Advice From Mothers Who Almost Died

[Anonymous]

Anonymous wrote:A lot of the things the women in the article discuss are familiar to me. I had severe preeclampsia and gave birth at 29w. I also had 8 significant fibroids, which combined with low-platelets and an emergent c/s led to an emergency hysterectomy. There should have been much better communication between the various providers I was seeing-I assumed that they were sharing notes, but in retrospect I don't think that was necessarily true.

And while I totally support less medicalized births for lower-risk women, I think the natural birth community endangers the lives of women with preeclampsia every day. As one of the women in the article said, natural birth people say that preeclampsia happens to women who don't eat well and don't take care of themselves, and I've seen in books and online dangerous advice to try and fix preeclampsia with dietary and herb routines.

I also had severe preeclampsia and was well taken care of at a local hospital. The dietary approach to preeclampsia and GD (if you eat enough protein and veggies and calories and drink enough water, then you won't get either of these) is dangerous and wrong. It's also insulting, because it means that you did something wrong if you get preeclampsia or GD or other complications.

Most of my friends and family had less complicated, less medicalized births. I didn't. Thankfully, we each have healthy children, whatever route of delivery.

[Anonymous]

Anonymous wrote:So what are the best hospitals in the area to deliver at?

PP. IMO, a Level 1 trauma and academic facility would be my top choice. In the DC area, GW, WHC, and INOVA Fairfax qualify.

[Anonymous]

Anonymous wrote:OP, these stories worry me a lot too. I think the biggest things are:

1. Choose your hospital and doctors wisely. What are their hemorrhage protocols? What experience do they have with serious, rare complications? Do they have a ICU, NICU, etc.?

2. Educate yourself and your partner, whoever that is. Trust your providers, but also know enough to know what questions to ask and when to push back.

3. Don't be afraid to speak up and push back if you feel like you're being ignored. DON'T be rude off the bat, but don't let politeness take precedence over advocating for yourself.

I had preeclampsia and a very complicated delivery at WHC with the midwives (and OBs and MFMs). I always felt like I was receiving excellent medical care, but I also know that things were hard and scary enough at the time that I don't feel confident that I would have been with it enough to have caught a mistake. So ultimately, I think choosing your doctors and hospitals with "worst case" scenarios in mind is the most important thing during delivery, then self-education is most important for the postpartum period.

This is really important. I'm fortunate, in a way, because my mom is a neonatologist. She's also a little over-reactive, so I didn't really want her in the delivery room, but I made sure she knew when I was going into labor and insisted she not hop on a plane until baby was delivered so that DH or I could call her if anything happened. First delivery was long and some slight issues, but nothing really worrying. Second delivery seemed like it was going great, but then DS's heartrate started dropping and a number of other things went wrong. I called my mom to ask her about what was happening and whether it made sense to her, and she even ended up talking to the attending OB and provided her some details that weren't in my chart for some reason. I have no idea if that call made a difference, but at least I had someone knowledgeable to advocate for me (or tell DH what to advocate for if need be).

If I didn't have my mom available, I probably would have done a lot more reading up on things...and I suspect I'm a priori more knowledgeable about this stuff having grown up around and even volunteered in hospitals and NICUs.

[Anonymous]

Anonymous wrote:I commented on the earlier thread about this. It gives me anxiety to read a laundry list of things I have to worry about beyond trying to stay healthy during pregnancy and then taking care of a newborn. Ridiculous. now we have to worry that we might die anyway due to hospital error or inadequate resources. A lot of these women developed a complication after leaving the hospital. Women need continuous checkups in the days and weeks after delivery. Other developed countries don't let new moms go without checkups for 6 weeks after giving birth.

In the U.S, healthcare policy is left up to the states, which do whatever they want. Look at Texas, where the maternal mortality rate is much higher than any other state. It's shameful. We need federal policy to force better maternal medical care across the board.

