The impact of intrapartum fetal death and other serious adverse perinatal events on healthcare professionals and the maternity services

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McNamara, Karen
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University College Cork
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Obstetrics and midwifery are high risk specialties. Sometimes and even despite the provision of the best medical care possible, serious adverse events do occur. While patients and service users of the Irish maternity services bear the bulk of the burden of harm from these adverse events, the healthcare staff who are also involved in these cases can be substantially affected. Stillbirth, which encompasses both antenatal and intrapartum death, is one of the more serious adverse events or outcomes that can happen during a pregnancy. Existing research focuses largely on the impact that antenatal stillbirth has on obstetricians and midwives, with no research focusing specifically on the impact that intrapartum fetal death has on maternity service healthcare professionals. Much is also now known and acknowledged about the increasing levels of burnout and compassion fatigue that are affecting healthcare professionals. In fact, it has been recognised that healthcare professionals are more likely to experience burnout than the general workforce and it is now estimated that burnout affects 1 in 2 doctors. Healthcare professionals in the maternity services are not exempt from these issues. What is apparent, however, is that relative to the literature pertaining to the general medical specialties, there is a clear paucity of research investigating the effectiveness of available support strategies for maternity healthcare professionals to access either in the aftermath of an adverse event or to help them tackle burnout in the longer term. This thesis focuses on the specific impact that intrapartum death, and other serious perinatal adverse events have on healthcare professionals. I have utilised both quantitative and qualitative research methods to describe in detail the scale of the impact, both personally and professionally, that these events have on the involved healthcare professionals. Obstetricians and midwives are profoundly and negatively affected by a personal involvement in an intrapartum death. Following a review of the existing literature, I identified a substantial lack of effective support strategies for maternity healthcare professionals to access to help them with the impact of adverse events. This finding was echoed by my research with the cohort of obstetricians and midwives who participated in my studies. By and large they had received no training in dealing with intrapartum death nor had they received any education on self-care strategies. This thesis concludes with two studies, aimed at addressing this deficit and these studies are an evaluation of both local and national support strategies for maternity healthcare professionals to potentially utilise on an ongoing basis. Finally, I discuss the implications that my research has on clinical practice, and I discuss the possibilities for future research that may potentially improve the support that maternity healthcare professionals are given in the aftermath of these adverse events.
Intrapartum death , Obstetrics , Adverse perinatal events , Burnout , Maternity services , Support structures
McNamara, K. 2019. The impact of intrapartum fetal death and other serious adverse perinatal events on healthcare professionals and the maternity services. PhD Thesis, University College Cork.