• birth experience;
  • cohort study;
  • postpartum hemorrhage;
  • qualitative data;
  • satisfaction with care

Abstract:  Background:  In the context of rising rates of postpartum hemorrhage and little data about its effect on women, this study aimed to describe the experiences of care, and the concerns and needs of women after a significant postpartum hemorrhage.

Methods:  A cohort of 206 women with a primary postpartum hemorrhage of 1,500 mL or more and/or a peripartum fall in hemoglobin concentration to 7 g/dL or less and/or of 4 g/dL or more was recruited from 17 major hospitals in Australasia. Women rated their satisfaction with care and provided written responses to questions in postpartum questionnaires completed in the first week and at 2 and 4 months postpartum.

Results:  In relation to care in hospital, consistently over 20 percent women responded that their needs for information, acknowledgment, and reassurance were only met sometimes, rarely, or never. Sixty-two percent reported that they were given adequate information about their likely physical recovery, and 48 percent about their likely emotional recovery. Four major themes were identified in response to the open-ended questions: adequacy of care, emotional responses to the experience, implications for the future, and concerns for their baby.

Conclusions:  This study is an important step in identifying the negative impact of experiencing a significant postpartum hemorrhage during childbirth for women who survive. Our results suggest that health professionals should pay greater attention to these women’s informational and emotional needs. (BIRTH 38:4 December 2011)