Lack of autonomy and professional recognition as major factors for burnout in midwives: A systematic mixed-method review.

aimThe aim of this study was to review the existing evidence on burnout levels in midwives and the main related factors.

designMixed studies systematic review. DATA SOURCES: PubMed, Scopus and Web of Science were sourced from 2018 and 2023. REVIEW

methodsInclusion criteria: quantitative cross-sectional or qualitative articles published in English within the last 5 years. EXCLUSION CRITERIA: studies with undergraduate or trainee midwives, studies examining the factors in a pandemic setting and those not answering the research question. Potential risk of bias was assessed using the Mixed Methods Assessment Tool (MMAT). A convergent synthesis design was followed through a thematic synthesis using Thomas and Harden's three-step method: inductive coding of the text, development of descriptive themes and generation of analytical themes. Qualitative approaches adopted exploratory descriptive studies and participatory action research.

resultsThirty-six studies were included, with a total of 17,364 participants. There were higher levels of burnout in midwives who were single, under 35-40 years of age, with less than 10 years of experience and those with young children. Stress, anxiety and depression, as well as the emotional impact of traumatic events, have been described as related psychological factors.

conclusionAlthough extrinsic work factors such as shifts, workload, pay and interpersonal relationships increase burnout, intrinsic factors such as lack of autonomy and recognition are the main factors related to it. IMPACT: What problem did the study address? Burnout among healthcare workers has been recognized as a global crisis requiring urgent attention, specifically in midwives. What were the main findings? There is a persistent shortage of midwives that is attributed in part to chronic retention difficulties related to job burnout expressed by these professionals. Where and on whom will the research have an impact? We seek to address the paucity of research on burnout in midwives in the current crisis in the profession. Work factors such as lack of autonomy or recognition in the profession carry an associated risk of burnout and job attrition. Understanding the factors that contribute to burnout will enable healthcare organizations to reduce the current problem. REPORTING

methodPREFERRED: Reporting items for systematic review and meta-analyses (PRISMA). PATIENT OF PUBLIC CONTRIBUTION: No patient or public contribution.