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Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Degree Name

Doctor of Philosophy (Ph.D.) Nursing




School of Nursing and Health Sciences



Maternity nurses work where positive outcomes are the norm, leaving them more vulnerable to the adverse effects of dealing with death. Limited data indicate that caring for a maternity patient who dies may result in nurses developing secondary traumatic stress and associated compassion fatigue, which may affect their job performance. Research is warranted to promote a better understanding of nurses’ experiences, especially since the increase in maternal mortality has resulted in more nurses being exposed to maternal death.


The purpose of this study was to explore relationships between secondary traumatic stress, compassion fatigue, and compassion satisfaction of maternity nurses (labor and delivery nurses and postpartum nurses) after caring for or witnessing a patient who succumbed to a maternal death. The factors nurses described that supported them and assisted in coping with this experience were also investigated.


A Concurrent Convergent Mixed Methods Design was used. An electronic survey was sent to members of the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN). Eligible participants were those who identified as labor and delivery or postpartum nurses and cared for a maternity patient who died. It included the Bride’s Secondary Traumatic Stress Scale (BSTS) and the Professional Quality of Life Scale (ProQOL), demographic questions, and three open-ended questions with text boxes to collect narrative responses.


The findings revealed that 43.6% of 202 participants were noted to have secondary traumatic stress. Significant negative correlations obtained between the BSTS, burnout, and compassion satisfaction scores indicate that higher stress levels and burnout were associated with lower reported compassion satisfaction. Participants’ age, years of experience as a maternity nurse, and use of religion/spirituality to cope with maternal death were associated with lower levels of stress. Several themes emerged from the narratives about the impact of the experience of maternal death on the nurses and their recovery from the event. These included Chaotic and Bloody, Like a War Zone, Traumatic and Distressing Experiences with Enduring Bad Memories, Guilt and Fear of Litigation, Preventable or Not, Institutional Support, Private Support, Positive Coping Mechanisms, and Negative Coping Mechanisms.


This study demonstrates that exposure to a work-related maternal death may have adverse effects on maternity nurses and the care they provide. This research highlights the need to develop strategies such as readily available, multifaceted organizational support to mitigate potential negative consequences

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Nursing Commons