Washington, June 30 : Obstetricians may be considered as life-saving angels for a lot of children, but the trauma associated with stillbirths and infant deaths takes an emotional toll on these child-doctors, so much so that almost one in 10 obstetricians consider to chuck their practice, says a new study.
A survey by researchers at the University of Michigan Health System was conducted on 804 obstetricians, out of which 75 percent said that the experience took a large emotional toll on them personally
"Our survey reveals that perinatal death has a profound effect on obstetricians, and 8 percent had considered giving up obstetrics because of the emotional difficulty of caring for patients with perinatal death. We know that stillbirth and infant death are traumatic events for families; this study suggests that they are also traumatic for the physician," said lead author Katherine Gold, M.D., MSW, of U-M's Department of Family Medicine and Department of Obstetrics and Gynecology.
According to estimates, 15 percent of pregnancies end in early losses (before 20 weeks gestation and on an average the typical obstetrician performing 140 deliveries a year could encounter nearly two dozen women with a miscarriage and one to two with stillbirth or infant death.
"Obstetricians want to see a healthy baby. When a fetus or baby dies, the loss can be devastating for the physician. Half of the time, the medical cause of a stillbirth is unknown, but physicians still may struggle with feelings of guilt or self-blame. When a fetus or baby dies, we focus on the family's needs, but obstetricians are often struggling with their own emotions too," noted Gold.
In fact, the threat of lawsuits also lingers on their head. In the study, 43 percent of obstetricians who responded said they had worried about disciplinary or legal action due to a perinatal death with no identified cause.
A majority of the study's respondents said that improved physician training would help obstetricians. The study said that physicians who said they'd had adequate bereavement training were less likely to report that they had considered giving up obstetric practice because of the emotional difficulty of perinatal death. Physicians who perceived their own training as adequate were less likely to worry about disciplinary or legal action when cause of death was unknown.
"As physicians, we get a lot of training in medicine but little in death and bereavement. Sudden and unexpected losses can be terribly difficult both for families and for the physicians involved in caring for the family. This study shows that stillbirths and infant deaths can have profound and persistent effects on obstetricians. We need to find ways to help both families and physicians cope with these devastating events," said Gold.
Two-thirds of physicians supported training by formal presentations or seminars, and nearly half recommended informal gatherings for physicians to discuss difficult experiences.
Many respondents suggested that a meeting with bereaved parents could serve as a useful training strategy as well as a way of helping physicians cope with their own feelings about the loss.
The study appeared in the latest issue of the journal Obstetrics and Gynecology.