“Quis custodiet ipsos custodes?” (Who watches the watchmen?) — Juvenal

Working in obstetrics and gynaecology (O&G) is deeply rewarding but also physically and emotionally demanding. The long hours, high-stakes decisions and emotional weight of patient care can take a toll on even the most dedicated professionals. In a field where we constantly care for others, how often do we pause to care for ourselves?

Why Mental Health Matters in Medicine

As healthcare professionals, we pride ourselves on resilience. Yet, studies show that doctors face higher risks of burnout, depression, substance misuse, and even suicide compared to the general population. Working in O&G is deeply rewarding, but the intense demands can quietly wear us down over time.

Our own illnesses are invaluable in allowing us to understand our patients, what makes people go to the doctor (or avoid going to the doctor), and the barriers we may erect to resist advice. Ignoring our own mental health doesn’t make us stronger. It puts our patients, colleagues, and families at risk—and it takes away the joy of why we chose this calling in the first place.

If our mental health significantly impairs our ability to perform our professional duties, it is essential that we recognise this and take appropriate action. The following signs may indicate that this threshold is approaching (1):

• Minimising every contact with patients, so that the doctor does the bare minimum required.
• Inability to concentrate on the matter at hand. Your thoughts are entirely taken up with the workload ahead or with other problems in your life.
• Excessive irritability with those around you at work or outside of work.
• Inability to take time off without feeling guilty.
• Feelings of excessive shame or anger when reviewing past débâcles/Persistent rumination over past mistakes, leading to thoughts that giving up medicine would be the only way to avoid future errors.
• Emotional exhaustion—such as knowing that you should feel pleased or cross with yourself or others, but on consulting your heart you draw a blank.

Recognise any of these? It’s time to pause.

How to Protect Your Mental Health

The first step in countering these unfavourable states of mind is to recognise that one is present. The next step is to confide in someone you trust. Give your mind time to rejuvenate itself.

If these steps prove ineffective, various psychotherapeutic approaches may be relevant, such as cognitive behavioural therapy (CBT) or you might try prescribing the symptom. For example, if you are plagued by recurring thoughts about how poorly you treated a patient, set aside time to deliberately ruminate on the affair, avoiding distractions. This is the first step in gaining control—you initiate the thought, rather than the thought initiating itself. The next step is to interpose some neutral topic once the ‘bad’ series of thoughts is under way. With repeated practice, the mind automatically flows into the neutral channel once the bad thoughts begin, disrupting the cycle of shame and rumination. In addition… learn from the experience!

Here are some useful CBT techniques commonly used by healthcare professionals:

2. Behavioural Activation

3. Thought Records

4. Problem-Solving Therapy

5. Stress Inoculation (Preparation for Stressful Events)

6. Relaxation Techniques (CBT-Integrated)

7. Values-Based Action (Acceptance and Commitment Therapy)

8. Managing Perfectionism

10. Compassionate Self-Talk

No one is immune to stress, but you can build habits to protect your well-being.

Emotional Intelligence

Emotional intelligence (EQ) is the ability to understand and manage your own emotions while also navigating interpersonal relationships effectively. A high EQ can help reduce stress, improve teamwork, and enhance patient care. Here’s how to cultivate it:

Self-awareness – Acknowledge your emotions and triggers. Take a moment to reflect on how stress is affecting you.
Self-regulation – Learn to manage emotions under pressure. Simple breathing exercises or mindfulness can help you stay grounded.
Social awareness – Develop empathy by tuning into the emotions of others’. Understanding their perspectives fosters trust and collaboration.
Social management – Strengthen professional interactions through active listening, clear communication, and a positive influence on others.
Effective communication – Express concerns openly and seek support when needed. Sometimes, a simple conversation with a colleague can lighten the burden. “We work in an environment full of emotion and developing skills to help us demonstrate our care, vulnerability and humanity in a sustainable and healthy way is essential – yet it’s so rarely taught. Developing emotional intelligence skills has enabled me to find enjoyment and positivity at work while protecting myself from the more extreme emotional challenges.” — Thomas Kitchen, Registrar

Prioritising Self-Care

🧘 Set Boundaries – It’s okay to say no. Protect your time outside of work for rest and personal activities.
😴 Prioritise Rest – Fatigue impairs decision-making. Aim for quality sleep, even with an unpredictable schedule.
💬 Seek Support – Speak to a mentor, trusted colleague, or professional counsellor if you’re struggling.
🚶 Take Breaks – A short walk, a few deep breaths, or even a coffee break can help reset your mind.
🏃 Stay Active – Regular physical activity can boost mood and energy levels.
🎯 Remember Your Purpose – Reflect on why you chose medicine/O&G. Reconnecting with your passion can reignite motivation.

Below are some useful resources which are easily accessible by all healthcare professionals.

• Centre for Clinical Interventions (CCI) (https://www.cci.health.wa.gov.au)
  • Offers free, high-quality CBT-based workbooks on perfectionism, stress, low mood, and worry.
• Psychology Tools (https://www.psychologytools.com)
  • Provides evidence-based CBT worksheets and handouts.
• NHS Every Mind Matters (https://www.nhs.uk/every-mind-matters/)
  • Offers public health resources on stress, anxiety, and low mood with CBT-informed guidance.
• Practitioner Health (www.practitionerhealth.nhs.uk/self-help-and-wellbeing)
• Royal College of Psychiatry (https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/cognitive-behavioural-therapy-(cbt))

Seeking Help

If no progress is made, it may be time to consult an expert, such as a professional counsellor or a mental health professional.

If you think you need to consult a doctor, then do so, in privacy. Avoid ‘corridor consultations’ with colleagues. Other than for minor ailments, avoid self-diagnosis and management. Treat yourself as you would expect a patient with the same condition to be treated—and have a confidential consultation with a trusted health professional.

References

1.        Baldwin A, Hjelde N, Goumalatsou C, Myers G. Oxford Handbook of Clinical Specialties. 10th ed. Oxford: Oxford University Press; 2016. 332–332 p.