Background In addition to the immediate health implications of postpartum haemorrhage it is associated with post traumatic stress disorder (PTSD) and birth trauma.
Aim to explore the experiences of these events, as recounted by women, their birth partners and the health care professionals involved, to gain insight into their impact and improve future management.
Methods Data regarding blood loss were imported from NHS electronic records and a weighted sample of notes reviewed for women delivering in two units between 01/08/2008 and 31/07/2009 within the STOP study. Semi-structured qualitative interviews with women/partners (12) and health care professionals (10) and a focus group with 4 midwives were conducted. Thematic analysis was undertaken using manual coding and Nvivo8.
Results Major emergent themes were expectation, fear and professionalism. Women felt staff were in control, although staff body language was indicative of uncertainty or concern. Partners expressed surprise at the large amount of blood volume. Many couples were unaware of bleeding postnatally. Junior staff were unnerved by the speed of blood loss, and doctors appeared more detached than midwives when recounting experiences.
Staff expressed fear, several had suggestions for improving the training and management including better simulators and case analyses. Most women and partners expressed fear of dying or disability except one woman with a strong religious faith.
Conclusion Although commonly encountered, PPH invokes fear for all those involved. Women and partners do not expect severe bleeding. Staff feel anxious despite skills and drills training.
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