One of the things that came up when I was discussing this series with a friend of mine was just how many times I was in a doctor's office with my kid in the first few weeks after birth--but I don't remember anyone asking me how I was. I realize the absurdity of our healthcare system precludes it, but really, if I'm taking my kid in for a checkup, how hard would it be for the nurse to also check my blood pressure while she's getting the baby's vitals?

[Anonymous]

Anonymous wrote:

Anonymous wrote:A lot of the things the women in the article discuss are familiar to me. I had severe preeclampsia and gave birth at 29w. I also had 8 significant fibroids, which combined with low-platelets and an emergent c/s led to an emergency hysterectomy. There should have been much better communication between the various providers I was seeing-I assumed that they were sharing notes, but in retrospect I don't think that was necessarily true.

And while I totally support less medicalized births for lower-risk women, I think the natural birth community endangers the lives of women with preeclampsia every day. As one of the women in the article said, natural birth people say that preeclampsia happens to women who don't eat well and don't take care of themselves, and I've seen in books and online dangerous advice to try and fix preeclampsia with dietary and herb routines.

I also had severe preeclampsia and was well taken care of at a local hospital. The dietary approach to preeclampsia and GD (if you eat enough protein and veggies and calories and drink enough water, then you won't get either of these) is dangerous and wrong. It's also insulting, because it means that you did something wrong if you get preeclampsia or GD or other complications.

Most of my friends and family had less complicated, less medicalized births. I didn't. Thankfully, we each have healthy children, whatever route of delivery.

Thanks for posting this. I had a friend with a twin delivery that became full-blown HELLP. She had a super healthy pregnancy (was doing pilates through her third trimester etc), and she thinks that they were a little laissez-faire about following up her bloodwork because of that. She didn't have pre-E diagnosed earlier, but apparently the last BW taken a couple days before she went into labor would have shown some issues if they had bothered looking and noting that she had a twin pregnancy.

She almost died, and there is no reason for her to have gone through that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I commented on the earlier thread about this. It gives me anxiety to read a laundry list of things I have to worry about beyond trying to stay healthy during pregnancy and then taking care of a newborn. Ridiculous. now we have to worry that we might die anyway due to hospital error or inadequate resources. A lot of these women developed a complication after leaving the hospital. Women need continuous checkups in the days and weeks after delivery. Other developed countries don't let new moms go without checkups for 6 weeks after giving birth.

In the U.S, healthcare policy is left up to the states, which do whatever they want. Look at Texas, where the maternal mortality rate is much higher than any other state. It's shameful. We need federal policy to force better maternal medical care across the board.

One of the things that came up when I was discussing this series with a friend of mine was just how many times I was in a doctor's office with my kid in the first few weeks after birth--but I don't remember anyone asking me how I was. I realize the absurdity of our healthcare system precludes it, but really, if I'm taking my kid in for a checkup, how hard would it be for the nurse to also check my blood pressure while she's getting the baby's vitals?

I agree with this. In California, at least, I think questionnaires to screen for PPD that are given to mom's at well-child visits are mandated, but no other health questions are asked. I was just told to monitor for excess bleeding, and when I (TMI) had a huge softball sized clot I called and they told me NBD and no need to come in. Why tell me that's a reason to call, then?

[Anonymous]

I had a massive hemorrhage and nearly died. I dont remember much of it but DH has PTSD from it. He will never forget the moment he saw the look on the nurse's face and then her trying to hide it as she pressed the staff assist button (hemorrhage started after I was settled in after delivering DS). Then he noticed the blood and the panic and commotion. He and DS were taken out of the room and they began to work on me. I spent a day in the ICU (alert but my vitals had bottomed out and I'd almost been a code) and had 4 units of blood.

It was a complete freak thing. I'd been incredibly healthy up to that point. Labor was 4 hours and easy, I didn't even have tearing! They never found out what caused the hemorrhage.

