Background Nigeria bears the highest burden of maternal deaths globally; however, limited evidence exists on the work environments in which Skilled Health Personnel (SHPs) deliver maternity care and how these conditions shape care processes. Work-related stress (WRS), which arises when job demands exceed available resources, may undermine workforce wellbeing, care quality, and patient safety. Although workforce shortages and resource constraints are widely recognised challenges in LMICs, empirical evidence linking workplace stress to maternity service delivery remains limited. This study assessed the burden, drivers, consequences, and coping strategies associated with WRS among SHPs in Northern Nigeria.Methods We conducted a convergent mixed-methods study involving 194 SHPs from 48 public and private facilities in Kaduna, Bauchi, and Kwara States. Quantitative data were collected using the USDAW Workplace Stress Questionnaire, a single-item current stress measure, and a 1–10 stress severity scale and analysed using descriptive statistics and bivariate tests (Spearman’s correlation, t-tests, and ANOVA). Qualitative data from 7 focus group discussions and 8 key informant interviews were thematically analysed.Results Overall, 76% (147/194) of SHPs reported current stress, and 73% (107/147) attributed their stress primarily to work-related factors. Workload pressures were prominent: 36.6% worked > 60 hours/week, and 24.7% saw > 40 patients/day. Frequently reported stressors were heavy workload (39.2%), overcrowding (32.5%), and lack of equipment (31.4%). Stress severity was strongly correlated with heavy workload (r = 0.58, p < 0.01) and inadequate breaks (r = 0.50, p < 0.01). Mean stress scores differed significantly by cadre (F(12,181) = 2.58, p = 0.004; η² = 0.145), with higher levels among junior cadres. Qualitative findings described physical and emotional strain and perceived impacts on consultation quality of provider–patient interactions. Most participants (88.1%) reported no formal workplace stress support systems.Conclusion WRS among SHPs providing maternity care in Northern Nigeria is widespread, driven by structural and organisational conditions. Addressing WRS through workload-responsive staffing, supportive supervision, and institutionalised psychosocial support should be integrated into maternal health system strengthening efforts. Strengthening workforce wellbeing may be critical for sustaining safe, responsive, and high-quality maternity care delivery in high-burden settings.