Table 4.

Sub-themes of Theme 2 ‘Post-traumatic stress symptoms’

Sub-themes	Expression of midwives
Flashbacks	‘Whenever I hear a patient screaming, I will flashback to a patient who had an unmedicated (not even local) cesarean section and to the wailing of a mother when we were coding her baby in the delivery room.’ 1
Nightmares	‘I had nightmares for several weeks after that, wondering about … how that could happen and what it was … It was very difficult from the first few weeks afterward to come to work.’ 7 ‘When I go home and close my eyes, I see and feel that terrible incident in my dream. I try to forget, of course … but I even can't sleep …’ 23
Inability to forget	‘I can't forget it. I can still see the lady's face. I can't forget that. I'm not going to forget it.’ 11 ‘Time heals but it never goes away completely … I will never forget it … there is a scar … up to today.’ 10
Avoidance	I had a patient die in the delivery room; she was preeclamptic. I felt terrible, depressed, and impotent. I couldn't go into that delivery room for days …’ 24