title: Women and their birth partners' experiences following a primary postpartum haemorrhage: a qualitative study.
abstract: BACKGROUND
  Postpartum haemorrhage (PPH) is a common obstetric complication. Rates of PPH are increasing in a number of developed countries. This is concerning as PPH is recognised as a leading cause of maternal morbidity and mortality which includes psychological and emotional distress. There is limited understanding of the emotional impact of PPH experienced by women and their birth partners. This study qualitatively describes the experiences of women and their birth partners who experienced a primary PPH.
  
  
  METHODS
  Semi-structured interview study. Couples were recruited via maximum variation sampling, which, by purposive sampling drew participants from three groups depending on the degree of PPH: minor (500-1000 ml), moderate (1000-2000 ml) and severe (>2000 ml). Interviews took place from 4 to 14 months post birth, and data were analysed via Framework analysis.
  
  
  RESULTS
  In this qualitative study, 11 women and six partners were interviewed. Data were organised into four interrelated themes; Control, Communication, Consequence, Competence. Just over half of the women and their birth partners were unaware they had a PPH, and would have preferred more information either at the time or in the postnatal period. The findings suggest that birth partners also required more information, especially if separated from their partner during the PPH.
  
  
  CONCLUSIONS
  This study provides valuable insights into women's reports of their feelings and experiences during and after a PPH, and how their partners feel having observed a PPH. This study suggests that women who have had a PPH of any volume would like more information. Further investigations into the timings, methods and effectiveness of discussions following a PPH are recommended.
authors.affiliation: King's College Hospital Foundation Trust, London, UK. tessa.dunning@nhs.net.
authors.forename: T
authors.initials: T
authors.lastname: Dunning
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Harris
authors.affiliation: Women's Health Academic Centre, King's Health Partners, Division of Women's Health, King's College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Sandall
mesh_terms: D000328:Adult; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D036801:Parturition / Q000523:psychology*; D006473:Postpartum Hemorrhage / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D036301:Qualitative Research; D018454:Spouses / Q000523:psychology*
keywords: Birth partners; Birth trauma; Childbirth; Obstetric emergency; Post-traumatic stress disorder; Postpartum haemorrhage