The Emotional Toll on Physicians

A new study shows that one in 10 obstetricians have considered giving up their practice due to the emotional toll of stillbirths and infant deaths. The study, undertaken by researchers at the University of Michigan Health System had 804 obstetricians take a survey with 3/4 of the participants stating that these experiences caused them intense personal suffering.

Lead author of the study, Katherine Gold, M.D., MSW, of the University of Michigan's Department of Family Medicine and Department of Obstetrics and Gynecology stated that perinatal death has a profound effect on obstetricians, with the study revealing that 8% had considered giving up obstetrics as a result of having cared for patients with perinatal deaths. The emotional difficulties of the patient/doctor relationship in such a case were the significant factor. "We know that stillbirth and infant death are traumatic events for families; this study suggests that they are also traumatic for the physician.

Physicians Struggle, Too

1.3% of pregnancies end in stillbirth or infant death. The typical obstetrician performing 140 annual deliveries might encounter one or two stillbirths or infant deaths during the course of a year. Says Gold, "When a fetus or baby dies, we focus on the family's needs, but obstetricians are often struggling with their own emotions too."

Weighing Heavy

Malpractice suits tend to weigh heavy on physicians, too. Stillbirths are second only to births that involve terrible neurological outcomes in terms of malpractice allegations. Forty-three participants in the study worried about disciplinary or legal action relating to perinatal deaths without an identified cause.

Those obstetricians who had had bereavement training were less liable to report having considered giving up their practices due to the emotional difficulties of perinatal death, noted the study report. The study also found that physicians who felt confident about their level of training were less liable to concern themselves about disciplinary and legal actions for an unknown cause of death.

Until now, much of the focus surrounding stillbirths and infant deaths have been centered on the families. This study helped to show that such tragic occurrences have a profound effect on physicians as well as their patients. Gold comments, "We need to find ways to help both families and physicians cope with these devastating events."

Two thirds of the physicians supported formal presentations or seminars as a means of support training for obstetricians. Many of the respondents thought a meeting with the bereaved parents might serve as both a training strategy and as way of helping physicians to cope with their feelings about such loss.

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