Possible TW re post child birth maternal mortality

ionlyeatcandy

So I was listening to NPR morning edition in the car just now and a story came on detailing how we, especially those of us in the US, are at risk of dying from post pregnancy complications in the six weeks after birth, especially in just that first week.

In between crying and trying to get to work safely, I felt I had to post a link to this and encourage all of us to educate ourselves on the warning signs for possible complications.

Even if the last birth was easy, each one is different. And also, speaking as someone who immediately misplaced her discharge paperwork upon getting home and barely heard anything the nurse had to say due to having twenty people in the room ready to walk me out, I'm going to try and do better on learning about the risks.  

Here's the link to the story. I'm on mobile, so not sure if it will work out not. 

https://www.npr.org/sections/health-shots/2017/08/17/543924405/many-nurses-lack-knowledge-of-health-risks-for-mothers-after-childbirth

The story it self centers on the fact that discharge tends to be a little rushed and focused on the child and that some nurses aren't even aware that the mortality rate among new mothers is so high in the us. But it really made me consider that I have no idea what to look for even though I am having my second child.

If you know of any good sources for info so we can start learning warning signs and educating ourselves, please post them here.

KatieEl

Pro Publica has also posted a TON of excellent articles on this topic recently. They're doing their reporting in conjunction with NPR, I'll try to post links later today.

EmilyLove25

Thank you for sharing! I heard this on NPR a month or so ago and encountered a similar story again in The New York Times. Alarming to say the least.  However, I have to say that my experience was in near direct contradiction to this. The nurses were so attentive to my needs and monitoring me very closely for the two days/nights I was in the hospital. That said, I do think it is even in our nature to prioritize a newborn's needs over our own and this is such an important reminder to advocate for yourself as well. 

myorke24

Great post! I lived this. Textbook pregnancy, smooth and fast delivery for a first child (4 hours active labor, 20 minutes pushing), DS and I were wonderful. Until...I wasn't. I thank God each day for our Doula who checked in and said I just didn't look well. I immediately made an appointment with my OB-GYN and was diagnosed with Postpartum PreEclampsia. Can't advocate enough - any woman, any pregnancy (or Postpartum!). Signs: Headache not relieved by pain medication, vomiting, upper right quadrant pain (HELPP), facial and body swelling, high blood pressure, sudden visual changes (blurry, spotted, etc). All warrant a check up! 

Mudge85

@ionlyeatcandy thank you so much for sharing. I feel like its not talked about because its scary/sad and it IS but we need to know how to protect ourselves and what to look for.

bainidhedub

I listen to NPR all the time so I keep hearing these reports and trying not to get 1000% freaked out... Thanks for sharing your experience @myorke24 - there is so much new and different going on at that moment, I feel like you must need an outsider to notice things sometimes.

KatieEl

https://www.propublica.org/article/die-in-childbirth-maternal-death-rate-health-care-system

https://www.propublica.org/article/lost-mothers-maternal-health-died-childbirth-pregnancy

https://www.propublica.org/article/what-weve-learned-so-far-about-maternal-mortality-from-you-our-readers

a few links; obviously TWs abound.

scatteringashes

Somewhere there's an article about California' maternal mortality rate is something like 30% if the rest of the country's. It's focused a lot on bleeding (I cannot get close enough to spelling the H word to even let Google guess, apparently), but it also touched on the same thing: how post-chilsbirth, many care providers simply stop focusing on the mother. I think it's bleak and fascinating.

bainidhedub

@scatteringashes I could have sworn I heard that story on NPR too but it's not coming up - here's an article about it though: https://www.vox.com/science-and-health/2017/6/29/15830970/women-health-care-maternal-mortality-rate

agalvarado

Thank you for sharing! I also shared this with my husband, he's finishing up a master's program for nursing. He had no idea of the statistics either!

gilsam1

After reading that article, I just have to say I'm glad I live in California! Thanks for sharing guys. 

seltzerinstead

I was haunted for days after reading the NPR ProPublica story about Lauren Bloomstein's death that they posted on Mothers Day. So glad they are raising awareness with this investigation. A friend shared this response article:

https://www.skepticalob.com/2017/05/what-propublica-didnt-explain-and-possibly-didnt-even-know-about-maternal-mortality.html

FYI I don't know anything about that website, but seems legit.  I'm Not saying anything against the propublica articles, I think it's great investigative journalism and all should read, but I found that article to be slightly reassuring. 

burnsmommy27

Thanks for starting the convo. I think maternal care in general In the US needs to improve. Part of the problem of post partum care is the American attitude towards the post partum period. Most of the attention is on the new baby and not the healing mother.

