What do midwives fear?

There is evidence that a significant number of women are fearful about birth but less is known about the fears of maternity health providers and how their fear may impact on the women they care for.

The aim of this study was to determine the top fears midwives in Australia and New Zealand hold when it comes to caring for childbearing women.

From 2009 to 2011, 17 workshops were held in Australia and New Zealand supporting over 700 midwives develop skills to keep birth normal. During the workshop midwives were asked to write their top fear on a piece of paper and return it to the presenters. Similar concepts were grouped together to form 8 major categories.

In total 739 fears were reported and these were death of a baby (n=177), missing something that causes harm (n=176), obstetric emergencies (n=114), maternal death (n=83), being watched (n=68), being the cause of a negative birth experience (n=52), dealing with the unknown (n=36) and losing passion and confidence around normal birth (n=32). Student midwives were more concerned about knowing what to do, while homebirth midwives were mostly concerned with being blamed if something went wrong.

There was consistency between the 17 groups of midwives regarding top fears held. Supporting midwives with workshops such as dealing with grief and loss and managing fear could help reduce their anxiety. Obstetric emergency skills workshops may help midwives feel more confident, especially those dealing with shoulder dystocia and PPH as they were most commonly recorded.