Teaching resources

Long term effects

Key Learning Points
  • Women’s relationships with their partners are often put under severe strain, and additional support may be required in this context
  • Parenting advice can be important, since:

             - existing children can be severely affected by nearly losing a parent

             - building a relationship with the new baby following a near-miss event can be

               challenging even when the baby does not require neonatal unit care

  • Issues around future fertility and family size can be complex:

             - some women require support to come to terms with a loss of future fertility

             - for others, the worry about the possibility of a near-miss event in a future pregnancy

               leads to a decision not to have further children and robust contraceptive advice

               can be important in these circumstances

  • Mental health impacts for both mothers and fathers may require long-term management
  • Help may not be sought for long-term mental health issues; actively offering counseling may therefore be beneficial
  • Mental health and other impacts can lead to significant changes in career or life paths which place an additional burden on parents
  • Many women reported that they would have welcomed more support in the community. In particular'

             - access to mother and toddler or other parent’s groups where other women had

               similarly “abnormal” birth experiences

             - GP and Health Visitor support for first time mothers to help with feelings of isolation

Some women appear resilient and their near miss experience does not seem to have a long lasting effect on them or their families. But for others it is different.
 
Relationships
 
Many said that although they had been through a very difficult and traumatic time, their experiences had made their relationship with their partner stronger, and brought them closer. But some relationships did not survive the experience.
Impact on children and family life
 
A near miss in childbirth not only affects the parents, but can have a significant effect on their children as well. Several felt that what they had to cope with in the early weeks and months affected how they were as parents.
Some felt that the impact lasted well beyond the immediate emergency and time in hospital.
Some women had their babies very prematurely because, for example, of pre-eclampsia or placenta praevia. Having a premature baby can have a long lasting impact on the whole family. Kerry had placenta praevia and her baby was born at 28 weeks and in special care for 11 weeks.
Issues relating to a woman’s future fertility and family size
 
For many women, their near miss had a long lasting impact on their fertility or their approach to future pregnancies. Some women had a hysterectomy as a life-saving procedure during the emergency. For some, this was not a big issue as they felt their family was already complete. But for others it was devastating to have a hysterectomy before having all the children they had hoped for.
Some women did not have hysterectomies and could potentially still get pregnant and have more children. While they would have liked more children, some felt that the risks were too high, after what they had been through.
Impact on mental health of the mother
 
There was great variation in how these traumatic events affected women. Some felt it did not affect their mental health, but others did, and told us about having anxiety, panic attacks, flashbacks and post-traumatic stress disorder in the aftermath of their near miss. There was also variation in when women first experienced anxiety or depression, and how long it took to recover.
 
 
 
Impact on mental health of the father
 
Although the partners we spoke to have all been deeply affected by their partner’s life threatening experiences, for some it has had a profound impact on their long-term health, including experiencing depression, flashbacks, a breakdown or post traumatic stress disorder (PTSD) in the months/years since the emergency.
 
 
 
Career or life path can change significantly
 
A near miss sometimes triggered major work and life changes. For some, there were physical consequences they and their families needed to get used to.
 
Several women decided to change career after their near miss, but other parents found that their experience had a negative effect on their working lives. Tom had a nervous breakdown after his wife’s near miss and was passed over for promotion. Rob suffered PTSD and has been unable to go back to work since.
 
Women can feel very isolated
 
Women were often struggling with their recovery from a serious medical emergency, and with a newborn baby. For first time mothers this was particularly challenging. They felt excluded from the normal support routes, such as National Childbirth Trust (NCT) groups, or local play groups, because their experiences were so extreme, and they felt very isolated.
 
 
Need for support
 
What support women and their families received in the community once they were discharged from hospital varied greatly. Some felt the support from their local GP and health visitors was excellent, but others were offered little, and felt they would have liked more support, after such a traumatic time in hospital.
 

  

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