In many other cultures the post partum mother is taken care of for the first month. I forget what culture it is but they observe the "sitting in period". During the first month post partum the women of the family come and care for the new mom surrounding her with love and support as she heals. I believe many Asian cultures have a similar tradition. 

I am glad light is being shed on this important issue. Knowledge is power.

ionlyeatcandy

@seltzerinstead thanks for posting that response article, I did get the feeling reading though that Laura story that the real issue was medical malpractice, but it was still horrifying. The whole thing just really brought to light for me that we need to be the number one person looking out for ourselves. 

It's definitely a part of the American health care system that I don't like (and there's so much not to like! ) that seems to fall under the culture of victim blaming (a rant for another day) where it's up the patient to examine a doctor's credentials and determine whether or not they are up to par. We shouldn't have to advocate for ourselves in these kinds of situations, the doc should know because it's their job! 

I think I'd be less frustrated if my dad hadn't just gone through a multi day ordeal about some massive chest pains he had that ultimately led to the hospital discharging him with a "I don't know" diagnosis. Latest is "maybe it's a lung issue?" and lots of shoulder shrugging.

Ugh, anyway, I feel kinda bad bringing this much of a downer into the board. When I posted this and realized the other thread was about decorating baby nurseries, I felt a little crummy. But I do think it's important. 

bainidhedub

@ionlyeatcandy Don't feel bad! This is important information! Planning a nursery is fun but health is more important, how can we advocate for ourselves if we don't know?

I don't remember anything like this (what to watch for postpartum) discussed at my prenatal classes, and if it was in the info packet from the hospital - personally I signed those papers at 3am after being awake for 20 hours and on a dose of Demerol, they went onto a table I couldn't reach from my bed, and I didn't find them again until a week after we got home. Like everything else, we need time to learn, research, and absorb.

ionlyeatcandy

Did a little googling and found a good list of symptoms on the baby centre UK site. I found it especially endearing for using the word "wee" to refer to peeing, lol. Good info though, and stuff I wasn't aware of. Tried to find something similar on this site, but couldn't really find much other than tear jerker videos. 

https://www.babycentre.co.uk/a1011242/postnatal-symptoms-you-should-never-ignore

Eta to say @bainidhedub I found my discharge paperwork in my car about two years later. Apparently I wasn't supposed to be driving immediately upon getting home. Oops.

KLake42

One reason for the high level of maternal mortality in the U.S. is that we are just about the only economically advanced nation that does not have universal health care.  So a lot of people fail to get proper treatment because they don't have insurance, and they don't seek care.

Another piece of this is that in the U.S., a lot of medical providers believe that birth "cures" preeclampsia.  This ignores post-partum preeclampsia.  In the UK, screening for post-partum preeclampsia is the standard of care, and the mortality rate from eclampsia is very low.  And that's just not the case here.

myorke24

@KLake42 Yes! I was readmitted to the mother and baby unit because I was 5 days PP at that time. But it was like a whirlwind.  Everyone acting like they didn't know where I would best be treated - ER, ICU, or Postpartum floor. It was terrifying and disheartening to have no true advocate - everyone was ready to hand me off, so to speak. 

auntieraindrop

@myorke24 that's terrifying. I'm high risk for preeclampsia so I hope they'll be on the lookout for symptoms. I've already made sure to let hubby know some things to watch for (puffy eyes, etc.)

agalvarado

I was induced at 38 wks because of HBP with DD and given magnesium. It was my first, so I was so unaware of all the complications and symptoms to look out for. It's not until reading these articles two years later that I am truly thankful for the care I received. I went back to the hospital 7 days PP because my blood pressure had gone up again. (Thankfully it wasn't at dangerous levels) I had my husband read these links as well so he knows the signs and symptoms too, for during and after the arrival of this LO. 

PleaseSendPicklesNow

@myorke24 My postpartum preeclampsia experience was similar to yours: My health and blood pressure were perfect during my pregnancy. My son was diagnosed with a congenital heart defect at the anatomy scan, so all eyes were on him at birth, and rightfully so.

