Women\u2019s experiences following emergency Peripartum hysterectomy at St. Francis hospital Nsambya. A qualitative study

Patrick Pilli,Peter Sekweyama,Anthony Kayira

doi:10.1186/s12884-020-03428-3

Patrick Pilli, Peter Sekweyama + Show 1 more

Open Access

https://doi.org/10.1186/s12884-020-03428-3

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Abstract

BackgroundEmergency peripartum hysterectomy (EPH) is a known remedy for saving women’s lives when faced with the challenging situation of severe post partum hemorrhage not responsive to conservative management. However, EPH by its nature is also a traumatic birth event that causes serious physical, emotional and psychological harm. Unfortunately at St. Francis Hospital Nsambya nothing much is known about these experiences since no study has been undertaken and these women are not routinely followed up. The purpose of this study was to explore these emotional experiences.MethodsThis was a qualitative phenomenological study carried out between August and December 2018. All those women who had undergone EPH between January 2015 and August 2018 were eligible to participate in the study. Purposive sampling was used. 18 women were interviewed before saturation was reached. All interviews were audio-recorded and then transcribed verbatim. Thematic analysis was used to analyze the data.ResultsThree major themes were identified as the main experiences of these women in this study and they were; Loss of Womanhood, Joy for being alive and Loss of marital safety.ConclusionWomen experience serious emotional consequences following EPH. We recommend routine follow-up to help appreciate these experiences and advise them on appropriate mitigating measures.

Highlights

Emergency peripartum hysterectomy (EPH) is a known remedy for saving women’s lives when faced with the challenging situation of severe post partum hemorrhage not responsive to conservative management
This is mainly due to severe post partum hemorrhage secondary to abnormal placentation, abruption placenta, uterine atony, ruptured uterus and genital tears [17,18,19] In Sub-Saharan Africa, the incidence of EPH is five times higher than the global average mainly because of high parity, lack of skilled attendance at birth, prolonged and obstructed labor [14, 20,21,22]
Francis Hospital Nsambya, the prevalence of EPH during the study period was 1.2/1000 births (Hospital records 2015–2018) the emotional experiences of these women is unknown since no routine follow-up or psychotherapy sessions are conducted

Summary

Introduction

Emergency peripartum hysterectomy (EPH) is a known remedy for saving women’s lives when faced with the challenging situation of severe post partum hemorrhage not responsive to conservative management. Emergency peripartum hysterectomy (EPH) is the surgical removal of the uterus within 24 h of delivery due to severe post partum hemorrhage not responsive to conservative management. It is a known remedy for saving women’s lives [1,2,3]. At St. Francis Hospital Nsambya, the prevalence of EPH during the study period was 1.2/1000 births (Hospital records 2015–2018) the emotional experiences of these women is unknown since no routine follow-up or psychotherapy sessions are conducted. At St. Francis Hospital Nsambya much as EPH is being done, no study has been undertaken to explore these experiences and no routine follow-up is being done.

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