Emotional Complications in Midwives Participating in Pregnancy Termination Procedures-Polish Experience

Background: Ethically controversial medical procedures, such as the termination of pregnancy, are frequently associated with a discrepancy between personal attitude and values versus requirements related to a professional situation. The study aimed to assess emotional complications in midwives participating in pregnancy termination procedures. Methods: The study included 181 midwives working in state-governed healthcare facilities in central and eastern Poland. The Oldenburg Burnout Inventory (OLBI) and the present authors' own questionnaire were used in the study. The results indicating the level of occupational burnout were presented in two scales: the exhaustion scale and the disengagement scale. Results: The study revealed that 48% of midwives had never participated in pregnancy termination procedures due to fetal defects. The level of occupational burnout described with the exhaustion factor (t = 2.06; p < 0.041) and disengagement factor (t = 2.96; p < 0.003) was significantly higher in the group of midwives participating in pregnancy termination procedures due to fetal defects than in the group of midwives who did not participate in pregnancy terminations. The most common factors contributing to burnout reported by midwives who participated in pregnancy terminations were: moral dilemmas (68%), seeing the aborted fetus (65%), anticipating the child's death in case it was born with signs of life (59%) and the lack of professional psychological support for medical personnel (56%). Conclusions: Importantly, pregnancy termination should be performed by persons who find such procedures acceptable from the viewpoint of their value system. It is a protective factor in regards to work with women who undergo terminations. Moreover, developing a system of informational and psychological support for midwives participating in pregnancy termination procedures is also a significant aspect.