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Conditions that threaten women’s lives in childbirth & pregnancy

Support for partners/fathers

We interviewed ten father’s whose wives/partners experienced a near miss event in childbirth, or shortly afterwards, and one lesbian partner.
 
Key Learning Points
  • All the partners/fathers we spoke to have been deeply affected by their partner’s life threatening experiences, for some it has a profound impact on their long-term mental health
  • In situations where an emergency delivery might be anticipated, such as when a women has placenta praevia, explanation of what might happen really helps partners prepare and cope subsequently.
  • Frequent updates during the emergency help partners/fathers feel less isolated and anxious
  • Personal touches of support from individual staff make a real difference to how partner’s cope
  • Partners remember more about events than the woman who is ill, but still appreciate repeated explanations
  • Partners/fathers can find seeing their partner in high dependency or intensive care very traumatic, and may need support from staff and family members to:

             - enable them to visit their partner

             - understand that the situation is not hopeless' their partner may recover

             - come to terms with what has happened 

  • Long-term mental health problems in partners/fathers after a near-miss experience may have a big impact financially, practically and emotionally and families may need additional support in this event
  • Partners/fathers who experience mental health symptoms do not necessarily seek help, although they do feel that counselling, if offered, could be beneficial.
Watching a wife or partner going through a life-threatening emergency in childbirth was very frightening and stressful for the men (and one lesbian partner) we interviewed. They feared losing their wife, baby and family life. Our interviews with fathers/partners indicated that they appreciated clear communication and support in hospital, and potentially support once their wives/partners are home.
 
In Hospital: Communication matters
Maternal near miss events can unfold in different ways. In some cases, clinicians will have time to explain to the woman and her partner what is happening and the likely course of treatment.
 

Michael's wife developed HELLP syndrome. He appreciated the clear communication before his wife...

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Michael's wife developed HELLP syndrome. He appreciated the clear communication before his wife...

Age at interview: 32
Sex: Male
Age at diagnosis: 32
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And were you in the room when anyone came to explain to you what was happening and why they had to do the emergency C Section or had that all happened earlier?

 

I think they’d explained a lot of that to my wife in the morning, but I did sort of only arrive may be an hour and a half after she had sort of been woken up. So some people had come and explained it. Right you’re going to having the baby today because of this, this, and this. And she had a bit of explanation made to her, but then we seemed to have plenty of doctors that would come in and sort of explain everything.

 
Some of it, my wife had heard before, a lot of it was new to both of us. Sort of finding out a lot of information. There was possibly a bit of information overload because we were just trying to understand things ourselves, and there seemed to be this strong procession of, you know, one doctor after another doctor, another doctor, I don’t know if that’s normal or if it’s not normal, but there seemed to be a lot of doctors. My memory’s probably not that great, because I’m thinking of so many different things, but I have this sort of vague memory of being introduced to about four anaesthetists and it sort of, there was just one after the other, after the other. 
 
They explained, there was a little bit of an overlap between some of them, but a lot of them were explaining slightly different things, as to what their role was going to be.
 
Was it difficult information to take in or just too much of it?
 
No I think they did actually a wonderful job of trying to explain it in a way that a medical dummy like me could sort of understand things. So, there were lots of sort of key words that I was trying to make sure okay. Pre eclampsia, a couple of doctors had mentioned that. I actually have never heard of that before. I don’t know if it’s common or not common, but okay. That’s you know, what we’ve got here. So just trying to remember a couple of key words. And sort of take in as much as I could.

 

In other instances, the emergency does not allow time for explanations. While the men we spoke to understood the priority was the safety of mother and baby, several were left for hours without knowing whether their wife and baby were alive or dead. This was a very distressing time for them and small updates would have made it easier for them.
 

Simon and his mother waited in an ante-room for a couple of hours, without any updates on how his...

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Simon and his mother waited in an ante-room for a couple of hours, without any updates on how his...

Age at interview: 35
Sex: Male
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So I tried to go back through to the wards, the operating room. I just asked for some kind of update, and again the guy said, “Oh sorry, you know, you can’t, there’ve been a, there’ve been a few complications but everything’s fine.” And of course, by that stage, the everything fine message isn’t entirely believed. Not necessarily that they’re lying, but it just carries no weight in terms of emotional reassurance by that stage. Because everything should have been fine all the way along, but you know.
 