I absolutely credit the staff for me not being dead. According to the doctor and DH, the nurse very quickly realized it was going to be an emergent situation and after swiftly and calmly. The procedures they had in place allowed me to get blood quickly. They noticed when I started to bottom out and intervened before I coded. I'm very fortunate for the care I received.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I commented on the earlier thread about this. It gives me anxiety to read a laundry list of things I have to worry about beyond trying to stay healthy during pregnancy and then taking care of a newborn. Ridiculous. now we have to worry that we might die anyway due to hospital error or inadequate resources. A lot of these women developed a complication after leaving the hospital. Women need continuous checkups in the days and weeks after delivery. Other developed countries don't let new moms go without checkups for 6 weeks after giving birth.

In the U.S, healthcare policy is left up to the states, which do whatever they want. Look at Texas, where the maternal mortality rate is much higher than any other state. It's shameful. We need federal policy to force better maternal medical care across the board.

One of the things that came up when I was discussing this series with a friend of mine was just how many times I was in a doctor's office with my kid in the first few weeks after birth--but I don't remember anyone asking me how I was. I realize the absurdity of our healthcare system precludes it, but really, if I'm taking my kid in for a checkup, how hard would it be for the nurse to also check my blood pressure while she's getting the baby's vitals?

And during pregnancy, I was getting weekly growth scans for my IUGR baby, but it was a u/s facility so they didn't check my blood pressure at any of those visits-even though slowing growth of my baby and my creeping blood pressure were both key symptoms-it seems to me that every time a woman goes in she should be a basic screen of symptoms.

[Anonymous]

I chose Fairfax because it was close to my house, had a level one trauma center and the highest ranked NICU with a delivery room. I also knew they had high risk lbs on staff all the time due to the high risk ward. In the end, I was fine but my water broke at 29 weeks and from the moment we walked in the ER at 2 am until I left over a week later, we were well taken care of. Regular check ins by the nurses, etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I commented on the earlier thread about this. It gives me anxiety to read a laundry list of things I have to worry about beyond trying to stay healthy during pregnancy and then taking care of a newborn. Ridiculous. now we have to worry that we might die anyway due to hospital error or inadequate resources. A lot of these women developed a complication after leaving the hospital. Women need continuous checkups in the days and weeks after delivery. Other developed countries don't let new moms go without checkups for 6 weeks after giving birth.

In the U.S, healthcare policy is left up to the states, which do whatever they want. Look at Texas, where the maternal mortality rate is much higher than any other state. It's shameful. We need federal policy to force better maternal medical care across the board.

One of the things that came up when I was discussing this series with a friend of mine was just how many times I was in a doctor's office with my kid in the first few weeks after birth--but I don't remember anyone asking me how I was. I realize the absurdity of our healthcare system precludes it, but really, if I'm taking my kid in for a checkup, how hard would it be for the nurse to also check my blood pressure while she's getting the baby's vitals?

This. I developed (annoying and non-life threatening) stomach flu after delivery and was at my first's first well baby checkup crumpled up and doubled over with severe stomach cramps (we didn't know I had a bug; I just thought I didn't feel well after surgery). They gave me the tdap and that was it. In retrospect I cannot believe that a physician looked at me, almost grey in the face and severely dehydrated, and just didn't bother to ask anything at all.

[Anonymous]

Anonymous wrote:A lot of the things the women in the article discuss are familiar to me. I had severe preeclampsia and gave birth at 29w. I also had 8 significant fibroids, which combined with low-platelets and an emergent c/s led to an emergency hysterectomy. There should have been much better communication between the various providers I was seeing-I assumed that they were sharing notes, but in retrospect I don't think that was necessarily true.

And while I totally support less medicalized births for lower-risk women, I think the natural birth community endangers the lives of women with preeclampsia every day. As one of the women in the article said, natural birth people say that preeclampsia happens to women who don't eat well and don't take care of themselves, and I've seen in books and online dangerous advice to try and fix preeclampsia with dietary and herb routines.

I don't think this is fair at all. Any "community" that gives advice not backed by science is dangerous. But, as someone who had pre-e and gave birth UNMEDICATED, I did not encounter this view at all.

