Midwives' experiences of postpartum haemorrhage: A web-based survey in Sweden

Abstract

Objective: The objective was to describe midwives' experiences of postpartum haemorrhage (PPH) >1000 ml in connection with childbirth.

Design: A qualitative web-based survey with open-ended questions was used and the results were analysed with content analysis.

Setting: Participants were recruited through convenience sampling from a national Facebook group for midwives.

Participants: The study sample included 24 midwives with varying work experience at different maternity units in Sweden, all of whom had experience of postpartum haemorrhage >1000 ml.

Findings: The midwives described that the treatment of PPH is limited by a lack of cooperation, knowledge, and assistance, as well as by staff inexperience. They also described how a high-pressure work environment contributed to feelings of inadequacy. Good cooperation, team training, having colleagues present, embodied knowledge, and good working conditions, led to successful handling of such situations, which contributed to feeling at ease with what had happened.

Key conclusions and implications for practice: Good working conditions related to external contextual factors such as total load and support, as well as internal factors such as self-efficacy, can help midwives manage PPH while providing patient-safe care and feeling confident in their ability and at ease with the events. Therefore, midwives need to be given opportunities for emotional support, education, and team-based training to maintain the quality of midwifery care and avoid negative long-term effects for both midwives and patients.

Keywords: Childbirth; Cooperation; Midwifery; Qualitative study; Third-stage labour; Work environment.