By PPH Foundation

When a woman experiences a life-threatening maternal emergency such as postpartum haemorrhage (PPH), the focus is rightly placed on stopping the bleeding and saving her life. Yet, behind the urgent clinical response are healthcare workers who may also carry the emotional effects of the experience long after the emergency has passed.

For midwives, nurses and obstetricians, a maternal emergency can involve intense pressure, uncertainty and the possibility of losing both mother and baby. Even when the team successfully manages the complication, the experience may leave healthcare workers shaken, distressed or questioning their actions. When the outcome is tragic, feelings of grief, guilt and helplessness may become even more difficult to process.

Research increasingly recognises that witnessing a traumatic birth can affect the mental health and professional lives of maternity care providers. A 2022 systematic review of 18 studies involving 8,630 maternity health professionals found that secondary traumatic stress was reported in 12.6 to 38.7 per cent of participants. The proportion meeting diagnostic criteria for post-traumatic stress disorder varied widely across the studies, from 3.1 to 46 per cent. The review identified negative emotions and symptoms, responsibility and regret, changes in professional practice, challenges to professional identity and the importance of team support as key themes (Uddin et al., 2022).

Dr Eunice Atsali, a midwife and Co-Lead of the End Postpartum Haemorrhage Initiative, has emphasised that maternal emergencies depend on a coordinated team response. In a PPH Foundation article on emergency care, she describes postpartum haemorrhage as one of the clearest examples of team-based emergency care, highlighting the roles of midwives, nurses, obstetricians, anaesthetists and other healthcare professionals in saving a mother’s life (PPH Foundation, 2026). While teamwork is essential during the emergency, the wellbeing of those providing that care also deserves attention after the event.

Healthcare workers may experience intrusive memories, difficulty sleeping, anxiety, reduced confidence or fear of facing a similar emergency again. Some may feel responsible for outcomes that were beyond their control. Others may continue working without discussing what happened, particularly in busy maternity units where staffing pressures leave little time for reflection.

A systematic review and meta-synthesis published in 2021 found that midwives who witnessed traumatic births commonly experienced shock, sadness, guilt, helplessness and post-traumatic stress symptoms. Some reported losing confidence in their professional abilities or considering leaving the profession. The researchers highlighted peer support and psychological education as important ways of helping midwives cope (Aydın & Aktaş, 2021).

The emotional impact is not limited to individual workers. When distress goes unaddressed, it may contribute to difficulties in professional practice, challenges to professional identity and strain within the maternity workforce. Recognising these effects is therefore part of strengthening maternal healthcare systems, not a distraction from clinical care (Uddin et al., 2022).

Structured debriefing after a difficult maternal emergency can provide an opportunity for healthcare workers to reflect on what happened, discuss clinical decisions and acknowledge emotional responses. Such discussions should be supportive rather than blame-focused. Access to professional mental health support, mentorship, adequate staffing and a workplace culture where staff can speak openly are also important. Research on midwives’ experiences of traumatic births similarly emphasises peer support and access to psychological education (Aydın & Aktaş, 2021).

Saving a mother’s life is a profound achievement, but the people who provide emergency care should not be expected to carry the emotional weight alone. Supporting healthcare workers after maternal emergencies helps protect their wellbeing, sustain their confidence and strengthen the teams that care for women during childbirth.

References

Aydın, R., & Aktaş, S. (2021). Midwives’ experiences of traumatic births: A systematic review and meta-synthesis. European Journal of Midwifery, 5, 31. https://doi.org/10.18332/ejm/138197

PPH Foundation. (2026, July 14). Teamwork saves mothers: The human side of postpartum haemorrhage emergency response. https://www.endpphfoundation.org/pulse/teamwork-saves-mothers-the-human-side-of-postpartum-haemorrhage-emergency-response

Uddin, N., Ayers, S., Khine, R., & Webb, R. (2022). The perceived impact of birth trauma witnessed by maternity health professionals: A systematic review. Midwifery, 114, 103460. https://doi.org/10.1016/j.midw.2022.103460