As we are sure you have noticed, the rates of PPH are increasing.  A recent study carried out in Australia in 2007 found that PPH occurred in 6% of all births, irrespective of delivery.  There is much speculation as  to the reasons for this increase, such as rising rates of caesarean sections, which can then lead to increases in the occurrence of placenta praevia.  Society is changing as well, with a trend to leave childbearing to later in life. Women wishing to have a family later in life may require assisted conception techniques such as IVF, which may have lead to larger numbers of multiple pregnancies, a risk for PPH.  There has also been a rise in maternal obesity, which has been shown to increase the risk of PPH. The purpose of the STOP study is to look at all PPH’s occurring at St Thomas’ Hospital, London and Queen Mary’s Hospital, Sidcup.  We will then be able to examine all the influencing factors upon each particular PPH and see where the trends really lie.

We may also find from this study that the definition of PPH is no longer pertinent to UK society.  Women are on the whole well-nourished, and provided any antenatal anaemia is effectively treated, we may be able to show how much blood women can lose without being compromised. 

Apart from examining the influencing factors on PPH, we are also interested in how staff cope with such an emergency.  With ever decreasing numbers of midwifery staff, it is important to note that many midwives quote a traumatic experience such as a PPH as being the reason they left the profession.  We would like to know how you feel the emergency is handled, what you would see improved etc.  Do you feel comfortable that you would know what to do given a massive obstetric haemorrhage? What do you think would help in the management, for example, increasing the number of skills drills, posters in all delivery rooms etc.

We would like to approach multidisciplinary staff who have been involved in a PPH.   This  will hopefully include doctors of all grades, midwives, student midwives, HCA’s, theatre staff and more. We would like to know your thoughts on what was handled well or poorly.  It is intended to be reflective, and should you give consent, we will interview at a time and place that is convenient to you.  The interviews should not last longer than an hour and will be recorded with your permission.  Anything you say will be entirely confidential, for example, if you mention a particular member of staff.

Although we should automatically be made aware of all PPH’s occurring at St Thomas’ and Queen Mary’s, we would really like to hear from you if you think there is something we should look at.  Was a PPH avoided because of good management, and if so, what do you think caused the avoidance?  Are you concerned that blood loss is not being estimated appropriately? Your thoughts on this topic are crucial to our study, and we would appreciate any input from you.  Please  find details of how you can contact us on the ‘Contact’ page.  Thank you.