Story by Drish Lokee.
In Vietnam, inadequate and limited access to health care during pregnancy, childbirth and early childhood contributes to 600 maternal deaths and more than 10,000 neonatal deaths per year. This demonstrates a need to increase the midwifery workforce and improve their working conditions to reduce morbidity and mortality among mothers and infants in low and middle income countries
“Incentives and support are important to retain a strong workforce of midwives in any healthcare system, particularly Vietnam,” says Dr Sofia Holmlund a Research Fellow at the Judith Lumley Centre at La Trobe University. “High workload due to low staffing levels, lack of continuity of carer, low support from colleagues, challenging clinical situations and low levels of clinical autonomy are all found to be correlated with poor emotional wellbeing among midwives.”
Dr Holmund worked with a research team including La Trobe collleague Associate Professor Dr Kristina Edvardsson and academics from international institutions in Sweden, Vietnam and Rwanda to examine the challenges faced by Vietnamese midwives when working in maternity care system. The research shows how midwives experience work-related psychological distress as part of their professional routine.
The team worked in three different hospitals in the Hanoi region and gathered responses of 25 midwives based on four focus group discussions. The study is part of the CROss-Country UltraSound (CROCUS) exploring midwives and obstetricians’ experiences and views of obstetric ultrasound in six low, middle and high-income countries.
“The focus group discussions revealed that midwives felt pressure due to high workload, and ethically demanding duties,” says Dr Holmlund. “They also reported that they were sometimes vulnerable to criticism, and blamed by patients and their families for unforeseen and unavoidable childbirth complications which couldn’t be prevented, even with the best effort.”
The research also states that one in five healthcare professionals experience workplace violence in Vietnam. Midwives reported having to endure work-related burnout which can be aggravated by exposure to workplace violence.
Dr Holmlund says recruiting more midwives and increasing training will improve the experience of working Vietnamese midwives.
“There is a need to scale up the midwifery workforce, globally and in Vietnam, to decrease workload in maternity care and to improve quality of care for women and their newborns,” says Dr Holmund. “This will not only improve health outcomes for mother and infants, but it will also deliver benefits to midwives themselves in terms of lower burnout rates and higher levels of job satisfaction.”
