The experience of manual removal of placenta in women with retained placenta: a qualitative study

Retained placenta (RP) is associated with increased maternal morbidity. Manual removal of the placenta (MROP) is an effective method to address RP, but it also increases the pain and risks for women. The exploration of the psychological impact on women who have undergone MROP is currently limited. The study was to explore the experience of manual removal of placenta in women with retained placenta.

A descriptive qualitative approach was adopted in this study. Semi-structured, in-depth interviews with 15 women who had undergone manual removal of placenta (≥ 30 min of the third stage of labor). The interviews were analysed using traditional content analysis.

Three themes and their affiliated nine sub-themes were identified: (1) Cognition and autonomy including lack of knowledge about MROP and low autonomy during MROP. (2) Adverse physical and psychological experiences included fear and anxiety before MROP, significant pain during MROP, the ordeal of repeated MROP, and concerns about MROP-related complications. (3) Access to and need for professional support included perceived lack of significant pain with analgesics, feeling of professionalism and concern from medical staff during MROP, and desire for comprehensive information support.

Women undergoing MROP may experience a significant lack of knowledge, diminished autonomy, and considerable physical and psychological distress. Medical staff should pay attention to the real experience of women with RP in the process of MROP, timely understand their analgesic and psychological needs, and reasonably choose the timing of MROP according to the individual situation, as well as to provide convenient, efficient and professional information support for women through a variety of forms.