But anyway so I went back to wait some long, some more. And then after, I don’t know how long. You know, it’s one of those things, actually, now, you kind of think it will be totally like burned on your brain, and it’s not. But after ever so many kind of hours it was, one of the guys came through down, the anaesthetist I think it was, the anaesthetist came through and kind of said, well I mean, the good news is that [Hannah] was okay, [Hannah] was, you know, all right. But then that she’d had, she’d had various complications and had been taken up to intensive care. And they’d had to regulate her blood gases and so therefore she was on a vent. And, you know, I’d been able to go up and see her, in whatever it was, in a while.
 
And I was like, “Okay, okay thank you very much.” And that’s, that’s when I do remember actually being, getting, that’s like, you know, when it wells, just because she’s going to wake up on a vent, she’s going to wake up. That’s exactly what she was petrified of doing, and, and the image and experience that was so, you know, so much part of the bad experiences with her Mum, and that kind of stuff. And that’s what she was going to do, and she was going do it alone, because I wasn’t going to be there, and so I did kind of well at that. 
 
And then it was just a case of wanting to see her, and, and, get the, get [daughter] to her, get the baby to her because you know, we’d always wanted as much as a natural birth as possible and the baby being Caesarean, feeding as soon as possible and all that kind of stuff. And so then, it just became a case of right I just want to see her as soon as I can, and go and get baby to her.
 
And again, I don’t know how much time I’m afraid went by, but we went up and saw her and she was kind of tubes here and there and... actually I was surprised in theatre and afterwards in intensive care that that didn’t bother me too much. I, you know, I wasn’t, I wasn’t aware how I’d be with that kind of stuff, but actually it just was what it was, and that was fine. 
 
And she was actually okay, and by that stage I remember like, just in terms of talking about it before, you know, from that stage on basically my main emotion was kind of gratitude really that it had, you know, it had stopped. You know, it had got so far, and that was horrendous but the, she, you know, she was okay. [Hannah] was, you know, [Hannah] was okay. Not great, but she was alive. And [daughter] was alive and [Hannah] was alive and so yes, kind of gratitude at that and just kind of love and protection for [Hannah] really. Just that real sense of okay she’s gone through all this and I haven’t been able to anything else. You know, hopefully now I do get a chance to help her out and just try and protect her a bit from all of it. 
 
 

Craig's wife needed an emergency caesarean to deliver their twins. He'd been told she had stopped...

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Craig's wife needed an emergency caesarean to deliver their twins. He'd been told she had stopped...

Age at interview: 48
Sex: Male
Age at diagnosis: 48
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All I could hear was “Crash theatre one. Crash theatre one.” Being echoed and I knew we were in theatre one, so my immediate thought was I’ve lost my wife Or you know, I’ve lost one or both the children, or everybody. I was in pieces, absolute pieces. And I poked my head out of the room and some young lady came up and said, “Oh you’re in the way there. Can you go back in the room.” And I asked her to come in the room, and I just explained to her that I’d been stuck in here for well over an hour, well it felt like two days, but I’m sure it was a very short time, and that I was getting quite distraught and if somebody didn’t and see me very soon, then I’d start shouting and screaming, until somebody does come in and talk to me and tell me what’s going on with my family.
 
And then a sister turned up and said, “Oh there’s been a problem. Everything’s okay, but there’s been a problem.” And that my wife had been ill when she was being intubated. And she’d stopped breathing. So immediately it goes through your head, oxygen starvation, brain damage, blah di blah. She said, “Stay in the room, and we’ll give you a shout, when they’re coming out the operating theatre.” 
 
And I was asked to come up, stand outside the operating theatre when everybody went past. So I saw the children go past. And probably didn’t really recognise the children to be honest. I just saw two little things going past. Didn’t really pay that much attention to be honest, because I was a little bit on the freaked side about my wife because I saw her getting wheeled out and she had tubes coming out of everywhere and there was lots of blood and stuff, and I just didn’t know what was going on. You know, people can tell you, for a nurse or a doctor, or a surgeon I should say, they would have experienced this before, they’ve seen it before, they understand it. But a drop of blood will go, will make, you know, make a spot this big, but for me, you know, seeing everything covered in blood and everything, I thought somebody was dead.

 

 
Mark’s wife was rushed to hospital in an ambulance and had an emergency caesarean after a placental abruption. While he has not felt traumatised by what he witnessed, he feels doctors could have taken a few minutes to explain to him what had happened and made sure that he was OK. 
 

Mark feels he is ‘a pretty strong guy’, but that other men could have been very affected by...

Mark feels he is ‘a pretty strong guy’, but that other men could have been very affected by...

Age at interview: 41
Sex: Male
Age at diagnosis: 37
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So dealing with that particular time period, what do you think could have been done differently or better?
 
