Mental health and Placenta Accreta Spectrum

Placenta accreta spectrum is a rare complication of pregnancy. The placenta becomes imbedded in the lining of the womb and fails to separate after the baby is born. This exposes both the mother and baby to serious risks including life-threatening bleeding, removal of the womb (hysterectomy), and the need for a premature birth. Where a diagnosis of placenta accreta spectrum has been made during pregnancy, close monitoring for mother and baby is needed, which may mean staying in hospital for weeks or months before the birth. In cases where the birth has been complicated, mothers may need admission to intensive care. Because the baby is often delivered a number of weeks before the due date, they may need to spend sometime in the special care unit.

Given these circumstances, it seems that women who have a pregnancy complicated by placenta accreta are at high risk of experiencing mental health problems both during and after their pregnancy. However, very little is known about the impact of placenta accreta spectrum on women’s mental health. So far, only a few studies have looked at this relationship and found that women with placenta accreta spectrum are indeed more likely to experience post traumatic stress disorder and experience low mood compared to women with pregnancy conditions.

In order to further explore the impact a pregnancy complicated by placenta accreta has on women, an interview study was conducted with 7 women who had had a pregnancy complicated by placenta accreta within the past 2 years. The purpose of the study was to better understand -  what is it like for women to have a diagnosis of placenta accreta spectrum? Is it better to be prepared for delivery or does that heighten anxiety and worry? What is it like for women after a pregnancy complicated by placenta accreta?

While each woman’s placenta accreta story is unique, interviews revealed shared feelings of loss, bewilderment, loneliness and pain, both mental and physical. Women emphasized the shock of being diagnosed with a condition they had never heard of, being separated from their family during long hospital admissions and the immense guilt of feeling like a burden on others. A fear of dying-  both for their baby and themselves - was profound as the day of the birth arrived. Women felt overwhelmed after their discharge from hospital and the challenges of trying to get life back to normal. While women were keen to praise the medical care they received, they were also keen to highlight areas they felt could be improved, in particular in relation to pain relief and after care. Women were unanimous in their call for additional mental health resources, both to help them cope during their pregnancy but in particular to provide longer term supports many months after delivery.

This is the first study to explore the lived experience of placenta accreta spectrum, and adds to the growing body of research in this area.


written by Dr Helena Bartels

Click here to read the abstract for this study, or to find links to the full text: