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Midwifery Advocacy Peer Support (MaPs)

An innovative project attempting to optimise the wellbeing of midwives, by developing and delivering a package of ‘psychological first aid’ and peer support through Professional Midwifery Advocates (PMAs).

Read comments 7
  • Idea
  • 2018

Meet the team: #NGHMaPs


  • Heather Gallagher (Associate Directory of Midwifery)
  • Tara Pauley (Associate Director of Nursing and Midwifery)
  • Professor Greenberg
  • Gavin Rogers
  • Paula Briody

Depression, anxiety, stress and burnout, accounts for a quarter of all sickness absence in the NHS (NHS Survey, 2016). We know that emotional traumas and burnout associated with caring work often remain unrecognised, and therefore can leave staff feeling unsupported and isolated (Wilkinson, 2015). Midwives in psychological distress can often “suffer in silence” (Deery and Kirkham, 2006).

Maternity staff are an NHS group that don’t always experience workplace trauma, the same way that other NHS professionals do. Traumatic events in maternity are always tragic, rarely expected, and in predominately young generally healthy women and babies. These events can sometimes result in death or life long, life limiting disability, and on occasion due to errors (not necessarily disease progression/illness).

The whole maternity team often have to wrestle with trauma exposure, experiencing the initial trauma and then ongoing with the investigation, and then the accountability of that, often resulting in sometimes long lasting psychological distress. Midwives and maternity staff can be described as ‘second victims’ due to this, this area is well researched and evidenced (Perzaro, et al 2015). Midwives can struggle with the accumulation of multiple exposures to ‘smaller’ traumatic events, or one large traumatic event which all of which may result in psychological distress, or indeed midwives can experience psychological distress due to the more day-to-day occupational stressors (Fig.1).

It is therefore of paramount importance to highlight midwives’ experiences and support the needs of staff in psychological distress, midwives deserve access to evidence-based support and care in their workplaces. There are clear direct correlations between staff health, wellbeing and the quality of ‘patient’ care delivered by staff (Francis, 2015). Perzaro et al (2015) called for urgent research to explore and develop new, evidence-based solutions to support midwives in work-related psychological distress.


This application is for support to initiate an innovative project attempting to optimise the wellbeing of midwives, by developing and delivering a package of ‘psychological first aid’ and peer support through Professional Midwifery Advocates (PMAs).

This project will develop and pilot an innovative hybrid package of interventions; (psychological first aid and on-going peer support) for support midwives in psychological distress.  The package will be designed and developed in collaboration with leading mental health professional Professor Greenberg (Occupational, academic and forensic psychiatrist) and March on Stressã (Psychological Health Consultancy).

March on Stressã currently offer two excellent different training programmes; TRiM and StRaW®.

  • TRiM is a trauma-focused peer support system designed to help people who have experienced a traumatic, or potentially traumatic event.
  • StRaW: Sustaining Resilience at Work is a peer support system to detect and prevent occupational mental health issues and boost psychological resilience.

However, it was felt that midwives required a different programme to TRiM and StRaW, requiring a specifically tailored programme to their occupational needs, covering both aspects of whether the psychological distress was due to exposure to workplace trauma, or the consequence of other occupational stressors (Fig.1).

The programme/package will be designed and developed by Professor Greenberg, March on Stressã and the senior Midwifery Team at Northampton. The package will be based on the most current research and the growing evidence base around peer support and trauma response.

March on Stressã will deliver the newly designed training programme to the Professional Midwifery Advocates (PMAs*) at Northampton. The PMA team will implement the interventions/package to the midwifery team (and to the wider maternity team as required). The project will include evaluation of the training programme, evaluation of the package of psychological first aid and peer support, both in terms of the experience of delivering the interventions and experience of receiving them.

This project is innovative in that this has not been previously done before, it uses the newly developed PMA role, the issue is highly current in the light of maternity safety, healthy midwives are paramount for the delivery of high quality maternity care (Perzaro, et al 2015), and if successful has the ability for mass roll out.

Project Aim and Objectives

  • To build resilience by safeguarding the psychological wellbeing of midwives (and wider maternity team) through the prevention, detection and treatment of occupational and operational stress, including exposure to traumatic events.
  • To develop, deliver and evaluate a specialised hybrid training programme for PMAs, to be able to address midwives in psychological distress needs in the workplace.
  • To develop, pilot and evaluate a package of ‘psychological first aid’ and peer support interventions for midwives in psychological distress.

How you can contribute

  • - Experience of other Q members and their colleagues in relation to a similar project, key learning points from similar initiatives
  • - Any expertise to add to project
  • - Constructive feedback on proposal


  1. This sounds like a great idea and with wave 1 of the NHSI maternity and Neonatal collaborative receiving their safety culture results, and wave 2 going through theirs, this will provide a good option to provide support for some of the highlighted areas for improvement. Would be interested in seeing how this will work in practice.

  2. Guest

    Helen Graham 4 years, 1 month ago

    This is a very worthwhile project and the way forward. All too often, stress and exposure to trauma for midwives and allied professionals is not taken seriously enough . The silent suffering can lead to negative effects on the individual and subsequent changes in the way that they may be able to care for subsequent women , creating a cycle of anxiety and fear .

    I was fortunate enough to train with psychotherapist  Jennifer Mullan and qualify as a birth trauma resolution practitioner . As a midwife , I can support women or partners who  are suffering from the effects of a traumatic birth experience and have a degree of PTSD ,  We use the rewind technique amongst other tools to take away the emotional tag of their memory which haunts them in 1-4 sessions.

    This therapy would also be very relevant to staff who are suffering from the effects of trauma from their professional exposure and I would advocate that the trained practitioners in the UK should be utilised in this very important area of work as much as possible. For further information on the training and therapy


  3. Have you seen this important event coming up in October? 

    I can link you with the key people in Coventry and Warwickshire if you aren’t already connected

  4. This is a brilliant idea. We are in the process of recruiting 1 PMA. Trying to maintain their resilience will be difficult but this would really help.

  5. Sorry, autocorrect typo! *“develop some bespoke Whose Shoes scenarios and poems to promote discussion and understanding”*

    This also links strongly with our #MindNBody perinatal mental health work which launches in London on Friday 15/6, funded by 3 NHS regional networks: London, West Midlands and the South-West.

    Again, the common theme is that both women and families AND the staff who look after them are affected by traumatic experiences. We need to join up these initiatives and (with over 1 billion Twitter impressions!) #MatExp community has the network to do so. 

  6. As creator of Whose Shoes and co-founder of the #MatExp campaign, we hear in all our workshops just how important this work is. It is only by caring for the staff that we can care for women and families. I would be very happy to support this project. I am talking with Heather Gallagher about how we could develop some bespoke Whose Shoes scenarios and poems Do I discussion and understanding.. I can also support through social media, with 25,000+ Twitter followers. For example linking people to this new highly relevant Facebook group and making strong links for the project team. Excellent idea!


  7. I would love to hear more about this idea and consider what we could share in regards to my project looking to support junior doctors

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