Attitudes and practices surrounding obstetric hemorrhage among patients and providers.

Abstract

Background: Postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality worldwide and the second most frequent cause of pregnancy related death in the United States. There are discernible differences among healthcare providers in identifying risk factors and managing obstetric hemorrhage. Furthermore, there is limited data on patient's awareness and attitudes toward hemorrhage risk factors and preventive measures, as well as their involvement in clinical decisions. This project aimed to identify educational gaps for providers and patients in preventing and managing postpartum hemorrhage to optimally reduce maternal morbidity and mortality.

Methods: Cross-sectional anonymous surveys were distributed among obstetric patients and providers at a single maternity healthcare center from November 2022 to June 2023.

Results: The study cohort included 629 patients and 22 providers. Most of participants, 84% (n = 526), lack knowledge or are uncertain about the risk factors associated with postpartum hemorrhage. When participants were asked how likely they would be willing to accept a preventative medication to reduce the risk of postpartum hemorrhage, 55% (n = 344) responded "very likely" followed by 28% (n = 176) as "somewhat likely". Patients are likely to accept preventative medications to reduce the risk of postpartum hemorrhage. The majority of providers, 73% (n = 16), express confidence in using tranexamic acid for postpartum hemorrhage treatment.

Conclusion: There is lack of knowledge among pregnant patients about the risk factors for hemorrhage and the standard medications to prevent it. Despite this, most participants are willing to receive preventive medication. Practice patterns regarding the prevention and management of hemorrhage should be part of a shared decision making between patients and providers.