Clinician Resilience after Traumatic Child Birth Exposure

Abstract

Background: Traumatic Childbirths (TCE) involving actual or threatened serious injury or death to a mother or child are documented sources of occupational stressors. Maternity care is a profession often perceived as filled with joy. However, TCEs may affect both professional practice and personal life and can contribute to burnout. Clinician resilience may play an important role in coping with TCEs. Purpose: The aims of this study were to describe and explore the frequency and severity of TCE experiences in OB clinicians, assess associations between TCEs and levels of resilience, and determine if TCE exposure and resilience are associated with OB clinician burnout. Methods: An anonymous survey was administered via a web link to obstetrical clinicians in five Maryland hospitals. The survey had four sections: demographics, TCE (frequency, severity, and influence on personal and professional practice), resilience (25-item Connor-Davidson Resilience Scale), and burnout (Maslach Burnout–Human Services Survey for Medical Personnel). Multi-level modeling explored factors influencing resilience and burnout nested within hospitals. Results: The 160 usable surveys included registered nurses (N=104), certified nurse-midwives (N=17), attending physicians (N=28), and resident physicians (N=11). Nearly all had experienced at least one TCE during their careers, with shoulder dystocia and stillbirth being the most frequent. The frequency of TCE exposure was associated with influencing the OB clinician’s professional practice (r=.415, p<.001) and personal life (r=.386, p<.001). Perception of severity strongly influenced professional practice (=.52, p<.001) and personal life (=.46, p<.001). Resilience scores were significantly lower in clinicians aged 35-54 years compared to the 55 or older group (B=-7.60, p=.011). TCE exposure was not associated with burnout. However, nearly a third (31%) of the convenience sample reported high emotional exhaustion, and 13% reported high depersonalization. Conclusion: TCE exposure can affect the professional practice and personal life of maternity care clinicians. While TCE did not have a strong relationship with resilience and burnout, a third of the respondents reported high emotional exhaustion, a dimension of burnout. Longitudinal research is needed to understand the short and long-term effects of TCEs and the role of resilience in helping clinicians cope with occupational stress.