Research Article| Volume 26, ISSUE 1, P26-32, March 2013

Factors that may influence midwives work-related stress and burnout

Published:September 02, 2011DOI:


      Research question

      To determine the incidence and level of work-related stress and burnout in midwives and contributing and protective demographic factors that may influence those levels.

      Participants and method

      All registered midwives (152) working in two public hospital maternity units within the same health service district in NSW completed the Maslach Burnout Inventory Human Services Survey and a demographic survey including care model, shift work, lifestyle data and exercise level.


      There was a response rate of 36.8% with 56 (56/152) midwives completing the surveys. Almost two thirds (60.7%) of midwives in this sample experienced moderate to high levels of emotional exhaustion, a third (30.3%) scoring low personal accomplishment and a third (30.3%) experiencing depersonalization related to burnout. Significant differences were found among groups of midwives according to years in the profession, shifts worked, how many women with multiple psychosocial issues were included in the midwife's workload and the midwife's uptake of physical exercise. Those midwives who had spent longer in the profession and exercised scored low burnout levels.


      The impact of years in the profession, shifts worked, how many women with multiple psychosocial issues were included in their workload and the midwife's level of exercise significantly affected how these midwives dealt with burnout and provided care for women. As the response rate was low, and the study cannot be generalised to the entire midwifery workforce but provides important insights for further research. Understanding factors related to burnout can benefit health care institutions financially and in terms of human costs, especially in view of consistent international shortages of midwives.


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      1. NSW Health. Families NSW Supporting Families Early: Safe Start Strategic Policy. Sydney: NSW Department of Health: 2009 Sydney. ISBN 9781 74187 285 9.

      2. NSW Health. Keep them safe: making a child protection report. Information Bulletin IB 2010_005. Available at:

        • Burke R.
        • Greenglass E.
        Hospital restructuring and nursing staff wellbeing.
        International Journal of Stress Management. 2000; 7: 49-59
        • Mollart L.
        • Bullard M.
        Changing practice and improving care: Midwives and families.
        in: CD proceedings of the Australian health outcomes collaboration conference: the quest for practice improvement, Canberra; 20–21st August2003
        • Mollart L.
        • Newing C.
        • Foureur M.
        Midwives’ emotional wellbeing: impact on conducting a Structured Antenatal Psychosocial Assessment (SAPSA).
        Women and Birth. 2009; 22: 82-88
        • Maslach C.
        • Jackson S.E.
        • Leiter M.P.
        Maslach burnout inventory manual.
        C.P.P. Inc., California1996
        • Maslach C.
        • Schaufeli W.
        • Leiter M.P.
        Job burnout.
        Annual Review of Psychology. 2001; 52: 397-422
        • Deery R.
        An action-research study exploring midwives’ support needs and the affect of group clinical supervision.
        Midwifery. 2005; 21: 161-176
        • Skinner V.
        • Agho K.
        • Lee-White T.
        • Harris J.
        The development of a tool to assess levels of stress and burnout.
        Australian Journal of Advanced Nursing. 2007; 24: 8-13
        • Lee H.
        • Song R.
        • Cho Y.S.
        • Lee G.Z.
        • Daly B.
        A comprehensive model for predicting burnout in Korean nurses.
        Journal of Advanced Nursing. 2003; 44: 534-545
        • Bakker R.
        • Groenewegen P.
        • Jabaaij L.
        • Meijer W.
        • Sixma H.
        • de Veer A.
        Burnout among Dutch midwives.
        Midwifery. 1996; 12: 174-181
        • Cordes C.L.
        • Dougherty T.W.
        A review and an integration of research on job burnout.
        The Academy of Management Review. 1993; 18: 621-656
        • O’Donnell C.
        • Stephens C.
        The impact of organisational, social, environmental and job content stressors on the work related strains of probation officers.
        The Australian and New Zealand Journal of Criminology. 2001; 34: 193-203
        • Patrick K.
        • Lavery J.
        Burnout in nursing.
        Australian Journal of Advanced Nursing. 2007; 24: 43-48
        • Curtis P.
        • Ball L.
        • Kirkham M.
        Ceasing to practise midwifery: working life and employment choices.
        British Journal of Midwifery. 2006; 14: 336-338
        • Birch L.
        Stress in midwifery practice: an empirical study.
        British Journal of Midwifery. 2001; 9: 730-734
        • Borritz M.
        • Rugulies R.
        • Bjorner J.
        • Villadsen E.
        • Mikkelsen O.
        • Kristensen T.
        Burnout among employees in human service work: design and baseline findings of the PUMA study.
        Scandinavian Journal of Public Health. 2006; 34: 49-58
        • Akizuki Y.
        • Fujimura K.
        Burnout of Japanese midwives working in hospitals.
        Journal of Japan Academy of Midwifery. 2007; 21: 30-39
        • Alparslan O.
        • Dogane G.
        Relationship between levels of burnout of midwives who work in Sivas, Turkey province centre and identified socio-demographic characteristics.
        International Journal of Nursing and Midwifery. 2009; 1: 019-028
        • Tracey S.
        • Hartz D.
        North Sydney Central Coast Area Health Service.
        in: Quality review of the Ryde Midwifery Caseload Practice. 2005
        • Field A.
        Discovering statistics using SPPS.
        2nd ed. SAGE Publications, London2005
        • Pallant J.
        SPSS survival manual. A step by step guide to data analysis using SPSS.
        2nd ed. Allen & Unwin, Sydney2005
        • Dorz S.
        • Novara C.
        • Sica C.
        • Sanavio E.
        Predicting burnout among HIV/AIDS and oncology health care workers.
        Psychology and Health. 2003; 18: 677-684
        • Taormina R.
        • Law C.
        Approaches to preventing burnout: the effects of personal stress management and organizational socialization.
        Journal of Nursing Management. 2000; 8: 89-99
        • Chrisopoulos S.
        • Waters B.
        Nursing labour force 2002 (No. 29).
        Australian Institute of Health and Welfare, Canberra2003
      3. Australian Institute of Health and Welfare, (2006). Nursing and midwifery labour force (No. HWL 38). Australian Institute of Health and Welfare: Canberra; 2004.

