‘I couldn’t change the world, but the world changed me.’ Experiences, perspectives and patient care impact of midwives in Scotland following traumatic perinatal and Significant Adverse Events

Abstract

In this dissertation, I explore the experiences of midwives working in Scotland who have been involved in traumatic perinatal or Significant Adverse Events, and how these affected their personal wellbeing and subsequent care provision. By conducting 10 semi-structured interviews with midwives who had worked in a tertiary hospital in the last year, I was able to thematically analyse the data, to which 4 themes arose: feeling unprepared for traumatic events, changes to emotions and personal perceptions, the weight of interpersonal relationships, and systemic frustration from lack of support. The findings suggest the subjectivity of trauma in midwifery and a link between how events are managed and the personal perceptions of those involved. Participants reported feelings of fear, self-criticism, and burnout, which they felt impacted their ability to provide the quality of care they wished to. The importance of supportive interpersonal relationships was emphasised, with many midwives expressing frustration at systemic issues and lack of formal support in policy. This research adds to the growing body of literature on vicarious trauma in maternity care. The findings indicate an intrinsic connection between workplace culture, midwives' self- perceptions, and care quality. Recommendations include implementing automatic support mechanisms, involving staff in defining trauma, and further research into blame culture in healthcare settings. The findings highlight the need for cultural change and improved support systems to enhance both midwife wellbeing and patient safety and satisfaction.