A PHENOMENOLOGICAL STUDY OF OBSTETRICIANS’ LIVED EXPERIENCES IN MANAGING HIGH-RISK OBSTETRIC CASES

Authors

  • Humaira Jadoon Ayub teaching hospital Abbottabad
  • Attiya bibi Khan ATH Abbottabad
  • Ansa Islam ATH Abbottabad
  • Salar Ahmed Khan
  • Maria Khan
  • Junaid Sarfaraz

Keywords:

Obstetricians’ experiences; High-risk cases; Postpartum hemorrhage, Antepartum

Abstract

Background: This phenomenological study examines the experiences of obstetricians handling high-risk cases, such as postpartum hemorrhage, antepartum hemorrhage, uterine rupture, and sepsis, in a resource-limited tertiary care hospital in Pakistan. Method: Through questionnaires (open ended questions) with 10 obstetricians, the study identifies four key themes: emotional challenges and psychological stress, systemic resource shortages, professional resilience and coping strategies, and recommendations for institutional support. Results: Obstetricians reported a heavy emotional burden, worsened by their frequent encounters with maternal and neonatal deaths, and a lack of access to mental health services. Systemic issues, such as delays in lab tests, not enough ICU beds, bureaucratic obstacles, and inadequate blood bank support, often delayed care and increased clinical risks. Despite these difficulties, clinicians used informal coping methods like peer support, teamwork, and following protocols. Participants highlighted the need for non-punitive feedback systems, regular emergency drills, decentralizing low-risk deliveries, and integrating mental health services for staff. Conclusion: The study employs Colaizzi’s method to analyze the narratives, showing the complex, emotional, and systemic aspects of maternal care that are often missed in quantitative research. The findings stress the urgent need to make healthcare systems more compassionate by recognizing provider stress and implementing structural, psychological, and procedural changes. This research deepens the understanding of obstetric practices in low-resource settings and provides insights for policies aimed at improving maternal outcomes and clinician well-being. While the study is limited by being conducted at one site, it sets the stage for further exploration into healthcare professionals’ experiences in low-to-middle-income countries.

References

1. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. The Lancet global health. 2014 Jun 1;2(6):e323-33.

2. UNICEF. Maternal mortality. UNICEF [Internet]. 2019.

3. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. The lancet. 2006 Apr 1;367(9516):1066-74.

4. Bonet M, Nogueira Pileggi V, Rijken MJ, Coomarasamy A, Lissauer D, Souza JP, Gülmezoglu AM. Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation. Reproductive health. 2017 Dec;14:1-3.

5. Nishtar S, Boerma T, Amjad S, Alam AY, Khalid F, ul Haq I, Mirza YA. Pakistan's health system: performance and prospects after the 18th Constitutional Amendment. The Lancet. 2013 Jun 22;381(9884):2193-206.

6. Hafeez A, Dangel WJ, Ostroff SM, Kiani AG, Glenn SD, Abbas J, Afzal MS, Afzal S, Ahmad S, Ahmed A, Ahmed H. The state of health in Pakistan and its provinces and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Global Health. 2023 Feb 1;11(2):e229-43.

7. Ilyas A. Maternal health services in Pakistan. Pakistan Journal of Medical & Health Sciences. 2023 May 27;17(05):2.

8. Wu AW. Medical error: the second victim: the doctor who makes the mistake needs help too. Bmj. 2000 Mar 18;320(7237):726-7.

9. Mumtaz Z, Salway S, Waseem M, Umer N. Gender-based barriers to primary health care provision in Pakistan: the experience of female providers. Health policy and planning. 2003 Sep 1;18(3):261-9.

10. Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Social science & medicine. 1994 Apr 1;38(8):1091-110.

11. Ahmed S, Hill K. Maternal mortality estimation at the subnational level: a model-based method with an application to Bangladesh. Bulletin of the World Health Organization. 2011;89:12-21.

12. Van Manen M. Phenomenology of practice: Meaning-giving methods in phenomenological research and writing. Routledge; 2023 Jun 8.

13. Finlay L. Phenomenology for therapists: Researching the lived world. John Wiley & Sons; 2011 Jul 11.

14. Crist JD, Tanner CA. Interpretation/analysis methods in hermeneutic interpretive phenomenology. Nursing research. 2003 May 1;52(3):202-5.

15. Colaizzi PF. Psychological research as the phenomenologist views it.1978.

16. Jones GA, Colville GA, Ramnarayan P, Woolfall K, Heward Y, Morrison R, Savage A, Fraser J, Griksaitis MJ, Inwald DP. Psychological impact of working in paediatric intensive care. A UK-wide prevalence study. Archives of Disease in Childhood. 2020 May 1;105(5):470-5.

17. Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reeves D, Buskirk SJ, Sloan JA, Swensen SJ. Impact of organizational leadership on physician burnout and satisfaction. InMayo Clinic Proceedings 2015 Apr 1 (Vol. 90, No. 4, pp. 432-440). Elsevier.

18. Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PloS one. 2016 Jul 8;11(7):e0159015.

19. World Health Organization. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. World Health Organization; 2023 Feb 22.

20. Leape LL, Shore MF, Dienstag JL, Mayer RJ, Edgman-Levitan S, Meyer GS, Healy GB. Perspective: a culture of respect, part 1: the nature and causes of disrespectful behavior by physicians. Academic medicine. 2012 Jul 1;87(7):845-52.

21. Mealer M, Burnham EL, Goode CJ, Rothbaum B, Moss M. The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depression and anxiety. 2009 Dec;26(12):1118-26.

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Published

2026-01-14

How to Cite

1.
Jadoon H, Khan A bibi, Islam A, Ahmed Khan S, Khan M, Sarfaraz J. A PHENOMENOLOGICAL STUDY OF OBSTETRICIANS’ LIVED EXPERIENCES IN MANAGING HIGH-RISK OBSTETRIC CASES. J Ayub Med Coll Abbottabad [Internet]. 2026 Jan. 14 [cited 2026 Jan. 19];37(3):346-51. Available from: https://www.jamc.ayubmed.edu.pk/index.php/jamc/article/view/14746