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Women’s Experiences of Care and Their Concerns and Needs Following a Significant Primary Postpartum Hemorrhage

Authors

  • Jane F. Thompson BSc (Hons), MSc, PhD,

    1. Jane Thompson is the Senior Research Officer with Women’s Hospitals Australasia, Canberra; Jane Ford is a Senior Research Fellow, Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; Camille H. Raynes-Greenow is a Postdoctoral Fellow, Sydney School of Public Health, University of Sydney, Sydney; Christine Roberts is an Associate Professor and Head of Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; and David Ellwood is Associate Dean in the School of Clinical Medicine, Deputy Dean and Professor of Obstetrics & Gynaecology, Australian National University Medical School, Canberra, Australia.
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  • Jane B. Ford BA (Hons), PhD,

    1. Jane Thompson is the Senior Research Officer with Women’s Hospitals Australasia, Canberra; Jane Ford is a Senior Research Fellow, Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; Camille H. Raynes-Greenow is a Postdoctoral Fellow, Sydney School of Public Health, University of Sydney, Sydney; Christine Roberts is an Associate Professor and Head of Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; and David Ellwood is Associate Dean in the School of Clinical Medicine, Deputy Dean and Professor of Obstetrics & Gynaecology, Australian National University Medical School, Canberra, Australia.
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  • Camille H. Raynes-Greenow BA, GradDipPopHealth, MPH, PhD,

    1. Jane Thompson is the Senior Research Officer with Women’s Hospitals Australasia, Canberra; Jane Ford is a Senior Research Fellow, Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; Camille H. Raynes-Greenow is a Postdoctoral Fellow, Sydney School of Public Health, University of Sydney, Sydney; Christine Roberts is an Associate Professor and Head of Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; and David Ellwood is Associate Dean in the School of Clinical Medicine, Deputy Dean and Professor of Obstetrics & Gynaecology, Australian National University Medical School, Canberra, Australia.
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  • Christine L. Roberts MBBS, DipObs, DrPH,

    1. Jane Thompson is the Senior Research Officer with Women’s Hospitals Australasia, Canberra; Jane Ford is a Senior Research Fellow, Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; Camille H. Raynes-Greenow is a Postdoctoral Fellow, Sydney School of Public Health, University of Sydney, Sydney; Christine Roberts is an Associate Professor and Head of Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; and David Ellwood is Associate Dean in the School of Clinical Medicine, Deputy Dean and Professor of Obstetrics & Gynaecology, Australian National University Medical School, Canberra, Australia.
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  • David A. Ellwood MA, DPhil, MBBS

    1. Jane Thompson is the Senior Research Officer with Women’s Hospitals Australasia, Canberra; Jane Ford is a Senior Research Fellow, Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; Camille H. Raynes-Greenow is a Postdoctoral Fellow, Sydney School of Public Health, University of Sydney, Sydney; Christine Roberts is an Associate Professor and Head of Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney; and David Ellwood is Associate Dean in the School of Clinical Medicine, Deputy Dean and Professor of Obstetrics & Gynaecology, Australian National University Medical School, Canberra, Australia.
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  • This study was funded by Women’s Hospitals Australasia and the Australian Capital Territory Health and Medical Research Fund, Canberra. Jane Ford is supported by a National Health and Medical Research Council (NHMRC) Capacity Building Grant, 573122; Christine Roberts is supported by a NHMRC Senior Research Fellowship; and Camille Raynes-Greenow is supported by an NHMRC Post-Doctoral Fellowship, Canberra.

Address correspondence to Dr. Jane F. Thompson, BSc (Hons), MSc, PhD, Women’s Hospitals Australasia, PO Box 50, Deakin West, Canberra, ACT 2600, Australia.

Abstract

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)

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