Burnout and Occupational Stress
Canadian and international studies show that midwifery care, and especially case load midwifery (the model practiced in BC) meets the Triple Aims of health system improvement and is linked to good outcomes among general populations of childbearing people and those with social risk factors. The midwifery model of care focuses on patient autonomy, and puts the needs and preferences of childbearing people first. Scaling up access to patient-centered, high quality models of health care delivery is a provincial priority, yet only a small proportion of families can access midwifery care and the profession is facing numerous challenges that threaten its growth and sustainability. A study conducted by Stoll & Gallagher (2018) revealed that 40% of BC midwives have seriously considered leaving the profession in the 12 months preceding data collection and 1 in 10 were actively making plans to leave. One in five reported that it is unlikely they will still be practicing as midwives in 3 years. Burnout and high levels of stress are associated with poor physical and mental health, and impacts on quality of care. Midwives suggested many strategies to reduce stress, such as: a broadened scope, more off-call career opportunities, ability to bill for additional supports and services for clients with complex care needs and initiatives to reduce inter-professional conflict. Addressing these issues requires the collaboration of key stakeholders, to develop an action plan for sustainable midwifery practice.
In 2019/2020 Dr. Stoll worked with a team of interprofessional trainees on a scoping review about the prevalence of and factors associated with burnout in midwifery. A total of 1,034 articles were identified and reduced to 27 articles across 17 countries. Prevalence of burnout was highest among Australian, UK, Western Canadian and Senegalese midwives and lowest among Dutch and Norwegian midwives. We identified 26 factors that were significantly associated with burnout. The most commonly reported factors were: insufficient organizational support/poor or stressful work environment, non-caseload/non-continuity models of care (such as hospital shift work), younger age, fewer years in practice, high workload, exposure to traumatic events, interpersonal conflict with colleagues, low recognition of midwives, low job/task satisfaction (e.g. too much administrative work), and lack of support from family or colleagues. Many of these factors were also cited by BC midwives.
Stoll K & Gallagher J. (2019). A survey of burnout and intentions to leave the profession among Western Canadian midwives. Women & Birth. 32(4): e441-e449. PMID:30341004
Sidhu R, Su B, Shapiro K & Stoll K (2020). Exploring prevalence of and factors associated with Burnout in Midwifery: A Scoping Review. European Journal of Midwifery, 4(February).
Burnout self-assessment tool
We created an online self-assessment that includes the 19-item Copenhagen Burnout Inventory (CBI) and generates scores automatically for people who complete the tool. Midwives can then review their scores on three subscales (measuring personal, work-related, and client-related burnout) and have the option of clicking on a link that takes them to an online report that shows the mean scores of all midwives who submitted data. This tool is meant for BC midwives only, can be completed multiple times and in the future will include a list of resources.