Teaching resources

Information and understanding

Key Learning Points
  • Women and their partners appreciate staff giving clear explanations in non-medical language at all stages before, during and after the emergency:

             - where conditions are diagnosed in the non-emergency situation antenatally, knowing what might happen helps women and their partners prepare and cope better afterwards

             - during the emergency, repeated reassurance is appreciated

             - being listened to and able to ask questions after the emergency is important for women

               to come to terms with what has happened

  • Partners/fathers can feel forgotten during and after the emergency:

             - Frequent updates from any member of staff help them to feel less anxious and isolated

             - Having another family member with them for support can help 

  • Knowing that staff have learned from a woman’s near-miss is reassuring for her
Understanding what was happening during the emergency, or what has happened after the event, was very important to the women who experienced a near miss, and their partners and families. It helped deal with anxieties during the emergency, and coming to terms with events afterwards.
The timescale of emergencies varied. In some cases, health professionals had time to explain their condition to women and their families so they were able to understand their condition before the birth of their baby. In other cases, emergencies developed so fast there wasn’t much time for explanations until afterwards. Clear communication and information is something that health professionals need to consider during the emergency, and in aftermath when they are caring for women during their recovery or follow up.
 
The importance of understanding: a case study
Alex and Kerry were both diagnosed with grade 4 placenta praevia. The information they received and their subsequent understanding was very different. Alex was kept in hospital for 8 weeks until her baby was delivered at 34 weeks. She said the way doctors explained her condition, and its risks, was excellent. It was like a “drip feeding process” which enabled her to process little things at a time. When she was interviewed three months later, she was recovering well and had not felt the need for counselling. In contrast, Kerry, felt that doctors did not explain the risks to her and when she started to haemorrhage in hospital, she was terrified. She later developed panic attacks, mostly focused around bleeding to death. She had counselling and was on medication.
Good communication
Several women described good communication with doctors about the emergency, particularly those who had a condition that developed more slowly so there was time for clear explanations and questions beforehand.
Reassurance
Sometimes the obstetric emergency developed so quickly there was little time for explanations. Even so, women appreciated calm reassurance from medical staff. Natalie recalled that as her haemorrhage started the consultant took her hand and said, “You don’t need to worry, you’re going to be fine.”
Clarity of language
Several partners we spoke to pointed out the importance of doctors using clear language when speaking to them. Craig’s wife was in intensive care after an emergency caesarean to deliver her twins. When he saw her there he assumed she was going to die, and doctors were just waiting to turn the machines off. “I actually thought she was dead.” When he later spoke to doctors he said, “I don’t want to hear medical talk, you know, you’ve used big long words that I have no idea what they mean. Is my wife going to be OK?” But being open and honest about the situation was also important.
Keeping fathers informed
Several partners described being left wondering what was happening to their wives/partners during the emergency.
Being listened to
Several people stressed the importance to them of the conversations they had with staff. It was important to be listened to, not to be treated as a number and feel that staff actually cared about them. Communication after the emergency was over was also important for women. It helped them understand what had happened and start to come to terms with it.

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