A systematic integrative review of the literature on midwives and student midwives engaged in problematic substance use

Sally Pezaro, Jenny Patterson, Gill Moncrieff, Ishan Ghai

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)
126 Downloads (Pure)


Objective: The objective of this systematic integrative review was to review the literature in relation to problematic substance use (PSU) in midwifery populations. Associated aims were to aggregate existing knowledge about midwives and student midwives’ personal engagement in PSU, to generate a holistic conceptualisation and synthesis of the existing literature regarding midwives and student midwives personally engaged in PSU and to present new understandings and perspectives to inform the development of future research questions. This review is the first of its kind. Design: Systematic searches were conducted in CINAHL, Academic Search Complete, MEDLINE, PSYCInfo, Scopus and the Cochrane Library. Findings were grouped into themes and subthemes relating to both midwives and student midwives and then analysed critically in relation to the wider literature. A quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). The PRISMA statement was used to guide reporting. Setting: Included studies were conducted in Scotland, Ireland, Australia and New Zealand. Participants: Studies included a total of 6,182 participants. Findings: A total of 3 studies were included. All included study types comprised quantitative survey designs, yet one also included a mixed methods design with the use of semi structured interviews. Two overarching themes emerged relating to both midwives and student midwives engaged in problematic substance use. For midwives, three subthemes are described: harmful daily alcohol consumption, working hours and harmful daily alcohol consumption and features associated with harmful daily alcohol consumption. For student midwives, two subthemes are presented: escape avoidance and alcohol, tobacco and cannabis use. Key conclusions: There is limited evidence available in relation to problematic substance use in midwifery populations in comparison to that available for other healthcare populations. Further research is required, and could usefully focus upon midwives and student midwives as distinct professions to be separated out from the wider healthcare workforce. Implications for practice: Problematic substance use among the healthcare workforce is associated with an increase in medical errors and inadequate care. Those affected can be reluctant to seek help, experience psychological distress and even contemplate suicide. Whilst evidence remains lacking for midwifery populations, they form a part of the general healthcare workforce and are exposed to similar workplace stressors. As such, it is likely that they too would be affected in similar ways.

Original languageEnglish
Article number102785
Early online date15 Jun 2020
Publication statusPublished - Oct 2020

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in Midwifery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Midwifery, 89, (2020)
DOI: 10.1016/j.midw.2020.102785

© 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/


  • substance use
  • midwife attitudes
  • midwife
  • Midwifery
  • burnout
  • stress
  • anxiety
  • student journey
  • Midwives
  • Health professional
  • Impairment
  • Integrative review
  • Substance use: alcohol
  • Workplace stress
  • Psychological distress

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Maternity and Midwifery


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