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Impact of adverse perinatal events on healthcare professionals

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Impact of adverse perinatal events on healthcare professionals

What was this project about?

Impact of adverse perinatal events on healthcare professionals 

Obstetrics and midwifery are high risk specialties. Sometimes and even despite the provision of the best medical care possible, serious adverse events do occur. While patients and service users of the Irish maternity services bear the bulk of the burden of harm from these adverse events, the healthcare staff who are also involved in these cases can be substantially affected.

Stillbirth, which encompasses both antenatal and intrapartum death, is one of the more serious adverse events or outcomes that can happen during a pregnancy. Existing research focuses largely on the impact that antenatal stillbirth has on obstetricians and midwives, with no research focusing specifically on the impact that intrapartum fetal death has on maternity service healthcare professionals. Much is also now known and acknowledged about the increasing levels of burnout and compassion fatigue that are affecting healthcare professionals. In fact, it has been recognised that healthcare professionals are more likely to experience burnout than the general workforce and it is now estimated that burnout affects 1 in 2 doctors. Healthcare professionals in the maternity services are not exempt from these issues. What is apparent, however, is that relative to the literature pertaining to the general medical specialties, there is a clear paucity of research investigating the effectiveness of available support strategies for maternity healthcare professionals to access either in the aftermath of an adverse event or to help them tackle burnout in the longer term.

This project focuses on the specific impact that intrapartum death, and other serious perinatal adverse events have on healthcare professionals.

What was involved?

  • Survey of the experiences of health care professionals (consultant obstetricians, trainee obstetricians and midwives) following exposure to intrapartum death (IPD) to identify opinions surrounding education and suitable support strategies, and to ascertain if involvement with an IPD had any impact on clinical practice
  • Descriptive study of intrapartum fetal deaths and unexpected neonatal deaths in Ireland from 2011 to 2014, using data obtained from the National Perinatal Epidemiology Centre
  • In-depth qualitative exploration of the attitudes and responses that Irish obstetricians have following direct involvement with an intrapartum fetal death
  • Retrospective observational study to to identify (i) if it was feasible to design a study that could objectively demonstrate if a change in labour ward clinical activity occurred in the 28 days following a serious adverse perinatal event, and (ii) if (i) proved possible, if these changes could be attributed to the preceding adverse event. Study conducted using data from a 25-month period from August 2013 to September 2015
  • To investigate whether an intervention which increases support for staff is feasible to implement and effective at improving staff wellbeing. This study was conducted in a tertiary university teaching maternity hospital. All doctors in training and midwives working in the delivery suite were invited to participate. The support interventions consisted of posters promoting self-care, team bonding sessions, and end of shift meetings
  • Evaluation of a novel workshop for trainee obstetricians using applied drama techniques–in collaboration with the National Theatre of Ireland, the national training body for obstetricians and gynaecologists, and patient support groups–to teach obstetricians skills in communication and self-care around the time of stillbirth.

Who was involved?

Project team

Name Affiliation Role
Dr Karen McNamara Pregnancy Loss Research Group  PhD Student
Professor Keelin O'Donoghue Pregnancy Loss Research Group  Primary Supervisor
Professor Richard Greene National Perintal Epidemiology Centre, UCC Co-supervisor

Dissemination activities

Journal articles

  • McNamara K, Meaney S, O'Connell O, McCarthy M, Greene RA, O'Donoghue K. Healthcare professionals' response to intrapartum death: a cross-sectional study. Archives of Gynecology & Obstetrics. 2017;295(4):845-852.
  • McNamara K, O'Donoghue K, Greene RA. Intrapartum fetal deaths and unexpected neonatal deaths in the Republic of Ireland: 2011 - 2014; a descriptive study. BMC Pregnancy and Childbirth. 2018;18(1):9.
  • McNamara K, Meaney S, O'Donoghue K. Intrapartum fetal death and doctors: a qualitative exploration. Acta Obstetricia & Gynecologica Scandinavica. 2018;97: 890-898.
  • McNamara K, O’Donoghue K. The perceived effect of serious adverse perinatal events on clinical practice. Can it be objectively measured? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2019;240:267-272.
  • O’Riordan S, O’Donoghue K, McNamara K. Interventions to improve wellbeing among obstetricians and midwives at Cork University Maternity Hospital. Irish Journal of Medical Science. 2020;189(2):701-709.
  • McNamara K, Smith A, Shine B, Cregan M, Prihodova L, O'Shaughnessy A, Martin A, Macdonald J, Kingston P, Fitzpatrick C, Hennessy M, O'Donoghue K. (2022) Addressing obstetricians’ awareness of compassion, communication, and self-care when caring for families experiencing stillbirth: Evaluation of a novel educational workshop using applied drama techniques. PLOS One. 2022;17(11):e0277496.

Project status

Completed: 2015 to 2018 

Further information

Please email Professor Keelin O'Donoghue: 

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,