Living beyond Placenta Accreta Spectrum: Mother’s and Father’s Experience of the Postnatal Journey and Recommendations for an Integrated Care Pathway

Abstract Background Placenta Accreta Spectrum is associated with significant clinical maternal morbidity and mortality, which has been extensively described in the literature. However, there is a dearth of research on the lived experiences of couples. The aim of this study is to describe living beyond a pregnancy and birth complicated by PAS for up to four years postpartum. Couples’ experiences of PAS inform the development of an integrated care pathway of family centered support interventions. Methods An Interpretative Phenomenological Analysis approach was applied to collect data through virtual interviews over a 3-month period from February to April 2021. Twenty-nine participants shared their stories; 6 couples were interviewed together (n = 12 participants), 6 couples were interviewed separately (n = 12 participants), and 5 women were interviewed without their partner. Couples were eligible for inclusion if they had a diagnosis of PAS within the previous 5 years. This paper focuses on the postnatal period, with data from the antenatal and intrapartum periods described separately. Results One superordinate theme “Living beyond PAS” emerged from interviews, with 6 subordinate themes as follows; “Living with a different body”, “The impact on relationships”, “Coping strategies”, “Post-traumatic growth”, “Challenges with normal care” and recommendations for “What needs to change”. These themes informed the development of an integrated care pathway for couples to support them from diagnosis up to one year following the birth. Conclusion Couples described the challenges of the postnatal period in terms of the physical and emotional impact, and how some were able to make positive life changes in the aftermath of a traumatic event. An integrated care pathway of simple supportive interventions, based on participant recommendations, delivered as part of specialist multidisciplinary team care may assist couples in alleviating some of these challenges.