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Midwifery in the 21st century: Are students prepared for the challenge?

02 January 2016
Volume 24 · Issue 1


The role of the midwife is emotionally and physically challenging: birth rates are increasing, there are staff shortages and increasingly more complex cases for which to coordinate care (Royal College of Midwives (RCM), 2015). There are also professional and policy requirements to be met, all in the context of practising in line with our core value of being ‘with woman’ and providing her with individualised, high-quality, evidence-based care. Such demands drive some midwives to leave the profession, citing stress, burnout, compassion fatigue and emotional exhaustion as causes (Curtis et al, 2006). Others develop strategies to cope with the complex and varied stressors of the role; they demonstrate resilience. The future of maternity services in the UK is dependent on the retention of resilient midwives, so it is important that the characteristics are explored to ascertain whether resilience is a personal trait or one that can be learned. In 2013, the RCM funded the first research project in the UK to investigate resilience in midwifery (Hunter and Warren, 2013). This article will provide an overview of the clinical, professional and political stressors qualified midwives have to deal with on a daily basis in order to understand the environment student midwives are exposed to when working under the tutelage of their midwife mentor. It will consider the relevance of Hunter and Warren's (2013) findings in the context of midwifery pre-registration education, as the future of midwifery practice in the UK depends on the recruitment, retention and successful qualification of student midwives who are adequately prepared to cope with the complex emotional and physical demands of the profession.

Resilience can be defined as ‘the ability to maintain personal and professional wellbeing in the face of ongoing work stress and adversity’ (McCann et al, 2013: 61). Stress is an individual's reaction to change: positive stress is beneficial as it can be motivational, thereby contributing to successful outcomes; conversely, negative stress can have an impact on the individual's confidence and self-esteem (Seaward, 2006; Rodder, 2012).

The literature conceptualises resilience through a number of lenses. Collins (2007) suggests it is both a personal trait and the ability to adapt to adverse situations. Lutha and Cicchetti (2000) argue that suggesting an individual is inherently resilient is misleading as, in their view, it involves a process whereby the individual learns to be resilient through coping with adverse situations. In addition to definitions of resilience as a personal quality and a learning process, Masten and Coatsworth (1998) view it as an outcome: the individual becomes competent in the skill of dealing with adversity. Regardless of whether resilience is conceptualised by trait, process or outcome, there is wide acceptance that it is the positive adaptation to an adverse situation (Adamson et al, 2012).

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