A socioecological model of posttraumatic stress among Australian midwives

Julia Leinweber, Debra K. Creedy, Heather Rowe, Jenny Gamble

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


Objective to develop a comprehensive model of personal, trauma event-related and workplace-related risk factors for posttraumatic stress subsequent to witnessing birth trauma among Australian midwives. Design a descriptive, cross-sectional design was used. Participants members of the Australian College of Midwives were invited to complete an online survey. Measurements the survey included items about witnessing a traumatic birth event and previous experiences of life trauma. Trauma symptoms were assessed with the Posttraumatic Stress Disorder Symptom Scale Self-Report measure. Empathy was assessed with the Interpersonal Reactivity Index. Decision authority and psychological demand in the workplace were measured with the Job Content Questionnaire. Variables that showed a significant univariate association with probable posttraumatic stress disorder were entered into a multivariate logistic regression model. Findings 601 completed survey responses were analysed. The multivariable model was statistically significant and explained 27.7% (Nagelkerke R square) of the variance in posttraumatic stress symptoms and correctly classified 84.1% of cases. Odds ratios indicated that intention to leave the profession, a peritraumatic reaction of horror, peritraumatic feelings of guilt, and a personal traumatic birth experience were strongly associated with probable Posttraumatic Stress Disorder. Conclusions risk factors for posttraumatic stress following professional exposure to traumatic birth events among midwives are complex and multi-factorial. Posttraumatic stress may contribute to attrition in midwifery. Trauma-informed care and practice may reduce the incidence of traumatic births and subsequent posttraumatic stress reactions in women and midwives providing care.

Original languageEnglish
Pages (from-to)7-13
Number of pages7
Early online date6 Dec 2016
Publication statusPublished - 1 Feb 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016 Elsevier Ltd


  • Midwives
  • Obstetric violence
  • Occupational health
  • Posttraumatic stress
  • Trauma
  • Workforce attrition

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Maternity and Midwifery


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