Armour, SKeedle, HGilkison, ADahlen, HG2025-06-302025-06-302024-10-03Journal of Advanced Nursing, ISSN: 0309-2402 (Print); 1365-2648 (Online), Wiley, 81(6), 3096-3109. doi: 10.1111/jan.164690309-24021365-2648http://hdl.handle.net/10292/19441Aims: Assess the psychological impact that providing TOP care beyond 12 weeks gestation has on midwives in Australia and New Zealand, improve understanding of TOP care and explore what support midwives have and what they might need to deal with their work experiences. Design: Online survey. Methods: A web-based, self-reported questionnaire with a total of 63 questions collected data from June to October 2022. Two validated psychometric tools were included to assess emotional well-being. Numerical data were analysed using descriptive statistics, frequencies, percentages and means. The STROBE guideline was used for reporting. Results: Most midwives felt unsupported and affected by their experiences of providing termination of pregnancy care. Recognition and regular post-care debriefing with management were minimal. Lack of staff impacted the ability to provide individualised care. Mental health support was not commonly offered to midwives. Psychometric tools showed burnout and high levels of compassion fatigue, but also compassion satisfaction. To feel supported midwives need a fully staffed workforce, the ability to provide one-on-one care, recognition from managers and team support. Conclusion: Midwives who deliver termination of pregnancy care are unsupported and at high risk of burnout and compassion fatigue. Providing appropriate support is vital to increase midwives' well-being and sustain women's access to safe, high-quality care. Impact: Study addresses a knowledge gap about midwives' support needs when caring for women undergoing termination of pregnancy beyond 12 weeks. Findings show the urgent need to recruit and retain midwifery staff, acknowledge the mental health risks of termination of pregnancy care and implement mental health strategies for midwives. Research benefits midwives who provide termination of pregnancy care, midwife managers, healthcare organisations and professional bodies. Patient or Public Contribution: No patient or public involvement.© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.http://creativecommons.org/licenses/by-nc-nd/4.0/abortionburnoutcompassion fatiguemental healthmidwifery caretermination of pregnancyworkplace stressworkplace support4203 Health Services and Systems4204 Midwifery4205 Nursing42 Health SciencesMental Health7.1 Individual care needs8.1 Organisation and delivery of servicesGeneric health relevanceReproductive health and childbirth3 Good Health and Well Being1110 NursingNursing4204 Midwifery4205 NursingHumansFemalePregnancyAdultAustraliaNurse MidwivesNew ZealandSurveys and QuestionnairesMiddle AgedMidwiferyBurnout, ProfessionalAbortion, InducedHumansAbortion, InducedBurnout, ProfessionalMidwiferyPregnancyAdultMiddle AgedNurse MidwivesAustraliaNew ZealandFemaleSurveys and QuestionnairesHumansFemalePregnancyAdultAustraliaNurse MidwivesNew ZealandSurveys and QuestionnairesMiddle AgedMidwiferyBurnout, ProfessionalAbortion, InducedJournal ArticleOpenAccess10.1111/jan.16469