Four days after birth, a few hours before I was discharged from the hospital, the swelling began. Then the headaches. I couldn't sleep because every time I laid down, I  couldn't breathe. My nurses had warned me about that symptom, so I called the hospital, per their instructions.

The doctor I spoke to told me I was just an anxious new mother. Then she refused to help me differentiate  between the symptoms of anxiety and more serious problems.  I got off the phone in tears because I was so frustrated and embarrassed for calling the hospital.

48 hours later, my son's nurse in the CICU took one look at me and ordered me to go to the emergency room. It turned out I was in the throes of postpartum preeclampsia, and I had got into congestive heart failure.

We learned that when you think something is wrong,  FIGHT. Be persistent and annoying. If you have to, be rude. It's better than being dead!

My husband was shocked by how quickly the ER doctors brushed me off and called me "just nervous." My feet were so swollen I had to be rolled in to the ER in a wheelchair, but they said it was normal post-birth swelling. NOPE. Then I had an echocardiogram and a CT scan, and they quickly changed their tune. It was a terrifying night.

alice0218

(visiting from February BMB)

Thank you guys for sharing the links on this thread and for being brave enough to share your stories. It is so sad and terrifying but sooo important! Thank you thank you!

I have heard about how the US has a relatively high maternal mortality rate compared to other countries. I haven't read all those article yet (bookmarked), but I will and I will share them with DH and my mom. It is so scary and no one talks about this! It's all about the baby. At my first OB appt. I asked about what kind of postpartum treatment there is for me and I was told I will have a check up after 6 weeks. Well, don't people who die usually die before that? Not that I'm planning on that happening but one woman's risk is no different than the next so I think everyone should be concerned. But the baby has an appt. after one week so I guess I can bring up concerns then too? But she was like "trust me, you will be so tired you don't want to leave the house. You won't want more appointments." So I've been thinking of hiring a postpartum doula. Probably that would help me feel safe and any symptoms that should arise would be noticed by a doula, but I realized I probably can't really afford that. I will look into it more though. I think I will have my mother over as often as possible the first week or two to help us with the baby and life postpartum and I want DH and mom to be aware of any symptoms they should look for that mean we should go to the hospital.

I am a FTM and I know it probably sounds like I'm overreacting and anxious and hormonal, but I think this is a legitimate worry. It's not the majority or mothers affected by this, but it's common enough that it's not some rare anomaly. 30% is a high rate. And even if it's mostly rural and uninsured patients, your insurance card isn't gong to jump up and say, "get to the hospital, you have symptoms of ____!" So I feel like everyone is equally at risk.

eta: I started reading the articles and I'm sobbing already

myorke24

@PleaseSendPicklesNow I'm so sorry you experienced this as well. I say I wouldn't wish it on anybody as it truly robbed me of the initial joy of transitioning home and set off Postpartum Anxiety that took me quite a bit to recover from. However, it did make me a more informed patient and opened my eyes to healthcare bias. The "anxious woman" attitude truly endangers women and their care. We are always told to follow our mother's instinct yet when we have a feeling about our own body, we are an overreacting new mother. In my case, I was impacted by physical bias, as well. I am 5'2, a 1/2 marathoner, and gained just 20lbs carrying my son. There's "no way" I could develop such a condition. *Eye roll*. Lifestyle factors impact PreEclampsia the least. It's a response mechanism that is driven by an incorrectly implanted placenta. It scares me how little medical professionals understand the condition. 

@alice0218 Hello! Don't ever apologize for being anxious and/or wanting to have all the facts and be prepared. My Doula is the one who absolutely led to the discovery of how sick I was. The PreEclampsia Foundation is a wonderful resource in addition to what is posted here.  

[Deleted User]

@PleaseSendPicklesNow and @myorke24 I'm so sorry you both had to go through that. I can't imagine how it feels to have healthcare professionals brushing you off like that.

I dealt with high BP almost my entire pregnancy with DD, and after hearing these stories, I'm so thankful for the care I received. I had a follow-up phone call with a nurse 2 days after we went home, as well as a check-up at my clinic a week after just to check my BP. The hospital also had a nurse line I called twice in the middle of the night because I was nervous about some swelling (which was gone within an hour and totally normal). 

Just putting that out there for nervous FTMs that some places do have good care, and even if they don't, please advocate for yourselves! You know your body best and if something doesn't feel right, don't let them tell you no.