Date of Award


Degree Type


Degree Name

Doctor of Philosophy (Nursing)


School of Nursing and Midwifery

First Advisor

Professor Craig Speelman

Second Advisor

Associate Professor Sara Bayes


The development of the midwifery profession and the culture of childbirth are inevitably entwined from an historical perspective through to current day practice. Early written accounts describe the fifteenth century midwife as dealing with high maternal and child mortality rates, the invention of forceps, the rise of male obstetric practitioners, and the complex social and cultural changes of that era. The twenty-first century midwife faces challenges in Australia and worldwide, which are not dissimilar to our midwifery predecessors.

Midwifery clinical practice has become more complex due to the medicalisation of childbirth and 21st century lifestyles, which have contributed to a rise in critical incidents and emergency situations amongst labouring, birthing and postpartum women. Therefore, the purpose of this study was to examine whether clinical midwifery practice causes midwives work-related stress which may have implications for the emotional well-being and career decisions from the perspective of Western Australian midwives. Work-related stress has been extensively researched amongst other health professionals, but relatively little is known about Western Australian midwives and work-related stress, therefore this required further exploration. A classic grounded theory study design was used, which included 21 in-depth individual face-to-face interviews with Western Australian registered midwives from May 2014 to December 2015. ‘Midwifery is Stressful but it is not the Job Itself’, was the core problem to emerge from the collected data, with three major sub-categories emerging which included workloads, coordinators and traumatic incidents. These factors were identified as causing stress. The sub-categories are explored in relation to the consequences, context and process that affected, influenced and constrained the participants. Emotional distress, commitment to midwifery and future career decisions are the final sub-categories identified that provide an understanding of the relationship between the categories. A new substantive theory of work-related stress in midwifery is presented entitled ‘Fighting a Losing Battle’: Midwives’ Experiences of and Response to Workplace Stress.


Paper Location