A cross-sectional survey of the mental health of midwives in Ontario, Canada: Burnout, depression, anxiety, stress, and associated factors

Elizabeth C Cates; Claire Ramlogan-Salanga; R Katie MacKenzie; Karline Wilson-Mitchell; Elizabeth K Darling

doi:10.1016/j.wombi.2024.101613

A cross-sectional survey of the mental health of midwives in Ontario, Canada: Burnout, depression, anxiety, stress, and associated factors

Women Birth. 2024 Apr 13;37(4):101613. doi: 10.1016/j.wombi.2024.101613. Online ahead of print.

Authors

Elizabeth C Cates¹, Claire Ramlogan-Salanga², R Katie MacKenzie³, Karline Wilson-Mitchell⁴, Elizabeth K Darling⁵

Affiliations

¹ McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada; Department of Pathology & Molecular Medicine, McMaster University, Hamilton, ON, Canada; Midwifery Education Program, Mc McMaster University, Hamilton, ON, Canada.
² McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada; Midwifery Education Program, Mc McMaster University, Hamilton, ON, Canada; Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
³ McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada.
⁴ Midwifery Education Program, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON, Canada.
⁵ McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada; Midwifery Education Program, Mc McMaster University, Hamilton, ON, Canada; Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada. Electronic address: darlinek@mcmaster.ca.

PMID: 38615516
DOI: 10.1016/j.wombi.2024.101613

Abstract

Problem: Burnout and the psychological co-morbidities stress, anxiety and depression have a significant impact on healthcare providers, including midwives. These conditions impact the quality of care provided to women, and midwives' ability to remain in the profession.

Background: There is growing concern regarding the retention of maternity care providers in Canada, particularly midwives. Nationally, 33% of Canadian midwives are seriously considering leaving practice; impacts of the profession on work-life-balance and mental health being commonly cited reasons. Burnout has been shown to contribute to workplace attrition, but little is known concerning burnout among Canadian midwives.

Aim: To assess levels of stress, anxiety, depression, and burnout among midwives in Ontario, Canada and potential factors associated with these conditions.

Methods: A cross-sectional survey of Ontario midwives incorporating a series of well-validated tools including the Copenhagen Burnout Inventory and the Depression, Anxiety and Stress Scale.

Findings: Between February 5, and April 14, 2021, 275 Ontario midwives completed the survey. More than 50% of respondents reported depression, anxiety, stress, and burnout. Factors associated with poor mental health outcomes included having less than 10-years practice experience, identifying as a midwife with a disability, the inability to work off-call, and having taken a prior mental health leave.

Discussion & conclusion: A significant proportion of Ontario midwives are experiencing high levels of stress, anxiety, depression, and burnout, which should be a serious concern for the profession, its leaders, and regulators. Investment in strategies aimed at retaining midwives that address underlying factors leading to attrition should be prioritized.

Keywords: Anxiety; Burnout, Psychological; Depression; Midwifery; Obstetrics; Occupational Stress.