Experience and effects of near-miss maternal morbidity

Background: Scant research is available on what happens to women who nearly die in childbirth. This study qualitatively explores women's peripartum experiences and postpartum effects of near-miss maternal morbidity through survivors of postpartum hemorrhage and emergency peripartum hysterectomy (EPH). The impact of EPH may have physical, social, and psychological ramifications and with more women experiencing EPH, its study is salient. Methods: A purposive sample was obtained from members of a private on-line support group for EPH survivors. The use of an on-line community is an innovative method of studying rare or stigmatized conditions. One to two hour long in-depth semi-structured telephone interviews were conducted (n=15). The interview covered the experience of EPH, including perceptions, thoughts and feelings, as well as the physical, psychological and sexual effects of EPH. Constant Comparative Analysis is being used for qualitative data analysis, using grounded theory. Two coders are currently working on analysis. Kappa statistics will be calculated for inter-rater reliability. Results: Preliminary analysis suggests EPH as a life-changing event, which profoundly affects women and their families. After physically healing, participants describe long-term social and psychological effects, often ignored by health care providers. Key themes will be further described. Conclusions: The childbearing experience may have lifelong implications for an infant, mother and family. This study will inform providers of what the near-miss experience entails for women, and how to change practices to enhance women's experiences and satisfaction with their birth in order to enhance their health in the long-term.