Exploring the psychological well-being of midwives after maternal deaths: an integrative review

Introduction: The mental health of midwives is crucial both for their professional performance and personal well-being, particularly following traumatic incidents like maternal fatalities. Though these experiences can be emotionally draining, research is scarce on the coping mechanisms employed by midwives in such situations. This integrative review seeks to investigate and combine current studies concerning the mental health of midwives after experiencing maternal mortality, pinpointing the psychological effects, coping strategies, and available support networks. Methods: An integrative review was carried out by searching databases including PubMed, PsycINFO, CINAHL and Google Scholar. Studies from 2015 to 2025 were selected if they examined midwives' psychological reactions to maternal deaths. Information was gathered, assessed, and organized around main themes. Results: Ten studies were examined in the review, uncovering several psychological effects on midwives such as guilt, anxiety, depression, and burnout. Coping mechanisms encompassed peer support, professional counseling, and debriefing sessions. Moreover, the level of institutional support demonstrated significant variation. Discussion: This integrative review outlines the considerable psychological distress experienced by midwives following maternal deaths, such as feelings of grief, guilt, anxiety, and secondary trauma, particularly in settings with limited resources. Coping mechanisms like peer support, debriefing sessions, and spiritual practices provide some relief, yet frequently prove insufficient due to a lack of proper institutional backing. The review advocates for further research into the long-term effects, strategies to enhance resilience, and the formulation of trauma-informed policies and mental health services to better support midwives in a variety of healthcare contexts.