Depression, anxiety and stress in Swedish midwives: A cross-sectional survey

INTRODUCTION: Midwives are exposed to emotional strain, which could affect their overall health. Lack of emotional well-being could be a reason for workforce attrition. The aim of the study was to investigate the prevalence of depressive symptoms, anxiety and stress among Swedish midwives in relation to background variables. METHODS: A random sample of 1000 midwives were asked to participate and complete a questionnaire. Participants completed the Depression, Anxiety and Stress Scale, Copenhagen Burnout Inventory and Quality of Life inventories together with demographic and work-related data. RESULTS: In all, 470 midwives responded to the questionnaire (48%). The prevalence of moderate/severe/very severe symptoms of depressive symptoms was 12%, anxiety 8.6%, and stress 7.2%. Midwives aged <40 years and those with <10 years work experience reported higher levels of depressive symptoms, anxiety and stress. The factors most strongly associated with symptoms of depression were personal burnout (AOR=12.26), client burnout (AOR=1.95) and quality of life (AOR=0.26) The factors most strongly associated with symptoms of anxiety were work burnout (AOR=2.53) and personal burnout (AOR=5.61). The factors most strongly associated with stress were personal burnout (AOR=3.90) and work burnout (AOR=3.58) and high quality of life (AOR=0.34). CONCLUSIONS: Swedish midwives experience symptoms of depression, anxiety and stress. Symptoms of burnout were associated with all aspects of mental health, while high quality of life was protective against these symptoms. These findings are relevant to consider in the work environment for Swedish midwives in order to reduce attrition rates.