Table 3.

Sub-themes of Theme 1 ‘Post-traumatic feelings’

Sub-themes	Expression of midwives
Being shocked	‘The difficulty is both physical and emotional, your blood boils … and there is no blood that goes to the brain, your whole body is paralyzed from shock. I was totally in shock.’ 17
	‘… I mean she was more shocked than me because she entered the labor room and I said oh my god [name omitted] baby's dead.’ 11
Crying	‘… The doctor and I began to work through tears in our eyes. We just started to quietly cry ...’ 1
	‘I felt terrible, such a loss. I cried with the woman—that's the way it was—a very deep sadness. The second midwife also cried with us.’ 17
Feeling the chaos	‘What I remember happening is, walking in and everybody's flurried around doing all kinds of stuff. And I noticed that the patient's blood pressure on the monitor machine is very low ... And I just went to the obstetrician... [then] I went to the anesthesiologist, “What can I do for you? What do you need?” ’ 18
Feeling helpless	‘I have thought many times that we do not have good follow-up routines after critical incidents. You feel abandoned, and you have no one to lean on.’ 19
Being disrespected as a midwife	‘I was abused in front of the woman when I had turned off the Syntocinon infusion because of decelerations during contractions.’ 20
Feeling powerless	‘I have stood by helpless and watch [sic] babies die due to my inability to perform a cesarean and my [back up] is 30 minutes out.’ 4
Feeling sadness	‘I was absolutely devastated. Absolutely, I broke down …’ 11
Feeling guilty	‘So that instantly knocks you back into going “hang on a minute”, what's wrong with me, did I make that really bad for the woman? It was just so terrible, I felt so guilty.’ 6
Feeling shame	‘Unfortunately, I think that many midwives feel such shame that they may not want to admit that a sphincter tear has occurred and then do everything to hide it.’ 2
Feeling like a failure	‘There's also I guess for me, there’s almost a sense of failure, and that I've failed this person.’ 6
Feeling disappointed	‘I felt that I had disappointed the family, although it was beyond my control, you know …’ 11