Burnout after perinatal LOSS in Midwifery: results of the BLOSSoM study

Burnout after perinatal LOSS in Midwifery: results of the BLOSSoM study

Claudia Ravaldi (1,2), Eleonora Cossu (2), Alessandra Bettiol (3), Niccolò Lombardi (3), Giada Crescioli (3), Elisa Carelli (4), Fabio Facchinetti (5), Alfredo Vannacci (1,3)

(1) Department of Health Sciences, University of Florence, Florence, Italy; (2) CiaoLapo, Charity for Healthy Pregnancy, Stillbirth and Perinatal Loss Support, Prato, Italy; 3 – Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; (3) University of Insubria, Varese, Italy; (5) Department of Medical and Surgical Sciences for Mothers, Children and Adults , University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico , Modena , Italy

Background:
Perinatal death and stillbirth are dramatic events, and the care of mothers, fathers and babies is usually perceived as an intense and stressful experience by professionals, often unskilled in coping with such a tragic and unexpected termination of pregnancy. Here we report the results of a nationwide investigation conducted in Italy in a sample of 534 healthcare professionals (mainly midwives and obstetricians) involved in perinatal loss care.

Methods:
Each subject was administered the Lucina questionnaire to explore professionals’ beliefs on perinatal loss, the Revised Impact of Event Scale (RIES) oriented on stillbirth experiences, and the Maslach Burn-Out Inventory (MBI) to assess the level of professional burn out.

Results:
The mean age was 33.6±9.2; the mean number of working years was 9.0±7.2. The levels of event impact and professional burnout scales were not significantly different between the various healthcare professions. The total number of stillbirths assisted during the career significantly correlated with the level of burnout dimensions (p<0.01). Correlation analysis showed a significant relationship between perceived event impact and professional burnout. In particular, the presence of avoidance symptoms after the event was associated with emotional exhaustion at work (rho=0.27, p<0.01) and with problems in personal accomplishment (rho=0.28, p<0.01).

Conclusion:
According to our experience in Italian settings, addressing the stress of professionals facing stillbirth and perinatal death is of paramount importance, since this experience could lead to professional burnout and emotional exhaustion. High level of burnout could in turn impair communication skills of caregivers, resulting in a poor quality of assistance for bereaved parents, a well-known factor in determining long-term psychological distress and poor quality of life.

Ethics statement:
According to Italian regulation, for this type of studies the approval by the Ethics Committee is not required (GU n. 76 March 31, 2008); data were collected in keeping with General Data Protection Regulation of European Union (GDPR, EU 2016/679) and written informed consent was obtained from all participants.


International Stillbirth Alliance, Annual Conference on Perinatal Mortality and Bereavement Care, Madrid, Spain. October 5-6th, 2019.

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