Focus on Infants During Childbirth Leaves US Moms in Danger

[Anonymous]

Maybe it's not the focus on newborns that's causing maternal deaths. Hell, the hospitals routinely miss things like tongue-ties and low blood sugar in newborns, and at some hospitals they won't take jaundiced babies to the NICU instead making the parents hold them on a warming blanket like we're in some third world country, plus even the "baby friendly" hospitals never seem to have enough qualified and competent lactation consultants. I almost hate to suggest this because I know how sensitive people get but I wonder if the maternal deaths from conditions like HELLP which are serious but treatable if caught early, are more the result of the more focus on "natural childbirth," not necessarily epidural-free labors but more the attitude of hospitals that the vast majority of births are perfectly fine and complication-free so why not leave women alone more after birth and not treat it as a serious medical event. The natural childbirth movement picked up a lot of steam in the 90s and into the 2000s and they didn't like the continuous monitoring, women being confined to the hospital bed during labor kind of stuff, and the longer hospital stays after birth, but without that, you do lose a lot of monitoring potential to catch some of these serious issues that can come up in the few days after birth.

[Anonymous]

Anonymous wrote:Maybe it's not the focus on newborns that's causing maternal deaths. Hell, the hospitals routinely miss things like tongue-ties and low blood sugar in newborns, and at some hospitals they won't take jaundiced babies to the NICU instead making the parents hold them on a warming blanket like we're in some third world country, plus even the "baby friendly" hospitals never seem to have enough qualified and competent lactation consultants. I almost hate to suggest this because I know how sensitive people get but I wonder if the maternal deaths from conditions like HELLP which are serious but treatable if caught early, are more the result of the more focus on "natural childbirth," not necessarily epidural-free labors but more the attitude of hospitals that the vast majority of births are perfectly fine and complication-free so why not leave women alone more after birth and not treat it as a serious medical event. The natural childbirth movement picked up a lot of steam in the 90s and into the 2000s and they didn't like the continuous monitoring, women being confined to the hospital bed during labor kind of stuff, and the longer hospital stays after birth, but without that, you do lose a lot of monitoring potential to catch some of these serious issues that can come up in the few days after birth.

Nope. Wrong. Read the article.

And those aren't "warming blankets" they are UV blankets to clear the bilirubin. Being warm doesn't clear jaundice.

And Insurance Companies were behind shorter hospital stays Post Partum. The fact that healthcare is a profit-based business is unethical. The rest of the developed world has Universal Healthcare....and lower Maternal Mortality Rates.

[Anonymous]

To me, the really horrifying part of the article was that this woman's husband was a doctor, who noticed symptoms, checked with an outside expert, and begged for it to be taken seriously as her condition worsened...and her OB just stalled and insisted he couldn't be wrong until it was far too late. You couldn't ask for much better patient advocacy but it didn't help a bit. What does it say about medicine when even a nurse married to a doctor who tried to get proper treatment , both working at that hospital, is fatally ignored?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yeah, it's not a focus on infants that's the problem. It's our terrible healthcare system.

I'm not so sure. They put a ton of resources into promoting breastfeeding, which has negligible if any benefits. The protocols developed by Canada to prevent pre-eclampsia wouldn't take that much money; just the organization/political will to do it.

I disagree that there are a ton of resources promoting breastfeeding. I'm a new mom struggling with breastfeeding and I'm struggling to get support. The hospital provided minimal service (and before my milk even came in with no follow up) and LCs are expensive. I went to a support group at the hospital but there were too many people there to get any specific guidance. Also, it's really tough to continue breastfeeding with a lack of paid maternity leave. Now Congress wants to get rid of the ACA mandates related to breastfeeding.

Have you checked out the free weekly support groups at the Breastfeeding Center? They were great for me. But I agree that more should be done to help women breastfeed.

[Anonymous]

Anonymous wrote:Didn't read the entire thread. But my guess is, we have far more "at risk" pregnancies in this country than countries with socialized medicine have.

If you have a higher number of AMA, women with chronic health conditions, pregnancy complications, you will also have a higher rate of maternal death. In other words, don't think that the other countries are doing so great - you can't fail if you don't even try...

To the extent that this is true, you've neatly ignored the chicken/egg problem with your argument. If we had better health care, women would have fewer chronic health conditions and pregnancy complications. Our shitty healthcare system is why we have far more "at risk", period.