I think someone could have explained what had happened at that point. Why we were in that situation, why there was the need for the crash team. Why she had been whipped away like that. Just to fill me in. I didn’t think so much of it at the time, because I was so wrapped up in the emotion of having a new born child in my arms. But afterwards I thought, there was space there, to actually involve me a bit more in what was going on, and it wouldn’t have taken too much effort, given that they were all ready and able to dash in and you know, eight or ten of them there, at the crash, to keep one of them behind for a few minutes, just to make sure that I wasn’t less sturdy than I was. Because I’m a pretty sturdy guy, I think, I like to think I am. So I could withstand it, but someone who was not quite as robust as me, might have really gone to pieces at that point, not knowing what was going on. You know, I just sat there and I put my faith in the service I think and thought well if anything is going to go wrong they will tell me. As long as it’s no news is good news kind of thing, well that’s what I was thinking at the time.
 
Others were unprepared for the emergency, and wished they had known that it might happen.  Mandy developed acute fatty liver and haemorrhaged after her son was born. She wishes now her husband had been better prepared for what might have gone wrong. 
 

Mandy started to bleed shortly after her son was born. Doctors tried several options to stem the...

Mandy started to bleed shortly after her son was born. Doctors tried several options to stem the...

Age at interview: 35
Sex: Female
Age at diagnosis: 28
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I remember waking up about sort of 6 o’clock (pm) feeling the contractions quite strongly. And at that time my husband still wasn’t there [laughs]. So I pretty much laboured on my own, which was fine actually. And I had the midwives come in, just to check me. And then the next thing I know is that I’m in established labour and in a delivery suite and you know, on gas and air and I have my baby. Okay he was delivered by ventouse. I was induced. I did have an oxytocin drip.  But otherwise that part of it was quite straightforward. So apart from him obviously being in potential danger. Fortunately his APGAR score was very high as well. It was 9 to 10. So against all the odds of my being quite ill that week before, he did really, really well.
 
It was the complication of afterwards that was the problem. What they then found, because they didn’t know what to expect. This is what they told me in retrospect as well. Was the amount of bleeding. You know, it wasn’t necessarily gushing as such, but my husband’s remarks were, oh you know, again in retrospect. But he came in, not knowing the condition. Because I obviously hadn’t contacted him before, which you know, in hindsight I should have done. The midwives hadn’t either. So the first contact had was the midwife asking me for his mobile and then him coming him. So he was just think oh we’re having the baby early great. 
 
So he went through the birth process as any Father would not knowing what was going to happen. The complications then happened. So he remembers going out, making all the phone calls, telling everybody about you know, son’s arrived, everything’s fine, and then seeing me on the bed with tarpaulin on the floor covered in blood. So from a Father’s point of view quite traumatic and again you know, probably could have been handled better by myself and the midwives and the staff really in that, you know, he should have been pulled aside and just said, “Look you know, this could potentially be quite tricky.”
 
The family obviously went through a very hard time afterwards, because then what happened was the bleeding didn’t stop. The next day in the morning we were told that, you know, they had to do something, because you know, I was, I think up to that point I had something like 14 units of blood. Something like, in the end there was 22 units of blood and 14 units of platelets to help with the clotting.
 
So the consultants came in and this bit was I felt was very good in the way they handled it. Because they had [husband] and myself and then there was two consultants who were going to sort of look at it. They brought experts in which was wonderful. I’ve seen the notes that they obviously contacted other hospitals to find out how to deal with this. And then they drew out diagrams about what could happen.
 
So the first option was to brace the wound. Which is I don’t know what they use but something that sort of puts pressure against the inside of the uterus to try and stop where the bleeding is coming from, basically where the placenta had come away. That was where the bleeding was from. So that would be the first operation.
 
And then what they explained to me very clearly was that if that didn’t work it would need to be a sub-total hysterectomy. So again they explained it in full detail. The ovaries would still be intact, because I was like worried about is that premature (menopause) sort of, you know, you know, the… I can’t remember what it’s called now, but meant that’s it. So I did think oh gosh, you know, at the age of 28 do I really want that? I obviously clearly understand that there would be no more children. 
 
But
 

Rob described how he had no idea that his wife's surgery could potentially go so wrong. When it...

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Rob described how he had no idea that his wife's surgery could potentially go so wrong. When it...

Age at interview: 34
Sex: Male
Age at diagnosis: 29
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So her Dad came down with us, you know, and she kept saying, you know, and she kept saying, she said stuff, and you know, and she was saying goodbye and all this. And I’m like, here don’t be bloody daft you know. You know, I was worried, you know, I’m not, I wasn’t like. I wasn’t oblivious to the fact that there wasn’t, you know, that it wasn’t going to be complicated, you know, I wasn’t going in, oh yes, it’s lovely …. You know, I knew some fact it was potentially going to happen, but you know, nothing, nothing prepared.
 
