Caring Futures Institute, College of Nursing & Health Sciences, Flinders University, Adelaide, Australia; Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom.
Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom; Elizabeth Garrett Anderson Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, United Kingdom. Electronic address: https://twitter.com/Silverio_SA_?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor.
Women Birth. 2021 Nov;34(6):e599-e607. doi: 10.1016/j.wombi.2020.12.002. Epub 2021 Jan 6.
Postpartum haemorrhage [PPH] remains a major cause of maternal morbidity and mortality. Whilst low-resource settings bear the greatest burden of deaths, women live with associated morbidities in all healthcare settings. Limited data exists regarding the experience for women, their partners, or healthcare professionals [HCPs], affected by PPH.
To qualitatively investigate the experience of PPH, for women (n=9), birth partners (n=4), and HCPs (n=9) in an inner-city tertiary referral centre. To provide multi-faceted insight into PPH and improve understanding and future care practices.
Participants were interviewed about their experiences within two weeks of a PPH. Data were analysed using thematic analysis.
Four distinct, but related, themes were identified: 'Knowledge specific to PPH'; 'Effective and appropriate responses to PPH'; 'Communication of risk factors'; and 'Quantifying blood loss'; which collected around a central organising concept of 'Explaining the indescribable'.
PPH was viewed as a 'crisis-style emergency', generating respectful fear in HCPs, whilst women and partners had little-to-no prior knowledge. Specific PPH knowledge dictated HCPs' response and risk communication. PPH risks were typically linked to quantification of blood loss, assessment of which varied with acknowledged questionable accuracy. Women's and partners' confidence in HCPs' ability to deal with PPH was unquestionable. Non-verbal communication was highlighted, with HCP body language betraying professional confidence.
Information about blood loss during childbirth must be imparted in a sensitive, timely manner. Whilst training for HCPs results in effective PPH management, consideration should be given to their non-verbal cues and the impact of dealing with this stressful, 'everyday emergency'.
产后出血（PPH）仍然是产妇发病率和死亡率的主要原因。虽然资源匮乏的环境承担着最大的死亡负担，但所有医疗环境中的女性都存在与 PPH 相关的疾病。关于受 PPH 影响的女性、其伴侣或医疗保健专业人员（HCP）的经历，数据有限。
定性研究城市内三级转诊中心中 9 名女性（n=9）、9 名分娩伴侣（n=4）和 9 名 HCP 对 PPH 的经历。提供对 PPH 的多方面见解，以提高理解并改善未来的护理实践。
在 PPH 后两周内对参与者进行采访，了解他们的经历。使用主题分析对数据进行分析。
确定了四个不同但相关的主题：“特定于 PPH 的知识”、“对 PPH 的有效和适当反应”、“风险因素的沟通”和“血液流失的量化”，这些主题围绕着“解释难以言喻的事物”的中心组织概念收集。
PPH 被视为“危机式紧急情况”，在 HCP 中引起尊重的恐惧，而女性和伴侣几乎没有事先了解。特定的 PPH 知识决定了 HCP 的反应和风险沟通。PPH 风险通常与血液流失的量化有关，对其评估的准确性存在疑问。女性和伴侣对 HCP 处理 PPH 的能力的信心毋庸置疑。非言语交流受到强调，HCP 的肢体语言暴露了专业的自信。
必须以敏感、及时的方式传达分娩期间的出血量信息。虽然 HCP 的培训导致了有效的 PPH 管理，但应考虑他们的非言语暗示以及处理这种有压力的“日常紧急情况”的影响。
