Dissertation/Thesis Abstract

A Mixed Method Study on the Peripartum Experience and Postpartum Effects of Emergency Hysterectomy Due to Postpartum Hemorrhage
by de la Cruz, Cara, Ph.D., University of South Florida, 2011, 396; 3461936
Abstract (Summary)

Background. Little is known about the experience and psychological outcomes for women who experience emergency peripartum hysterectomy (EPH). The objective of this study was to explore women's experiences of EPH and to determine if women who experience EPH were more likely to experience mental health sequelae.

Methods. This mixed method design involved a quantitative and a qualitative phase. The quantitative phase used a retrospective cohort design. Women were sampled through on-line communities, including an EPH support group, and a larger website for mothers. Women completed on-line surveys covering sociodemographic, obstetric/gynecological/ and psychiatric information, including screens for depression and Post-Traumatic Stress Disorder (PTSD). Logistic regression was used to calculate the independent risk that exposure to EPH has on screening positive for PTSD. Participants from the EPH support group who completed the on-line interview were then selected to participate in the second phase. In-depth telephone interviews were conducted and analyzed using Constant Comparative Analysis.

Results. 74 exposed women and 355 non-exposed women completed the survey. In the adjusted logistic regression model, women who experienced EPH were over 6 times more likely to screen positive for current PTSD compared to women who did not experience EPH (adjusted Relative Risk (aRR): 6.76; 95% CI: 4.24, 8.88). When women recalled their psychological state at 6 months postpartum, exposed women were 11 times more likely to screen positive for current PTSD (aRR: 11.35; 95% CI: 8.43, 12.95). In the qualitative phase, 15 women participated and 7 major themes were identified: fear, pain, death and dying, numbness or delay in emotional reaction, bonding with baby, communication and the need for information. A major finding is the need for additional follow-up visits to address the emotional after-effects and to fill in gaps in women's understanding and memory of what had occurred.

Conclusion. Understanding women's experiences and sequelae can help providers address not only women's initial complications but provide needed long-term support.

Indexing (document details)
Advisor: Coulter, Martha
Commitee: Alio, Amina, Daley, Ellen, Mahan, Charles, O'Rourke, Kathleen
School: University of South Florida
Department: Public Health
School Location: United States -- Florida
Source: DAI-B 72/10, Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Mental health, Public health, Clinical psychology
Keywords: Childbirth, Hysterectomy, Maternal morbidity, Mental health, Near-miss, Peripartum, Postpartum hemorrhage, Traumatic birth
Publication Number: 3461936
ISBN: 978-1-124-76380-4
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