Placenta Accreta and Mental Health Sequelae

Natalie Feldman, MD
Department of Psychiatry
Poster Overview

Many women experience childbirth as traumatic in some way. We don’t know much about those women’s experiences, or how that impacts their mental health. For this study, we spoke with 22 women who had experienced a condition called placenta accreta. In this condition, the placenta attaches too deeply to the uterus; it can lead to many complications, including death. In four group sessions, we asked these women about their experiences with placenta accreta and how it impacted them. We then reviewed their answers and identified common themes across multiple women’s experiences. These themes included fear of bad outcome, identifying these experiences as traumatic, loss and grief, anxiety, and isolation and loneliness. Now that we have a better understanding of how traumatic or risky childbirth experiences can impact women, our goal is to use that to build services within the Brigham which can help support women going through these experiences.

Scientific Abstract

Background/Introduction: 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 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.

Conclusions: 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.

Clinical Implications
Now that we have a better understanding of how traumatic or risky childbirth experiences can impact women’s mental health, our goal is to use that to build services within the Brigham which can help support women going through these experiences.
Research Areas
Authors
Natalie Feldman MD, Kate Salama MD, Margo Nathan MD, Lorna Campbell LICSW, Penny Wang, Daniela Carusi MD MSC, Leena Mittal MD
Principal Investigator
Leena Mittal and Daniela Carusi

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