But because obviously I wasn’t thinking that it could be as bad as that, bearing in mind how quickly they’d, the other two had gone, about ten, eleven minutes or whatever. Start to finish. I think half an hour had gone by and no-one had come out and I didn’t even, I wasn’t even worried. Because I though well obviously you’ve got this grade four. You know, I’ve never seen a placenta. I don’t know, you know, it might be quite tough to get through. And he might have to tie up some vessels. Who knows what? You know. 
 
So I didn’t worry, and then, and then it got to an hour she’d been in there, and I still hadn’t seen anybody. Because I was in like recovery. Pacing up and down. And so then after about an hour I was getting worried then, and you know, and I lie, I had seen a couple of nurses come in, “How are you, blah, blah, blah.” I said, “How’s things?” “Oh yes, it’s going all right. A few complications.” You know, but again that sort of made me think, well that’s of what we expected anyway so. 
 
Yes, then it got to an hour and I started to get a bit twitchy with an hour, you know, because I hadn’t had any real information. You know, saying there’s been a few complications, but you know, that’s not telling me anything is it, not really. .So, and then so it was an hour, may be an hour and ten, twenty, whatever. It had just gone over the hour and then a bloody nurse and a doctor came pounding into the room, and they was white, they was white. And I remember they were stood there and they both come up to me, and the nurse kind of come and stood next to me, all a little bit too close. I don’t like people standing too close to me. So she got in my zone and I wasn’t comfortable with that. And then they were both pale, you know, and he said, “ Something to ask you, I’ve got something to ask you Mr [name].” I said, “Well, what is it?” He says, “Yes, we’ve had some complications.” “Oh yeah.” You know. “And… baby’s all right, but we’re going to have to give your wife a hysterectomy. Because we can’t stop the bleeding.” With that the nurse touched me and so I kind of … you know, no thanks. “But we are going to have to do a hysterectomy to stop the bleeding, because we can’t stop it.” And I remember as clear as day, I said, “Well what you are stood here for then. Just go, just go and do it.” You know, he said, “Well we have to ask your permission…” I said, “Stop talking to me.” Do you know, none of this “We have to ask your permission.” You know, “Yes, I can understand why, you don’t want me suing you afterwards for doing it, when I didn’t say. But for goodness, sake, you know, if you know, if you’ve got to stop her bleeding, you just whip it out don’t you?” 
 
So he came to ask my permission to do it. And I thought you know, the first bit of information I’ve had is a guy asking me if he can do… So I just said, “Why are you talking to me, just go and do it.&
Some women had to be sent to intensive care for a few hours or days. Their husbands/partners were shocked to see their loved ones with so many wires and tubes.
 

Seeing his wife in intensive care, was for Rob 'the beginning of the end'. He later had a breakdown.

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Seeing his wife in intensive care, was for Rob 'the beginning of the end'. He later had a breakdown.

Age at interview: 34
Sex: Male
Age at diagnosis: 29
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But my wife’s care on the other hand couldn’t have been any further from it, you know, so. So blimey. So I went back down in the end. Well when I say in the end I was upstairs for a bit, and then I went down to find out what was going on. And that moment was the beginning of the end. Because further down the line, jump a bit, I did have a breakdown, diagnosed with post traumatic stress, which prior to having it, I didn’t actually believe was a real thing. You know, and I had depression as well and agoraphobia. A few little things you know.
 
But, but the… but the beginning of the end, you know, the beginning of that coming, was when I went back down to see, and find out what was going on, they said, well they’d finished everything they could do here, they’d got to take her over to Intensive Care. Because they just haven’t got the facilities that they need here, and they just can’t… They managed to stop the bleeding but they had to ring a surgeon who was in surgery, in the main hospital, get him out of that surgery and get him over here to sort her out and he used some special packing stuff which they use on [um] on the battle front, some special stuff to stop the soldiers bleeding. I don’t know what it’s made from, but that’s what they used on her, because they said it was like, you know, like a gun wound or whatever, you know, the bleeding, they couldn’t stop. So they did this stuff with this surgeon who was, you know, they called him out of another operation to come over. So that again told me you know, how serious, you know, again thinking back to all the conversations, we don’t induce women just because they’re tired. You know, we’re not doing that for this, you know. We’ll let you go two weeks overdue, and here I am getting all this news. Do you know what I mean?
 
