Prevalence and Risk Factors for Posttraumatic Stress among Australian Midwives

Abstract

Background Midwives are frequently exposed to traumatic birth events which may place them at risk of developing posttraumatic stress (PTS) symptoms. Posttraumatic stress can reduce empathic and cognitive abilities and increase perceptions of risk and danger. PTSD research and theory have identified personal, trauma event-related and work environment related variables as risk factors for PTSD. It is not known whether these factors also apply among midwives. Aims 1. To identify prevalence of posttraumatic stress among Australian midwives. 2. To identify risk factors for posttraumatic stress and use a socioecological model to explain posttraumatic stress in midwives. Methods A national internet survey of midwives who are members of the Australian College of Midwives was conducted. Trauma symptoms were assessed with the PTSD Symptom Scale Self-Report version (PSS-SR). Probable PTSD was assessed as meeting DSM IV PTSD diagnostic criteria B, C and D (a score of at least ‘one’ on the four-point frequency scale for a minimum of one intrusion, three avoidance and two arousal symptoms) and a total PSS-SR score ≥14. The Traumatic Experiences in Perinatal Care List (TEPCL) assessed which types of birth events were perceived as traumatic by midwives. The Sensitivity in Perinatal Care Scale (SPCS) was developed to assess sensitivity in perinatal caregiving. Other measures included the Interpersonal Reactivity Index (IRI) to assess empathy and the Job Content Questionnaire (JCQ) to assess job demands and job control.