Anonymous wrote:

Anonymous wrote:I'm pregnant with my third and feel so lucky to have had smooth deliveries with my first two that I'm constantly waiting for the other shoe to drop. The Lauren Bloomstein story was one of the most frustrating things I can remember reading. I was physically agitated sitting there reading it on my phone, wanting to be able to reach through and shake the people around her to get them to DO something. So scary.

That was horrible. Did you read the profiles on the related Lost Mothers project? One of the moms (Kira Johnson) died after her bladder was nicked during a scheduled c-section. Her husband pointed out she had blood in her catheter bag, by that point it was too late. Her family went to the media because they don't want it to happen to others. I teared up so bad watching the interview on people.com that I had to turn it off.

PP here, no I didn't, but probably will feel compelled to now. I have an acquaintance who was diagnosed with placenta percreta, so I once spent a day down the rabbit hole of those kinds of stories, which aren't necessarily med mal issues but extremely scary nonetheless. The woman I know wound up getting 15 units of blood and very nearly died (I know this from fb, lest anyone think I'm a stalker). I was praying for her and I barely know her.

Regarding hemorrhaging, there was an interesting article recently about "hemorrhage carts" that some CA hospitals are starting to implement that was posted on this forum: https://www.vox.com/science-and-health/2017/6/29/15830970/women-health-care-maternal-mortality-rate

I've posted before on this forum, so I hate to make it seem like there might be more than one that had this experience....but I almost died at Sibley, and I was really shocked at how ill-prepared they were. I was hemorrhaging rapidly. They were delayed in giving me the transfusion because there was no "blood warmer" in the OR so one of the doctors went (literally) running to look in other ORs to get one. They didn't have the right kind of gauze in the OR to pack the wound. They needed to call for the specialist to do the thing where they put stuff in your arteries to make the blood stop flowing....but the switchboard kept connecting them to the wrong department and when they finally got through to the right person who was on call, it took him hours to come in. (I was wondering whether he lived out in Loudon County or something.) This was about 8 years ago, so I really hope that they have improved their situation, but I think they are just not really set up to handle emergency situations. I think a hospital that gets a lot of trauma would probably have been better prepared.
That said, I did NOT die, so clearly they did many things right, and the anesthesiologist (who did the running and the calling and generally tried to get people to think clearly and not flip out) was fantastic. I think part of the reason things turned out well is that I did not go into DIC -- I remember the anesthesiologist calmly telling me that they were testing my clotting factor, and if my clotting factor was okay, that was really great. If my clotting factor had gone through the toilet with that specialist off God knows where, I don't think I'd be typing this. They gave me so much blood I joked that I went in for a baby but I got a full oil change thrown in.

Anonymous wrote:I'm pregnant with my third and feel so lucky to have had smooth deliveries with my first two that I'm constantly waiting for the other shoe to drop. The Lauren Bloomstein story was one of the most frustrating things I can remember reading. I was physically agitated sitting there reading it on my phone, wanting to be able to reach through and shake the people around her to get them to DO something. So scary.

That was horrible. Did you read the profiles on the related Lost Mothers project? One of the moms (Kira Johnson) died after her bladder was nicked during a scheduled c-section. Her husband pointed out she had blood in her catheter bag, by that point it was too late. Her family went to the media because they don't want it to happen to others. I teared up so bad watching the interview on people.com that I had to turn it off.

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 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.

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

I'd love to hear answers to this, too...

Get the heparin lock.

my coworker just mentioned these to me yesterday and I read the first article and the advice one. I had no idea preeclampsia after birth was possible!

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

I'm pregnant with my third and feel so lucky to have had smooth deliveries with my first two that I'm constantly waiting for the other shoe to drop. The Lauren Bloomstein story was one of the most frustrating things I can remember reading. I was physically agitated sitting there reading it on my phone, wanting to be able to reach through and shake the people around her to get them to DO something. So scary.

I agree, these stories make me very concerned. I'm early in my 2nd pregnancy, so I will ask my Dr at my appointment in a few weeks, but does anyone know if VHC has a hemorrhage protocol or amniotic fluid embolism protocol?

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.

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.

I too have been following it. Very scary.

Has anyone been following the NPR/ProPublica stories on maternal health? These have been giving me serious anxiety over something going horribly wrong in my second pregnancy. I felt very confident in the care I received from the doctors and nurses at Sibley. At one point during my first pregnancy, my blood pressure was slightly elevated. It ended up being a bad read, but my OB kept me in his office for monitoring for an hour.

Am I naive to think they would have caught some of the errors mentioned in this story?

http://www.npr.org/2017/08/03/541191480/if-you-hemorrhage-dont-clean-up-advice-from-mothers-who-almost-died