Two weeks, if, you know, two weeks over, we asked about two or three weeks before, you know, five weeks ago, all this could have been prevented, you know, however much the placenta grew in, five weeks is a long time in baby growth. Because [third daughter] had even had the injection to make her lungs ready to be born before the due date, they had even done that, and the doctor still said, “No.”  
 
You know, so I was thinking five, you know, we could have, we didn’t even need, we didn’t even need to be here, didn’t need to be here at all. So anyway… and then they said, “Do you want to go and see her, before we get the ambulance to take her over?” And yes, yes, I said, “Yes.” 
 
And then it came [laughs], the nurse said, “Right you can come in but bear in mind she’s got lots of wires and tubes and things. So obviously because she’s had this emergency surgery. And when you go in there,” she said “Just remember that the hearing is the last thing to go.” And then shut the door behind me. 
 
And I’m in the room alone and this nurse just said, “The hearing is the last thing to go.” You know, and… and she had like, I would say about ten or fifteen wires in her. I mean she had about ten coming out of her neck, and machines and everything. And you know what I mean, it’s just, you know, it doesn’t look nothing like it does in Casualty. Do you know what I mean? [laughs] No. But honestly it was horrific, absolutely horrific. And… and I couldn’t speak, not a word came out, not anything. I stood there just dumbstruck at what I was looking at. You know, my beautiful wife just, you know, dead. Because of the nurse, you know, hearing is the last thing to go. You know, what else are you going to, what else are you going to think, you know. And she wasn’t dead, than
 

Dean's wife developed amniotic fluid embolism and was sent to intensive care. He thought it was...

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Dean's wife developed amniotic fluid embolism and was sent to intensive care. He thought it was...

Age at interview: 43
Sex: Male
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That night, it was half past two, they were taking her down to Intensive Care, so I went in there and it was like a space ship, something out of Star Trek. It was just amazing. And then, they said, “Do you want to go and see her?” I said, “I’m not too sure.” Because she was like on the bed and it looked like hundred doctors around her and she was just swollen. You know, for somebody who was that size, so swollen, that’s fine, you know. And I just took one look and I just come back out, because I couldn’t like face seeing her like that so. And she had tubes obviously everywhere.
 
And it was a pretty rough night. For a week she had, by the sides of the bed she had, a bit like tubs of blood, either side. They were just dripping, they were filling them up. They had these, what are they called, when you put them, when you put the blood and so on?
 
Like a bag?
 
Yes. Well she had two bags either side and they were just draining down.
 
Okay.
 
And it was all just coming back out, so that’s all it was continuously doing, you know, and that was half two, three o’clock in the morning. My brother in law and sister in law went. I stayed there and they let me sleep there. Which is in a separate room for visitors coming. They let me sleep there.
 
Next to the Intensive Care Unit?
 
Obviously not in there. Made me a cup of tea. So I laid down. Obviously I’m not sleeping. I could go in there any time I wanted. All I had to do was knock on the door and they would come and get me. Obviously I managed to get to sleep I don’t know for about an hour and then, a fellow come and woke me up in the morning about 6 o’clock in the morning and he goes, “Do you want to come and see her?” I said, “Yes.”
 
And the first thing I looked at, I didn’t looked at her, I looked at these two tubes of blood, and when I see them say 3 o’clock in the morning they were just pouring out and now they was only dripping. So basically the clotting agent which they had made was obviously started to work. Which was really, really good. And that made me happy because of that. But it just didn’t look like her. It really didn’t. It was awful.
 
Because of the swelling or was she red as well?
 
Yes, she had like red eyes. It was like something out of a horror movie, it really was bad. She had tubes just sticking everywhere. It’s not a nice sight. It ain’t for anyone you know.
 

And then, I’d seen her, and they turned round and said, “She’s holding her own at the moment.” And I see another woman, she was an anaesthetist. She was fantastic she was. She was great. She sort of reassured me. She said, “The next 48 hours is basically critical for her.” But she had made that 24 hours. And when the doctor turned round and said, “All you can do is pray, if she lasts the night.” You know, and obviously she did last the night.  

Some hospitals made sure that fathers had support, from other family members or friends, during the emergency. This made a real difference. Dean had his sister and brother in law with him while his wife was in ITU, Simon had his mum.
 
Personal touches made a real difference
In the midst of the emergency, several partners mentioned personal touches of support and empathy from staff that made a real difference. Sally’s partner, Amy, had a post-partum haemorrhage after their first daughter was born. She was sent out of the operating theatre while the doctors stablised Amy.
 

After her partner's bleeding had been stopped and the emergency was over, Sally was invited back...

After her partner's bleeding had been stopped and the emergency was over, Sally was invited back...

Age at interview: 34
Sex: Female
Age at diagnosis: 33
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