Burnout and second victim phenomenon in obstetrics: Psychological impact of maternal and perinatal adverse events, medico-legal stress, workplace violence, and organizational culture.

Obstetrics is among the most psychologically demanding fields in medicine. Clinicians must safeguard the lives of both mother and fetus while managing unpredictable emergencies, life-threatening complications, and considerable medico-legal scrutiny. Repeated exposure to maternal and perinatal adverse events leaves obstetricians particularly vulnerable to burnout and the second victim phenomenon. This review examines the occupational stressors driving burnout in obstetrics, with particular attention to the second victim phenomenon, moral injury, medico-legal pressure, workplace violence, and the organizational factors that shape clinician well-being. A narrative review of English-language literature in PubMed and PubMed Central was conducted for studies published up to June 2026, using pre-specified search terms combined with reference-list screening of key publications; formal risk-of-bias assessment and protocol registration were not undertaken, consistent with a narrative rather than systematic review design. Burnout affects an estimated 40%-75% of obstetricians and gynecologists, and nearly 45% will experience the second victim phenomenon during their career, with 19% reporting an episode in the past year. Adverse obstetric events commonly provoke guilt, anxiety, sleep disturbance, and post-traumatic stress symptoms, compounded by long hours, litigation, workplace violence, moral injury, and dual responsibility for mother and fetus. These pressures drive defensive practice, reduced job satisfaction, medical errors, and workforce attrition. Structured peer-support programs, debriefing, Just Culture principles, and organizational wellness initiatives show promising, although largely observational, evidence of benefit. Burnout and second victim experiences are significant occupational hazards in obstetrics. Evidence-based organizational support is essential for clinician well-being, workforce retention, and the safety and quality of maternity care, although higher-quality, obstetric-specific intervention research is needed.