The impact of working in obstetrics on medical students and obstetric doctor's wellbeing, personal birth choices and professional development

Abstract

Aim The thesis explored the meaning of traumatic birth events in medical students and obstetric doctors. The impact on wellbeing, personal birth choices, career choices, satisfaction and professional development was explored.

Methods Medical students (N=247) were assessed using questionnaires and seven focus groups (N=39). A peer support programme was introduced (N=44) and six focus groups held plus one interview (N=41). Obstetric doctors were assessed through questionnaires (N=83) and interviews (N=13). Statistical analysis of quantitative data was performed with SPSS v29 and Microsoft Excel whereas for qualitative results framework methodology was used.

Results Medical students experienced childbirth as traumatic if they perceived an unacceptable event and were exposed to medicalised childbirth. Students enjoyed the placement when supported by the multi-disciplinary team, but found the clinical environment stressful, often traumatised by the ‘reality and brutality’ of childbirth. Personal birth choices were not significantly changed but increased knowledge generated a desire for control. Students were interested in an obstetric career, but the perceived lack of work-life balance and emotional toll of poor outcomes are deterrents. The placement promoted professional development in preparation for working as doctors and a formal peer support programme providing mentorship, academic and pastoral support was welcomed during their placement. Obstetric doctors experienced childbirth as traumatic if their contribution was perceived as detrimental. Despite good wellbeing levels, they felt anxious and doubted clinical decision making following traumatic birth events. Overall, thirty percent opted for a caesarean section as their own personal birth choice. Career satisfaction was lowered by the clinical environment and fear of litigation, but improved when supported by co-workers. They expressed desire for psychological support separate to the educational systems already in place.

Conclusion Labour ward presents a rewarding but challenging environment for both medical students and obstetric doctors. Psychological and educational support is needed to increase the reward of facilitating safe childbirth.