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Research confirms the need for change

Learn about the studies done on stress and burnout in the maternity care workforce, and what they conclude.
Hi, everybody. It’s Mary again, and I’m speaking here with my research hat on because it must have been quite distressing for you reading some of those stories about how hard midwives are facing it in the workforce at the moment. So it’s not just isolated midwives, and we know from our research that midwives around the world are doing it really tough at the moment. And I’m part of an international consortium that’s actually looking at the work and health life balance and emotional well-being of midwives around the world. And this consortium is called the Whelm Consortium.
So we’ve done research in the United Kingdom, in New Zealand, in Sweden, and in Australia, and what we know is using what we call validated tools. So that’s tools where people are asked questions and those questions are given a score and then the scores are worked out to find out just how stressed or depressed or burnt out the individuals completing those tools are. And what we’re finding are worryingly high levels of stress and depression and burnouts in the midwifery work force.
But what we’re also seeing, interestingly, is that the midwives who are working in relationship-based care models– that is, midwives who are actually working one-on-one providing continuity of care for women– are actually much less stressed and much less likely to actually experience burnout. So this is very much a watch this space. The research is emerging. But it’s important to know that even though the examples that we’ve given you are individual accounts of midwives, this is a very big problem, and we are definitely within our research looking for a solution. One of those solutions might be relationship-based care.

You’ll know Mary Sidebotham as one of the lead educators of this course. also leads an international consortium of researchers called WHELM (Work, Health, and Emotional Lives of Midwives) who together are looking at the work, health-life balance, and emotional wellbeing of midwives in a number of countries around the world. So far, research has been completed in Australia, the United Kingdom, New Zealand, Sweden, Canada, Lithuania, Norway, Holland, Denmark, and Germany.

Their research has confirmed that midwives are exhausted and at risk of burnout, with worryingly high levels of work-related stress identified in midwives across all of these countries.

While this video focuses on on some of the WHELM data looking at midwives, similar results have been found in research on obstetricians, with high numbers experiencing stress, fatigue, and burnout. While we can look at individual reasons for health professionals’ burnout and stress, at the core of the issue is a system-wide dysfunction in the way services are organised.

The WHELM consortium is doing more than just researching the problem. They’re also focused on identifying solutions to this growing issue. What’s emerged from the research is this: midwives need to work in a different way. Where midwives provide relationship-based, one-to-one continuity of care, they are happier, more fulfilled, and less likely to experience stress, anxiety and burnout. Where midwives provide care within a fragmented system, they are more stressed, more overwhelmed, and more likely to burn out.

The research confirms: relationship-based care is the most powerful solution to midwives’ stress, anxiety, and burnout.

Over to you

You will have seen from Mary’s video that there is increasing evidence that midwives are struggling with fragmented maternity care systems.

How do you think midwives and other maternity health professionals can avoid burnout? What’s causing such high levels of stress and anxiety?


  1. Creedy, D., Sidebotham, M., Gamble, J., Pallant, J., & Fenwick, J. (2017). Prevalence of burnout, depression, anxiety and stress in australian midwives: A cross-sectional survey. BMC Pregnancy and Childbirth, doi:10.1186/s12884-016-1212-5
  2. Dixon , L., Guilliland, K., Pallant, J., Sidebotham, M., Fenwick, J., McAra-Couper, J., & Gilkison, A. (2017). The emotional wellbeing of New Zealand midwives: comparing responses for midwives in caseloading and shift work settings. New Zealand College of Midwives Journal(53), 5-14. doi:
  3. Hildingsson, I., Westlund, K., & Wiklund, I. (2013). Burnout in Swedish midwives. Sexual & Reproductive Healthcare, 4(3), 87-91. doi:
  4. Hunter, B., Fenwick, J., Sidebotham, M., & Henley, J. (2019) Midwives in the United Kingdom: Levels of burnout, depression, anxiety and stress and associated predictors. Midwifery (79), 1-12.
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Maternity Care: Building Relationships Really Does Save Lives

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