[Anonymous]

Anonymous wrote:

Anonymous wrote:A lot of the things the women in the article discuss are familiar to me. I had severe preeclampsia and gave birth at 29w. I also had 8 significant fibroids, which combined with low-platelets and an emergent c/s led to an emergency hysterectomy. There should have been much better communication between the various providers I was seeing-I assumed that they were sharing notes, but in retrospect I don't think that was necessarily true.

And while I totally support less medicalized births for lower-risk women, I think the natural birth community endangers the lives of women with preeclampsia every day. As one of the women in the article said, natural birth people say that preeclampsia happens to women who don't eat well and don't take care of themselves, and I've seen in books and online dangerous advice to try and fix preeclampsia with dietary and herb routines.

I don't think this is fair at all. Any "community" that gives advice not backed by science is dangerous. But, as someone who had pre-e and gave birth UNMEDICATED, I did not encounter this view at all.

I posted upthread about my experience. I developed GD with my first and GD and pre-e with my second, so my experience is a couple years out of date now. But when I was pregnant with my first, there was a big pushin the natural birth movement to trivialize or ignore GD. It "wasn't real", doctors had changed the cutoffs, glucose is harmful so avoid it and the test, etc. That's not helpful. It's harmful. And so is the Brewer diet which, best case scenario, will make the mother gain 80 lbs during pregnancy and won't do a thing to prevent pre-eclampsia but may make her feel bad if she gets it.

[Anonymous]

I almost died but they caught it and treated me. Don't remember 24 hours after birth and I didn't get to hold my babies during that time. Everything turned out fine though, praise God.

[Anonymous]

Anonymous wrote:I had a massive hemorrhage and nearly died. I dont remember much of it but DH has PTSD from it. He will never forget the moment he saw the look on the nurse's face and then her trying to hide it as she pressed the staff assist button (hemorrhage started after I was settled in after delivering DS). Then he noticed the blood and the panic and commotion. He and DS were taken out of the room and they began to work on me. I spent a day in the ICU (alert but my vitals had bottomed out and I'd almost been a code) and had 4 units of blood.

It was a complete freak thing. I'd been incredibly healthy up to that point. Labor was 4 hours and easy, I didn't even have tearing! They never found out what caused the hemorrhage.

I absolutely credit the staff for me not being dead. According to the doctor and DH, the nurse very quickly realized it was going to be an emergent situation and after swiftly and calmly. The procedures they had in place allowed me to get blood quickly. They noticed when I started to bottom out and intervened before I coded. I'm very fortunate for the care I received.

I'm glad you're okay! But I actually think this attitude of feeling lucky for receiving adequate medical care is not right. Everyone has a right to that kind of care, and we should make sure everyone gets it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, these stories worry me a lot too. I think the biggest things are:

1. Choose your hospital and doctors wisely. What are their hemorrhage protocols? What experience do they have with serious, rare complications? Do they have a ICU, NICU, etc.?

2. Educate yourself and your partner, whoever that is. Trust your providers, but also know enough to know what questions to ask and when to push back.

3. Don't be afraid to speak up and push back if you feel like you're being ignored. DON'T be rude off the bat, but don't let politeness take precedence over advocating for yourself.

I had preeclampsia and a very complicated delivery at WHC with the midwives (and OBs and MFMs). I always felt like I was receiving excellent medical care, but I also know that things were hard and scary enough at the time that I don't feel confident that I would have been with it enough to have caught a mistake. So ultimately, I think choosing your doctors and hospitals with "worst case" scenarios in mind is the most important thing during delivery, then self-education is most important for the postpartum period.

+1

I also delivered at WHC with the midwives and I also work there as a clinician in a different department. I chose WHC because it's a Level 1 trauma center (blood bank will always be stocked with the appropriate products; imaging always available; other specialists in house 24/7, among other things) with a higher-acuity nursery/NICU and multiple ICUs capable of admitting prenatal and intra-/postpartum patients. Children's is also next door and works collaboratively with WHC's perinatal team.

+2 to WHC. I worked there for 10 years and lived close-by so delivering my first there was a no-brainer. Now I live way out in Rockville and I am still choosing to deliver there due to their NICU, proximity to Children's, and preparedness.