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The prevalence of occupational stress among Iranian midwives: a systematic review and meta-analysis

02 November 2021
Volume 29 · Issue 11



Occupational stress is one of the undesirable risk factors found in the midwifery profession. It can lead to job burnout, job loss and negatively affect the quality of patient care. This study aimed to estimate the prevalence of occupational stress among Iranian midwives.


Through searching national and international databases, a total of 11 observational studies with full texts were extracted. Observational studies in Persian or English that reported the prevalence or frequency of job stress among Iranian midwives were included in the analysis. Irrelevant studies, those conducted on midwifery students and gray literature were excluded. The meta-analysis was conducted using the random-effects model.


11 articles reviewed occupational stress in 1196 midwives (an average of 108 midwives per study). Analysis of the articles showed that the pooled prevalence of occupational stress was 70.82% in Iranian midwives. Meta-regression analysis showed that the prevalence of occupational stress was not related to mean age, work experience, articles' publication year or sample size.


The prevalence of occupational stress is high among Iranian midwives and it can have harmful consequences for them and their patients. Therefore, the training of stress coping strategies seems to be appropriate for this group.

Occupational stress is a known risk factor that can cause behavioral, psychological, and medical problems (Quick and Henderson, 2016). As a result of their professional nature, the possibility of healthcare providers being exposed to stress is higher than in other employees (Bruschini et al, 2018).

Occupational stress causes absenteeism, early retirement, and reduced working years in health workers (Bernburg et al, 2016). It has been identified as a major concern around the world (Seňová and Antošová, 2014). Occupational stress can be associated with multiple problems. These can be psychological, including anxiety, depression, fatigue, irritability, aggression, impulsive behavior, overeating, inability to make decisions, poor focus and low attention (Jahromi et al, 2016; Favrod et al, 2018; Chegini et al, 2019). They can also be physical, including migraine, tachycardia, hypertension, musculoskeletal pain, rheumatoid arthritis, pulmonary and digestive disorders (Mollart et al, 2013). Organisational issues such as low productivity, conflicts with colleagues, job dissatisfaction, reduced commitment to the organisation, and poor quality of health services have also been found (Favrod et al, 2018; Rasool et al, 2020). These complications are non-specific responses that the body exhibits against unmet needs that it encounters (Masoumi et al, 2013).

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