Postpartumblödning - det stora hotet

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Sammanfattning: Background: Postpartum haemorrhage is globally the leading cause of maternal mortality. Thethird stage of labour is the most critical part of the childbirth and it affects both women with andwithout risk factors and can quickly escalate. Atoni is the most common cause of postpartumhaemorrhage. Despite clear guidelines the numbers for postpartum haemorrhage continue toincrease in Sweden.Aim: The aim of this study is to investigate midwives opinions why postpartum haemorrhage isincreasing and suggestions how to decrease the bleedings.Methods: A qualitative method with semi-structured interviews was used and the material wasanalysed using a content-analysis method. Seven midwives were interviewed from one maternityward in a hospital in Sweden.Results: The analysed material resulted in two main categories: factors that can increase the riskof postpartum haemorrhage and factors that can reduce the risk of postpartum haemorrhage. Themain categories consist of four respectively five subcategories. Midwives opinion why postpartumhaemorrhage does not decrease is partly the woman’s individual conditions and an increase ofinductions and other interventions. Some of the midwives complained that the insidious bleadingis the most dangerous bleeding. Furthermore, environmental factors such as stress and high flowof patients were also highlighted. Improvement for trying to reduce postpartum haemorrhage isthat midwives needs to change their view of bleeding and contact the doctor earlier. Improvingcommunication and teamwork, and also raising awareness for women with risk factors could alsodecrease the risk for a big postpartum haemorrhage. It was also stated that more time for reflectionand simulation exercises could improve the outcome.Conclusion: The study’s conclusion is that there are factors that healthcare professionals can andcannot influence that the women suffers from a postpartum haemorrhage. Midwives should becautious and respect risk factors and give preventative medicine quickly. Continuous support isconsidered to be able to reduce interventions to prevent postpartum haemorrhage. Furthermorereflection time is required after treatment of postpartum haemorrhage, and to be able to performsimulation exercises related to postpartum haemorrhage. The midwife should also have the timewith every woman who gives birth to insure good patient-safe care.Keywords: postpartum haemorrhage, midwifery, third stage of labour, management,communication

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