Volume 127, Issue 5 p. 600-608
General obstetrics

Work-related post-traumatic stress symptoms in obstetricians and gynaecologists: findings from INDIGO, a mixed-methods study with a cross-sectional survey and in-depth interviews

P Slade

Corresponding Author

P Slade

Institute of Health and Life Sciences, University of Liverpool, Liverpool, UK

Correspondence: P Slade, Institute of Health and Life Sciences, University of Liverpool, Liverpool L69 3GB, UK. Email: [email protected]

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K Balling

K Balling

Institute of Health and Life Sciences, University of Liverpool, Liverpool, UK

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K Sheen

K Sheen

Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK

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L Goodfellow

L Goodfellow

Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK

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J Rymer

J Rymer

Division of Women’s Health, Kings’ College London Faculty of Life Sciences and Medicine, London, UK

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H Spiby

H Spiby

School of Health Sciences, University of Nottingham, Nottingham, UK

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A Weeks

A Weeks

Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK

Liverpool Women’s Hospital Foundation Trust and Liverpool Health Partners, Liverpool, UK

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First published: 27 January 2020
Citations: 27

Linked article: This article is commented on by C Gerada, p. 609 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.16095.

Abstract

Objectives

To explore obstetricians’ and gynaecologists’ experiences of work-related traumatic events, to measure the prevalence and predictors of post-traumatic stress disorder (PTSD), any impacts on personal and professional lives, and any support needs.

Design

Mixed methods: cross-sectional survey and in-depth interviews.

Sample and setting

Fellows, members and trainees of the Royal College of Obstetricians and Gynaecologists (RCOG).

Methods

A survey was sent to 6300 fellows, members and trainees of RCOG. 1095 people responded. Then 43 in-depth interviews with trauma-exposed participants were completed and analysed by template analysis.

Main outcome measures

Exposure to traumatic work-related events and PTSD, personal and professional impacts, and whether there was any need for support. Interviews explored the impact of trauma, what helped or hindered psychological recovery, and any assistance wanted.

Results

Two-thirds reported exposure to traumatic work-related events. Of these, 18% of both consultants and trainees reported clinically significant PTSD symptoms. Staff of black or minority ethnicity were at increased risk of PTSD. Clinically significant PTSD symptoms were associated with lower job satisfaction, emotional exhaustion and depersonalisation. Organisational impacts included sick leave, and ‘seriously considering leaving the profession’. 91% wanted a system of care. The culture in obstetrics and gynaecology was identified as a barrier to trauma support. A strategy to manage the impact of work-place trauma is proposed.

Conclusions

Exposure to work-related trauma is a feature of the experience of obstetricians and gynaecologists. Some will suffer PTSD with high personal, professional and organisational impacts. A system of care is needed.

Tweetable abstract

18% of obstetrics and gynaecology doctors experience post-traumatic stress disorder after traumatic events at work.