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A systematic integrative review of the literature on midwives and student midwives engaged in problematic substance use

Pezaro, Sally; Patterson, Jenny; Moncrieff, Gill; Ghai, Ishan


Sally Pezaro

Gill Moncrieff

Ishan Ghai


The objective of this systematic integrative review was to review the literature in relation to problematic substance use (PSU) in midwifery populations. Associated aims were to aggregate existing knowledge about midwives and student midwives’ personal engagement in PSU, to generate a holistic conceptualisation and synthesis of the existing literature regarding midwives and student midwives personally engaged in PSU and to present new understandings and perspectives to inform the development of future research questions. This review is the first of its kind.

Systematic searches were conducted in CINAHL, Academic Search Complete, MEDLINE, PSYCInfo, Scopus and the Cochrane Library. Findings were grouped into themes and subthemes relating to both midwives and student midwives and then analysed critically in relation to the wider literature. A quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). The PRISMA statement was used to guide reporting.

Included studies were conducted in Scotland, Ireland, Australia and New Zealand.

Studies included a total of 6,182 participants.

A total of 3 studies were included. All included study types comprised quantitative survey designs, yet one also included a mixed methods design with the use of semi structured interviews. Two overarching themes emerged relating to both midwives and student midwives engaged in problematic substance use. For midwives, three subthemes are described: harmful daily alcohol consumption, working hours and harmful daily alcohol consumption and features associated with harmful daily alcohol consumption. For student midwives, two subthemes are presented: escape avoidance and alcohol, tobacco and cannabis use.

Key conclusions
There is limited evidence available in relation to problematic substance use in midwifery populations in comparison to that available for other healthcare populations. Further research is required, and could usefully focus upon midwives and student midwives as distinct professions to be separated out from the wider healthcare workforce.

Implications for practice
Problematic substance use among the healthcare workforce is associated with an increase in medical errors and inadequate care. Those affected can be reluctant to seek help, experience psychological distress and even contemplate suicide. Whilst evidence remains lacking for midwifery populations, they form a part of the general healthcare workforce and are exposed to similar workplace stressors. As such, it is likely that they too would be affected in similar ways.


Pezaro, S., Patterson, J., Moncrieff, G., & Ghai, I. (2020). A systematic integrative review of the literature on midwives and student midwives engaged in problematic substance use. Midwifery, 89,

Journal Article Type Article
Acceptance Date Jun 13, 2020
Online Publication Date Jun 15, 2020
Publication Date 2020-10
Deposit Date Oct 2, 2020
Publicly Available Date Jun 16, 2021
Journal Midwifery
Print ISSN 0266-6138
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 89
Article Number 102785
Keywords Impairment, Health professional, Workplace stress, Midwives, Substance use: alcohol, Integrative review, Psychological distress
Public URL


A Systematic Integrative Review Of The Literature On Midwives And Student Midwives Engaged In Problematic Substance Use (accepted version) (293 Kb)


Copyright Statement
Accepted manuscript licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.

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