{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T01:05:43Z","timestamp":1785200743891,"version":"3.55.0"},"reference-count":36,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000325","name":"Wellbeing of Women","doi-asserted-by":"publisher","award":["RG1912"],"award-info":[{"award-number":["RG1912"]}],"id":[{"id":"10.13039\/501100000325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To explore the events perceived as traumatic by obstetricians and gynaecologists (O&amp;G), and to examine factors contributing to the perception of trauma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Mixed methods: cross-sectional survey and in-depth interviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample and setting<\/jats:title><jats:p>Fellows, members and trainees of the Royal College of Obstetricians and Gynaecologists (RCOG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An online survey was distributed to 6300 fellows (May\u2013June 2017), members and trainees of RCOG; 1095 (17%) completed surveys were returned. Of these, 728 (66%) reported work-related trauma experience, with 525 providing a brief description of an event. Forty-three participants with trauma experience were purposively sampled and completed an in-depth interview (October 2017\u2013March 2018), which were analysed using Template Analysis. Information regarding the scale and impact of trauma experience is presented elsewhere. The present analysis provides new information describing the events and perceptions of why events were traumatic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary outcome measures<\/jats:title><jats:p>The nature of traumatic events in this clinical setting, taken from survey descriptions of perceived traumatic events and information from the in-depth interviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Events perceived as traumatic by O&amp;G were similar between consultants, trainees and other RCOG members no longer working in O&amp;G. Maternal or neonatal death\/stillbirth, haemorrhage and events involving a difficult delivery were most frequently reported. Sudden and unpredictable events, perceived preventability, acute sensory experiences and high emotionality contributed to trauma perception. Respondents\u2019 trauma was compounded by an absence of support, involvement in investigation procedures and pre-existing relationships with a recipient of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Identification of events most likely to be perceived as traumatic, and wider circumstances contributing to the perception of trauma, provide a basis on which to focus preventative and supportive strategies for O&amp;G. Training on the nature of traumatic events, self-help for early stress responses, processing support and rapid access to trauma-focused psychological input (where required) are needed.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2022-061505","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T16:22:06Z","timestamp":1669047726000},"page":"e061505","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Which events are experienced as traumatic by obstetricians and gynaecologists, and why? A qualitative analysis from a cross-sectional survey and in-depth interviews"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1254-1763","authenticated-orcid":false,"given":"Kayleigh","family":"Sheen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Goodfellow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Balling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Rymer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Weeks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Spiby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Slade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"2022112108201355000_12.11.e061505.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-018-1659-1","article-title":"Work-related adverse events leaving their mark: a cross-sectional study among Dutch gynecologists","volume":"18","author":"Baas","year":"2018","journal-title":"BMC Psychiatry"},{"key":"2022112108201355000_12.11.e061505.2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31817d0582"},{"key":"2022112108201355000_12.11.e061505.3","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1111\/1471-0528.14259","article-title":"Post-traumatic stress symptoms in Swedish obstetricians and midwives after severe obstetric events: a cross-sectional retrospective survey","volume":"124","author":"Wahlberg","year":"2017","journal-title":"BJOG"},{"key":"2022112108201355000_12.11.e061505.4","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1111\/1471-0528.16076","article-title":"Work-related post-traumatic stress symptoms in obstetricians and gynaecologists: findings from INDIGO, a mixed-methods study with a cross-sectional survey and in-depth interviews","volume":"127","author":"Slade","year":"2020","journal-title":"BJOG"},{"key":"2022112108201355000_12.11.e061505.5","unstructured":"American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington DC: American Psychiatric Pub, 2010."},{"key":"2022112108201355000_12.11.e061505.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(99)00123-0"},{"key":"2022112108201355000_12.11.e061505.7","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12695"},{"key":"2022112108201355000_12.11.e061505.8","doi-asserted-by":"crossref","DOI":"10.1016\/j.srhc.2019.100483","article-title":"Left alone with the emotional surge: a qualitative study of midwives' and obstetricians' experiences of severe events on the labour ward","volume":"23","author":"Wahlberg","year":"2020","journal-title":"Sex Reprod Healthc"},{"key":"2022112108201355000_12.11.e061505.9","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Washington DC: American Psychiatric Pub Andersson, 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"2022112108201355000_12.11.e061505.10","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1097\/NMD.0000000000000214","article-title":"Subjective appraisal of threat (criterion A2) as a predictor of distress in childbearing women","volume":"202","author":"Devilly","year":"2014","journal-title":"J Nerv Ment Dis"},{"key":"2022112108201355000_12.11.e061505.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01476.x"},{"key":"2022112108201355000_12.11.e061505.12","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715002706"},{"key":"2022112108201355000_12.11.e061505.