Navigating the Strategies Used by Managers to Support Midwives Experiencing Adverse Events in a Selected District of Gauteng Province, South Africa ^†

Background: Midwives in South African public hospitals, particularly in Gauteng Province, operate in high-pressure environments where adverse events (AEs) such as maternal deaths can occur despite best practices. These AEs often lead to emotional distress, burnout, and litigation. While managerial support is critical during such events, limited research exists on the strategies managers use to support midwives experiencing AEs. Objective: To explore and describe the strategies used by managers to support midwives who experience adverse events in obstetric units of a selected district in Gauteng Province. Methods: A qualitative, exploratory, descriptive, and contextual design was employed. Twelve managers were purposively selected using non-probability sampling. Data was collected through semi-structured, in-depth interviews and analyzed using Tesch’s eight-step coding process. Ethical standards, including informed consent, privacy, and respect, were upheld throughout the study. Results: One central theme with six sub-themes emerged. Managers supported midwives by: (1) assisting with incident reporting; (2) assessing causes of AEs; (3) creating a supportive environment; (4) offering relevant training; (5) providing emotional support; (6) conducting follow-ups after incidents. Conclusions: Managerial support is critical in mitigating the emotional and professional impact of AEs on midwives. The study recommends the implementation of structured emotional support systems, routine debriefings, and ongoing training. These strategies might contribute in improving midwives’ well-being, reducing repeated AEs, and enhancing patient safety in maternal healthcare.