Information and understanding

Key Learning Points

  • Women and their partners appreciate staff giving clear explanations in non-medical language at all stages before, during and after the emergency:

– where conditions are diagnosed in the non-emergency situation antenatally, knowing what might happen helps women and their partners prepare and cope better afterwards

– during the emergency, repeated reassurance is appreciated

– being listened to and able to ask questions after the emergency is important for women

to come to terms with what has happened

  • Partners/fathers can feel forgotten during and after the emergency:

Frequent updates from any member of staff help them to feel less anxious and isolated

Having another family member with them for support can help

  • Knowing that staff have learned from a woman’s near-miss is reassuring for her
Understanding what was happening during the emergency, or what has happened after the event, was very important to the women who experienced a near miss, and their partners and families. It helped deal with anxieties during the emergency, and coming to terms with events afterwards.

Sarah had placenta praevia and needed a hysterectomy. She wished she had been given more…

Age at interview 29

Gender Female

Age at diagnosis 24

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The timescale of emergencies varied. In some cases, health professionals had time to explain their condition to women and their families so they were able to understand their condition before the birth of their baby. In other cases, emergencies developed so fast there wasn’t much time for explanations until afterwards. Clear communication and information is something that health professionals need to consider during the emergency, and in aftermath when they are caring for women during their recovery or follow up.
The importance of understanding: a case study
Alex and Kerry were both diagnosed with grade 4 placenta praevia. The information they received and their subsequent understanding was very different. Alex was kept in hospital for 8 weeks until her baby was delivered at 34 weeks. She said the way doctors explained her condition, and its risks, was excellent. It was like a ‘drip feeding process’ which enabled her to process little things at a time. When she was interviewed three months later, she was recovering well and had not felt the need for counselling. In contrast, Kerry, felt that doctors did not explain the risks to her and when she started to haemorrhage in hospital, she was terrified. She later developed panic attacks, mostly focused around bleeding to death. She had counselling and was on medication.

Alex found it hard being in hospital for weeks, separated from her two year old daughter. But…

Age at interview 37

Gender Male

Age at diagnosis 36

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Alex was in hospital for 8 weeks with placenta praevia before her baby was delivered. She felt…

Age at interview 37

Gender Male

Age at diagnosis 36

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Kerry felt doctors should have sat her down and explained the risks and dangers of her placenta…

Age at interview 27

Gender Female

Age at diagnosis 25

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Kerry had placenta praevia. She was in hospital being monitored after having had a smaller bleed…

Age at interview 27

Gender Female

Age at diagnosis 25

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Good communication
Several women described good communication with doctors about the emergency, particularly those who had a condition that developed more slowly so there was time for clear explanations and questions beforehand.

Samantha and her husband appreciated meeting with paediatricians who explained what would happen…

Age at interview 32

Gender Female

Age at diagnosis 31

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Mandy had acute fatty liver and doctors couldn’t stop her bleeding. Good clear communication by…

Age at interview 35

Gender Female

Age at diagnosis 28

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Anna developed septicaemia (blood poisoning) after her second son was born. She was put on…

Age at interview 22

Gender Female

Age at diagnosis 21

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Reassurance
Sometimes the obstetric emergency developed so quickly there was little time for explanations. Even so, women appreciated calm reassurance from medical staff. Natalie recalled that as her haemorrhage started the consultant took her hand and said, ‘You don’t need to worry, you’re going to be fine.’

When she started to haemorrhage (heavy uncontrolled bleeding) after her son was born, the midwife…

Age at interview 32

Gender Female

Age at diagnosis 30

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Naomi felt a terrible pain and called the ambulance. Her consultant was there, rubbed her cheek…

Age at interview 37

Gender Female

Age at diagnosis 35

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Clarity of language
Several partners we spoke to pointed out the importance of doctors using clear language when speaking to them. Craig’s wife was in intensive care after an emergency caesarean to deliver her twins. When he saw her there he assumed she was going to die, and doctors were just waiting to turn the machines off. ‘I actually thought she was dead.’ When he later spoke to doctors he said, ‘I don’t want to hear medical talk, you know, you’ve used big long words that I have no idea what they mean. Is my wife going to be OK?’ But being open and honest about the situation was also important.

Rob felt that communication with health professionals about his wife’s placenta praevia was…

Age at interview 34

Gender Male

Age at diagnosis 29

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When his partner was critically ill with amniotic fluid embolism (amniotic fluid enters the…

Age at interview 43

Gender Male

Age at diagnosis 40

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Rebecca had placenta percreta and then developed a blood clot in her leg. She would have liked…

Age at interview 49

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Keeping fathers informed
Several partners described being left wondering what was happening to their wives/partners during the emergency.

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

Age at interview 41

Gender Male

Age at diagnosis 37

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Doctors discovered Rebecca had placenta percreta when they started her caesarean operation. Her…

Age at interview 42

Gender Female

Age at diagnosis 40

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Being listened to
Several people stressed the importance to them of the conversations they had with staff. It was important to be listened to, not to be treated as a number and feel that staff actually cared about them. Communication after the emergency was over was also important for women. It helped them understand what had happened and start to come to terms with it.

After her haemorrhage and hysterectomy, doctors came to talk to Alison like a normal person and…

Age at interview 32

Gender Female

Age at diagnosis 30

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Sophie had a PE and a post-partum haemorrhage. Things had dragged on for so long she was…

Age at interview 38

Gender Female

Age at diagnosis 36

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