[Anonymous]

This article was heartbreaking. My wife nearly died from complications after childbirth at one of the best and most popular hospitals here in DC (from a different complication, not high bp). I absolutely agree that care is not sufficiently focused on mothers- they are given little information about what to look for after birth, symptoms are not taken seriously, and many get inadequate monitoring.

[Anonymous]

Looks like they got an overwhelming response from women after the article was published and are still looking to interview more; particularly African American women who almost died in childbirth to examine racial disparities in maternal care.

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

[Anonymous]

There was that horrible case in Texas a few years ago where a woman contracted a staph infection and the hospital kept dismissing the husband's calls about her fever until it was almost too late. She lived but ended up with all four limbs amputated.

[Anonymous]

Anonymous wrote:There was that horrible case in Texas a few years ago where a woman contracted a staph infection and the hospital kept dismissing the husband's calls about her fever until it was almost too late. She lived but ended up with all four limbs amputated.

I remember that one. That's why I chased down the nurses at GW to make them take the saline lock out of my hand as soon as I got to the post-partum room. It was suprisingly hard to make them do it, but I was like "no, I do not want this piece of medical equipment in my body any longer than necessary."

[Anonymous]

Anonymous wrote:There was that horrible case in Texas a few years ago where a woman contracted a staph infection and the hospital kept dismissing the husband's calls about her fever until it was almost too late. She lived but ended up with all four limbs amputated.

I got a fever and flu like symptoms during labor, and the first nurse I told totally dismissed me. Luckily she was getting off shift and the next nurse took my concerns seriously. Guess what? I had Chorioamnionitis and needed an emergency c section for the health of both me and the baby. It's sad but it seems like you need both luck and a staunch advocate in your birth partner to get any kind of decent labor and deliver/post partum care.

[Anonymous]

PP from the last post here.

Also don't even get me started on the shitty advice we received from the lactation consultants that caused my newborn to lose 9% of his birth weight by the time we left the hospital. We later found out that he wasn't able to latch on well and was receiving basically no breast milk from me. I feel very lucky the pediatrician caught this problem before we left the hospital and we did not continue to starve the baby. I swear people scoff at fed is best but lactation consultants are only interested in breastfeeding, they could get a shit about the health of the mother OR the baby, their sole goal seems to be to get everyone to breastfeed at the expense of everything else.

[Anonymous]

Pregnancy and childbirth made me realize how little doctors know. I would never trust one again for anything.

[Anonymous]

I agree with the overall point that not enough has been done to promote a focus on maternal health, but the article doesn't articulate this point well at all.

A casual viewer of Downton Abbey would've known that she was heading into Pre-E territory with that off-the-charts BP reading. It's absolutely shocking that an OB dismissed the reading as not of concern...that reeks of malpractice. It does not seem like the article's broader point that there are well documented protocols for catching pre-E early which most states have not adopted really mattered in this case. Her BP was read, and the value was dismissed. Maybe the protocol would have forced the OB to be more familiar with the signs of pre-E, but that seems like standard fare for an OB to understand.

I delivered both my babies in California, and they would not remove the BP cuff until a couple hours after delivery (can't recall exactly when) because they said they had to continue monitoring it. Then in recovery, they continued to come in and take regular readings. It's not an overly invasive protocol, but it could so easily save someone's life. It's truly shocking that other states haven't bothered implementing it.

[Anonymous]

Anonymous wrote:PP from the last post here.

Also don't even get me started on the shitty advice we received from the lactation consultants that caused my newborn to lose 9% of his birth weight by the time we left the hospital. We later found out that he wasn't able to latch on well and was receiving basically no breast milk from me. I feel very lucky the pediatrician caught this problem before we left the hospital and we did not continue to starve the baby. I swear people scoff at fed is best but lactation consultants are only interested in breastfeeding, they could get a shit about the health of the mother OR the baby, their sole goal seems to be to get everyone to breastfeed at the expense of everything else.

This is actually true to some extent. The ACA rewards hospitals for the percentage of babies who are EBF upon discharge, which I think does skew incentives. My mom is a neonatologist who has "prescribed" formula for dehydrated infants a couple times, and her hospital now conducts a review every time a pediatrician orders formula. She has told me she's had mothers beg her to order formula for their babies, because they are killing themselves trying to BF before their milk has come in.

I do not in any way endorse the ACHA, but I think repealing or revising the over-the-top BF promotion in the ACA would be a very good thing.

[Anonymous]

The latest in the series:
http://www.npr.org/sections/health-shots/2017/08/17/543924405/many-nurses-lack-knowledge-of-health-risks-for-mothers-after-childbirth