Support for mothers and their families after life-threatening illness in pregnancy and childbirth: a qualitative study in primary care.
BACKGROUND
One in 100 women who give birth in the UK develop life-threatening illnesses during childbirth. Without urgent medical attention these illnesses could lead to the mother's death. Little is known about how the experience of severe illness in childbirth affects the mother, baby, and family.


OBJECTIVE
As part of the UK National Maternal Near-miss Surveillance Programme, this study explored the experiences of women and their partners of life-threatening illnesses in childbirth, to identify the long-term impact on women and their families.


METHODS
Qualitative study based on semi-structured narrative interviews. Interviews were conducted in patients' homes in England and Scotland from 2010 to 2014.


METHODS
An in-depth interview study was conducted with 36 women and 11 partners. A maximum variation sample was sought and interviews transcribed for thematic analysis with constant comparison.


RESULTS
Women's birth-related illnesses often had long-lasting effects on their mental as well as physical health, including anxiety, panic attacks, and post-traumatic stress disorder. In some cases the partner's mental health was also affected. Women often described feeling isolated. Their experiences can have a profound impact on their relationships, family life, career, and future fertility. While some women described receiving good support from their GP, others felt there was little support available for them or their families after discharge from hospital.


CONCLUSIONS
A near-miss event can have long-lasting and major effects on women and their families. Support in primary care, including watchful waiting for mental health impacts, can play a valuable role in helping these families come to terms with their emergency experience. The findings highlight the importance of communication between primary and secondary care.
Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford.
Lisa
L
Hinton
Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford and NIHR Oxford Biomedical Research Centre, Oxford.
Louise
L
Locock
National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford.
Marian
M
Knight
D000328:Adult; D003266:Continuity of Patient Care / Q000458:organization & administration; D005192:Family Health / Q000706:statistics & numerical data; D005195:Family Relations / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000517:prevention & control; D008603:Mental Health / Q000706:statistics & numerical data; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000534:rehabilitation; D036801:Parturition / Q000502:physiology / Q000523:psychology; D011247:Pregnancy; D011320:Primary Health Care / Q000379:methods*; D000072858:Psychosocial Support Systems; D036301:Qualitative Research; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology; D057832:Watchful Waiting / Q000379:methods
childbirth; maternal illness; primary care; qualitative; support