REACT Study: Recognition of Excessive bleeding At ChildbirTh

• Research type

  Research Study

• Full title

  How much is too much? Exploring clinical recognition of excessive maternal blood loss during childbirth.

• IRAS ID

  137388

• Contact name

  Angela Hancock

• Contact email

  Angela.Hancock@manchester.ac.uk

• Sponsor organisation

  University of Manchester

• Research summary

  In developing countries, heavy bleeding is the most common reason why women die following childbirth. In developed countries like the UK, it is the leading cause of ill-health among women after childbirth. Deciding how much blood a woman has lost is commonly done by ‘visual estimation’. This is where the midwife or doctor looks at the blood and decides how much there is, in ml; with 500ml generally viewed as excessive blood loss or postpartum haemorrhage (PPH). However, visual estimation often underestimates blood loss because it gets soaked up by the sheets, towels and swabs. This is said to be a reason for treatment being delayed.
  Previous research has confirmed that visual estimation is inaccurate and is not improved by education. One study showed that using blood collection bags to measure blood loss increased the accuracy of visual estimation. However, more accurate visual estimation did not reduce the number of women having severe blood loss. This raises questions about how blood loss is actually assessed in practice and what other factors influence decisions. There has been very little research looking at what is understood about blood loss at childbirth; how blood loss is assessed; how decisions are made that the blood loss is too much; and how decisions are made to get help or start treatment. Therefore, we are planning a study to explore these issues with women, their birth partners, midwives and doctors. Focus groups and interviews will be used to develop new theories about how blood loss is assessed. The theories will then be tested in clinical simulation studies. An improved understanding of how blood loss is assessed and decisions are made will help us to develop new ways to support those people involved in making decisions about blood loss during childbirth.

• REC name

  North West - Greater Manchester East Research Ethics Committee

• REC reference

  14/NW/0052

• Date of REC Opinion

  10 Mar 2014

• REC opinion

  Further Information Favourable Opinion