can be traumatic for nurses and midwives. Organisational and collegial support needs to be available to enable these health professionals to talk about their feelings and concerns