Conditions that threaten women’s lives in childbirth & pregnancy

Follow up from the hospital

In this summary we discuss what women told us about contact with the hospital after they went home. Some had no follow up after their emergency, others had follow up meetings with doctors. Some found these meetings helpful, others less so.
It is good practice for women to be offered a follow up meeting with the hospital, several weeks after discharge. This can act as a ‘debrief’, providing women with the opportunity to understand the chain of medical events that occurred by talking them through in detail with staff. Many women who had this opportunity told us it was valuable in helping them make sense of what had happened. Being able to read their medical notes, to know the timing of everything, to “put the pieces together” and to have their questions answered had been very useful.
Mandy had a haemorrhage (heavy uncontrolled bleeding) and hysterectomy and was offered a debrief. To talk about what had happened some weeks after the immediate event was “really helpful”, because she had had time to reflect. She also said that reading her notes helped make things “clear in my mind. That’s why I can carry on as normal”
Natalie had a haemorrhage and was offered a meeting with a “special team”, who were not counsellors but “who read through your file, word by word, and explain any medical terms and allow you to question decisions that were made, or query why did you do this and not this?” She found it helpful to read the notes and understand what happened.
Women who had been in the intensive care units were also offered support by ITU staff. Anna was in intensive care with septicaemia (blood poisoning) and has found the support offered by the unit helped make sense of her memories – “the Intensive Care let me go up there and have a look at the room I was in to rationalise my thoughts, the dreams I had. Brilliant, yes.” Strange dreams or hallucinations are common in intensive care (see Intensive care' patients experiences ‘Sleep, dreams and hallucinations’). Karen also found follow up helpful after her haemorrhage and hysterectomy.
Some women were pleased to have the opportunity to discuss future pregnancies with doctors. Helen had developed HELLP syndrome a combined liver and blood clotting disorder.
Women valued being told that the door was open if they wanted to come back to discuss anything in the future. The opportunity to go back in and meet staff, even if it wasn’t to discuss the medical events, was described as a positive step towards “closure”.
For other women, there was no follow up offered. Julie had pre-eclampsia (high blood pressure) and wasn’t offered any follow up. She would have liked someone to have sat down with her and talked through what happened. “I want to put the picture together so I can sort of work forward from it.”
Others were offered a follow up, but did not find it helpful. Lisa was invited to a meeting at the hospital after her haemorrhage and hysterectomy, but found it very difficult being asked to go back to the area where she had been before for ultrasound scans. “We sat there in the waiting room, surrounded by pregnant women waiting for their scans in shell shock. We didn’t speak… staring into space… that was where we used to go when we were happy and excited about everything.”
Some people we spoke to had lost their babies during labour, and some said that for them, the lack of follow up was particularly upsetting. Joanna and Mike felt very upset that their hospital seemed so slow in investigating the death of their daughter. They felt that once they got home they were “completely and utterly forgotten about”. They had to chase follow-up appointments and the report into their baby’s death. Five months down the line, no one had spoken to them to see how they were, or for their version of events.
Deborah, who ultimately took the hospital to court, would have liked someone to apologise, “acknowledging that somebody made a mistake.” However she did receive a lot of support from a bereavement midwife who was “fantastic”.

Last reviewed April 2016.


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