Placenta Accreta and Mental Health Sequelae

Natalie Feldman, MD

Brigham and Women’s Hospital
Placenta Accreta and Mental Health Sequelae

Scientific Abstract

 

Background: Patients with high risk pregnancies, such as those with abnormal placentation, are susceptible to childbirth related mental health sequelae, though little is known about these women’s experiences and needs. Previously, we examined the health services implications of these experiences; we now examine the mental health sequelae of these pregnancies.

Objective: We aim to use qualitative data to understand how patients’ pregnancy and birth experiences affect their mental health, identify factors that may enhance obstetric and mental health care for women with complicated pregnancies, and build a clinical program that will produce better experiences for our patients.

Methods: For this exploratory study, we ran four focus groups, with a total of 22 women who had a history of placenta accreta. General questions about patient’s pregnancies, births, and postpartum experiences were asked. Using a grounded theory approach, themes were then identified.

Results: Initial themes that emerged included fear of bad outcome, identifying these experiences as traumatic, loss and grief, anxiety, and isolation and loneliness. Postpartum depression did not emerge as a significant theme.

Conclusions: These findings can guide practitioners from all specialties who care for women facing hemorrhage and/or hysterectomy at delivery. Using these preliminary themes, we aim to develop a clinical program to serve women with placenta accreta, as well as other women with high-risk or complicated pregnancies. This interdisciplinary program will include obstetric and anesthesia planning, psychotherapy, and psychopharmacology.

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research Areas

Authors

Natalie Feldman MD*, Kate Salama MD*, Margo Nathan MD, Lorna Campbell LICSW, Penny Wang, Daniela Carusi MD MSc, Leena Mittal MD Dr. Feldman and Dr. Salama are joint first authors