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2016.07.013"},{"key":"2022112108201355000_12.11.e061505.14","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ijnurstu.2016.10.009","article-title":"Self-reported exposure to severe events on the labour ward among Swedish midwives and obstetricians: a cross-sectional retrospective study","volume":"65","author":"Wahlberg","year":"2017","journal-title":"Int J Nurs Stud"},{"key":"2022112108201355000_12.11.e061505.15","unstructured":"International Classification of Diseases, Eleventh Revision (ICD-11). World Health Organisation (WHO) 2019\/2021. Available: https:\/\/icd.who.int\/browse11 [Accessed Jul 2022]."},{"key":"2022112108201355000_12.11.e061505.16","doi-asserted-by":"crossref","unstructured":"Krippendorff K . Content analysis: an introduction to its methodology. Los Angeles: SAGE Publications, 2018.","DOI":"10.4135\/9781071878781"},{"key":"2022112108201355000_12.11.e061505.17","unstructured":"Marmer CR , Weiss DS . The impact of event scale\u2013revised. In: Assessing psychological trauma and PTSD. New York: Guilford, 1997: 399\u2013411."},{"key":"2022112108201355000_12.11.e061505.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2008.04.006"},{"key":"2022112108201355000_12.11.e061505.19","unstructured":"Sheehan DV . The anxiety disease. New York: Scribner\u2019s, 1983."},{"key":"2022112108201355000_12.11.e061505.20","doi-asserted-by":"crossref","first-page":"426","DOI":"10.4135\/9781526435620.n24","volume-title":"Qualitative organizational research: core methods and current challenges","volume":"450","author":"King","year":"2012"},{"key":"2022112108201355000_12.11.e061505.21","unstructured":"Royal College of Obstetricians and Gynaecologists . Each baby counts 2015 full report. Royal College of obstetricians and gynaecologists, 2017. Available: https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/research--audit\/each-baby-counts-2015-full-report.pdf [Accessed 12 Nov 2021]."},{"key":"2022112108201355000_12.11.e061505.22","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.ogrm.2016.09.002","article-title":"Human factors in obstetrics and gynaecology","volume":"26","author":"Hinshaw","year":"2016","journal-title":"Obstet Gynaecol Reprod Med"},{"key":"2022112108201355000_12.11.e061505.23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k1333"},{"key":"2022112108201355000_12.11.e061505.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2009.07.003"},{"key":"2022112108201355000_12.11.e061505.25","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1192\/bjp.2020.109","article-title":"What should be done to support the mental health of healthcare staff treating COVID-19 patients?","volume":"217","author":"Tracy","year":"2020","journal-title":"Br J Psychiatry"},{"key":"2022112108201355000_12.11.e061505.26","doi-asserted-by":"crossref","first-page":"835811","DOI":"10.3389\/fgwh.2022.835811","article-title":"Secondary traumatic stress and moral injury in maternity care providers: a narrative and exploratory review","volume":"3","author":"Kendall-Tackett","year":"2022","journal-title":"Front Glob Womens Health"},{"key":"2022112108201355000_12.11.e061505.27","doi-asserted-by":"crossref","DOI":"10.1017\/S1754470X21000040","article-title":"Cognitive therapy for moral injury in post-traumatic stress disorder","volume":"14","author":"Murray","year":"2021","journal-title":"Cogn Behav Therap"},{"key":"2022112108201355000_12.11.e061505.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2016.06.007"},{"key":"2022112108201355000_12.11.e061505.29","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1111\/aogs.12760","article-title":"Learning about maternal death and grief in the profession: a pilot qualitative study","volume":"94","author":"Cauldwell","year":"2015","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2022112108201355000_12.11.e061505.30","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.ijnurstu.2018.07.016","article-title":"The erratic pathway to regaining a professional self-image after an obstetric work-related trauma: a grounded theory study","volume":"89","author":"Wahlberg","year":"2019","journal-title":"Int J Nurs Stud"},{"key":"2022112108201355000_12.11.e061505.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2015.10.003"},{"key":"2022112108201355000_12.11.e061505.32","unstructured":"Healthcare Safety Investigation Branch . National learning report support for staff following patient safety incidents, 2021. Available: https:\/\/www.hsib.org.uk\/documents\/270\/HSIB_Support_for_staff_following_patient_safety_incidents_Report_V03_003.pdf [Accessed 22 Jan 2022]."},{"key":"2022112108201355000_12.11.e061505.33","doi-asserted-by":"crossref","DOI":"10.1080\/20008198.2018.1518069","article-title":"A programme for the prevention of post-traumatic stress disorder in midwifery (POPPY): indications of effectiveness from a feasibility study","volume":"9","author":"Slade","year":"2018","journal-title":"Eur J Psychotraumatol"},{"key":"2022112108201355000_12.11.e061505.34","unstructured":"West M , Coia D . Caring for doctors caring for patients. How to transform UK healthcare environments to support doctors and medical students to care for patients, 2019. General Medical Council. Available: https:\/\/www.gmc-uk.org\/-\/media\/documents\/caring-for-doctors-caring-for-patients_pdf-80706341.pdf [Accessed 22 Jan 2022]."},{"key":"2022112108201355000_12.11.e061505.35","unstructured":"National Institute for Health and Care Excellence . Post-traumatic stress disorder [NG116], 2018. Available: https:\/\/www.nice.org.uk\/guidance\/ng116\/chapter\/Recommendations [Accessed 20 Sep 2022]."},{"key":"2022112108201355000_12.11.e061505.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2014.11.006"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-061505","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T08:41:31Z","timestamp":1678696891000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-061505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,21]]},"published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1136\/bmjopen-2022-061505"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-061505","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11]]}}}