"Living in a vacuum": Lived experiences of maternal near-miss among women with placenta accreta spectrum

Abstract

Background: Placenta accreta spectrum (PAS) is one of the life-threatening complications of pregnancy, the prevalence of which has increased in parallel with the caesarean section rate.

Objective: The purpose of this study was to investigate the experiences of mothers with PAS who have also experienced maternal near miss.

Methods: The participants of this study included 8 mothers who had experienced near miss due to placenta accreta during the past year, as well as two husbands and two health care professionals. Data collection was done using face-to-face, in-depth virtual and in-person interviews. In this qualitative study, the interpretive phenomenological analysis approach was used to analyse the data.

Results: The superordinate theme that emerged from the lived experiences of the studied mothers is 'Living in a vacuum', which was derived from 3 main themes. The theme of 'distorted identity' is related to the mothers' experience of losing the uterus as a symbol of femininity and nostalgia for the former self. The theme of 'exacerbated exhaustion' indicates the burnout and fatigue perceived by these mothers and has dimensions far beyond the exhaustion caused by performing parenting duties. The third theme, 'a threatened future', reflects these mothers' vague image of the future in terms of health, preservation of life, and the continuation of living together with the husband.

Conclusions: It seems that mothers with PAS need to be covered by integrated and well-organised psycho-social support from the time they are diagnosed with the complication until long after delivery due to the high potentiality of maternal near miss.

Keywords: Placenta accreta spectrum; experience; living; maternal near-miss; qualitative.