      4. NSW Nurses Association. Without support young nurses won’t stay. The Lamp; 2008a, April; 65: 18–20.

        • Maslach C.
        • Jackson S.
        Maslach burnout inventory.
        Consulting Psychologists Press, California1986
        • Pinikahana J.
        • Happell B.
        Stress, burnout and job satisfaction in rural psychiatric nurses: a Victorian study.
        Australian Journal of Rural Health. 2004; 12: 120-125
        • Payne N.
        Occupational stressors and coping as determinants of burnout in female hospice nurses.
        Journal of Advanced Nursing. 2001; 33: 396-405
        • McGrath A.
        • Reid N.
        • Boore J.
        Occupational stress in nursing.
        International Journal of Nursing Studies. 2003; 40: 555-565
        • Balevre P.
        Professional nursing burnout and irrational thinking.
        Journal for Nurses in Staff Development. 2001; 17: 264-271
        • Humpel N.
        • Caputi P.
        Exploring the relationship between work stress, years of experience and emotional competency using a sample of Australian mental health nurses.
        Journal of Psychiatric and Mental Health Nursing. 2001; 8: 399-403
        • Sciacchitano M.
        • Goldstein M.B.
        • DiPlacido J.
        Stress, burnout and hardiness in R.T.s.
        Professional Issues. 2001; 72: 321-328
        • Maslach C.
        Burnout – the cost of caring.
        Prentice Hall Press, New York1986
        • Spelton E.
        • Totterdell P.
        • Barton J.
        • Folkard S.
        Effects of age and domestic commitment on the sleep and alertness of female shift workers.
        Work & Stress. 1995; 9: 165-175
        • Lushington W.
        • Lushington K.
        • Dawson D.
        The perceived social and domestic consequences of shiftwork for female shiftworkers (nurses) and their partners.
        Journal of occupational health and safety, Australia and New Zealand. 1997; 13: 461-469
        • Fitzpatrick J.
        • While A.E.
        • Roberts J.D.
        Shift work and its impact upon nurse performance: current knowledge and research issues.
        Journal of Advanced Nursing. 1999; 29: 18-27
        • Zhao I.
        • Turner C.
        The impact of shift work on people's daily health habits and adverse health outcomes.
        Australian Journal of Advanced Nursing. 2008; 25: 8-22
      5. NSW Nurses Association. Studies show shiftwork is harmful. The Lamp 2008; April: 65: 17.

        • Stebnicki M.A.
        Stress and grief reactions among rehabilitation professionals: dealing effectively with empathy fatigue.
        Journal of Rehabilitation. 2000; 66: 23-29
        • Sharma A.
        • Sharp D.
        • Walker L.
        • Monsoon J.
        Stress and burnout among colorectal surgeons and colorectal nurse specialists in the National Health Service.
        Colorectal Disease. 2008; 10: 397-406
        • Bryant C.
        • Fairbrother G.
        • Fenton P.
        The relative influence of personal and workplace descriptors on stress.
        British Journal of Nursing. 2000; 9: 876-880