Long-term psychological impact of severe postpartum hemorrhage

Objective. To estimate the long‐term psychological impact of severe postpartum hemorrhage in women whose uterus was preserved. Design. Retrospective study. Setting. University‐affiliated tertiary referral center. Population. All consecutive women who underwent embolization for postpartum hemorrhage between 1994 and 2007 and whose uterus was preserved were included. Methods. Data were retrieved from medical files and semi‐structured telephone interviews. In semi‐structured interviews, women were asked about their perceptions and memories of the experience. Main Outcome Measures. Perceptions and memories of the postpartum hemorrhage during and after delivery. Results. Follow‐up was successful for 68 of the 91 (74.7%) women included. Of the 46 (67.6%) who reported negative memories of the delivery and postpartum period, the main memory for 24 was a fear of dying (35.3%). Of the 28 (41.2%) who reported continued repercussions, 16 (23.5%) thought about this delivery and its complications at least once a month, five (7.3%) reported persistent fear of dying, four (5.9%) reported sexual problems, and three (4.4%) women considered that the event was, at least in part, responsible for their subsequent divorce. Of the 15 women who had a subsequent full‐term pregnancy, nine (60%) reported intense anxiety throughout the pregnancy, and one (6.7%) developed depression requiring antidepressant treatment during pregnancy. Conclusions. Severe postpartum hemorrhage may have a long‐term psychological impact on women despite uterine preservation.