Patient Priorities and Experiences in the Management of Abnormal Postpartum Bleeding

The objective of this study is to assess patient experiences, priorities, and satisfaction with management of postpartum hemorrhage (PPH) requiring treatment beyond oxytocin.

We conducted a cross-sectional survey (January-April 2024) of postpartum individuals (≥37 weeks, aged 18-50) who experienced abnormal bleeding treated beyond first-line oxytocin at a tertiary academic center. Outcomes included patient priorities, treatment experiences, and satisfaction with decision-making.

Of 428 screened patients, 142 met inclusion and 100 consented. Most received uterotonics (92%); 26% antifibrinolytics; 9% intrauterine vacuum device; 1% surgical intervention. Compared with uterotonics alone, device users had higher blood loss (1,755 vs. 516 mL, p < 0.001), more transfusions (33.3 vs. 5.9%, p = 0.01), and more surgical interventions (11.1 vs. 0%, p < 0.01). Patient priorities (minimizing blood loss, avoiding transfusion, optimizing recovery) were consistent across groups. Dissatisfaction with treatment (5.4%) and clinician communication (15.1%) occurred only among those treated with uterotonics.

Patients valued minimizing morbidity and optimizing recovery, with overall high satisfaction, but communication gaps remain. These findings highlight the need for patient-centered strategies in PPH care and future trials comparing pharmacological versus mechanical second-line options.

· Patients value minimizing morbidity despite management approach.. · Patients value provider communication with complications.. · Assessing patient priorities guides patient-centered approaches..