Work, health and emotional lives of midwives in the United Kingdom: The UK WHELM study

A senior midwife has shared her thoughts on a study looking into the work, health and emotional lives of midwives in the UK which does not appear to have been publicised by the organisation that commissioned it, the Royal College of Midwives.

The paper, Work, Health and Emotional Lives of Midwives in the United Kingdom: The UK WHELM study, was initially published on the RCM website but but was not shared widely until Dr Helen Shallow wrote about it on the Birth Practice and Politics Forum blog. Reflecting on her week, Dr Shallow raised questions about how certain people and groups seem determined to continue to urge us to ‘stay positive’ in the face of an ever-growing crisis in the maternity services, a struggling NHS and a midwifery profession that is being attacked from all sides. The full report now appears to have been removed from the RCM website completely, but the academic paper published from it is now available.

Carried out by the School of Healthcare Sciences at Cardiff University, the study comprised of a survey of just under 2000 midwives which was commissioned in part to “contribute to the evidence base on how best to support and sustain the midwifery workforce” (Hunter et al 2018).

The findings are of deep concern and evidence significant levels of emotional distress among midwives, something that echoed Helen Shallow’s own research. In the RCM-commissioned study:

“83% of participants were suffering from personal burnout and 67% were experiencing work-related burnout. Client-related burnout was low at 15.5%. The personal and work related burnout scores were well above population norms as well as higher than the results from other WHELM collaborating countries.

Over one third of participants scored in the moderate/severe/extreme range for stress (36.7%) anxiety (38%) and depression (33%). This was well above population norms and those of other WHELM countries.

66.6% of participants stated they had thought about leaving the profession within the last six months. The two top reasons were: ‘Dissatisfaction with staffing levels at work’ (60%) and ‘Dissatisfaction with the quality of care I was able to provide’ (52%). Midwives intending to leave had significantly higher levels of burnout, anxiety, stress and depression than those who had not considered leaving.”

Factors associated with high levels of burnout, depression, anxiety and stress included “younger midwives (midwives aged 40 and below), midwives with a disability, midwives with less than 30 years’ experience and clinical midwives, particularly those working rotation in hospital and in integrated hospital/community settings.”

Helen Shallow has carried out her own research into this area, and her findings are echoed here: “The findings I could have predicted, as they mirror my own humble PhD. The direct quotes from the midwives were heart breaking and I had to suppress my tears and anger. The RCM response for not going public with this important study is that midwives need and say they want hope and positivity. There’s that juxtaposition again. If anyone tells it like it is, they are accused of negativity.”

Helen also contributed to Untangling the Maternity Crisis, and further asks, “Are we to stay positive at these stories of neglect of women in labour and abuse of midwives while ministers and senior Trust bureaucrats take advantage of health workers’ good will? Is it enough that they soldier on and do their best? This cannot be allowed to continue.”

No, it cannot. We need to speak out about it and we need to ensure that these midwives’ voices are heard. Please share this, or the BPPF blog post, and let midwives know that you hear them and support them.

Hunter B, Henley J, Fenwick J et al (2018). Work, Health and Emotional Lives of Midwives in the United Kingdom: The UK WHELM study. School of healthcare Sciences, Cardiff University.
Photo by Soroush Karimi on Unsplash

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