Patients' perceptions of postpartum hemorrhage management: a qualitative study

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. While efforts to prevent and improve the management of PPH, including the use of emergency checklists during a hemorrhage event, have increased, there has been limited attention to the lived experiences of pregnant people.

To describe patients' perceptions of their experiences with an inpatient multidisciplinary team response to PPH management when an emergency checklist was utilized.

Individuals who experienced PPH, defined as a cumulative blood loss of 1,000 mL or more, were approached to participate in the study. Purposeful sampling was employed to ensure diversity by both self-reported racial and ethnic identity and severity of PPH. Participants completed remotely conducted semi-structured interviews between February and November 2024. A qualitative phenomenological approach was employed to establish a shared understanding of participants' perceptions and lived experiences.

Twenty participants completed interviews. PPH imposed a substantial physical and emotional burden on patients. While patients often felt exposed and reported a loss of agency during their PPH, these concerns were eased when the care team maintained a steady presence and clearly articulated their management and interventions. Perception of the emergency checklist, when recalled, provided additional reassurance by reinforcing trust in systematic care and adherence to protocols. Participants emphasized the importance of ongoing education and guidance on PPH treatment and its implications after hospital discharge.

Patients who experienced PPH described feelings of vulnerability; however, the care team's composed presence and clear communication were perceived by participants as sources of reassurance during these experiences. Awareness of emergency checklist use, when present, was described by some participants as fostering confidence in team management. Patient support should extend beyond medical management throughout the postpartum period.