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.
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.
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 watching his wife's emergency.
Mark feels he is 'a pretty strong guy', but that other men could have been very affected by watching his wife's emergency.
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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 bleeding over a couple of days, before deciding that a hysterectomy was the only way to save her life.
Mandy started to bleed shortly after her son was born. Doctors tried several options to stem the bleeding over a couple of days, before deciding that a hysterectomy was the only way to save her life.
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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
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.
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...
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