Anonymous
Post 08/08/2017 15:20     Subject: Advice From Mothers Who Almost Died
Anonymous wrote:OH -- and make sure your partner or spouse is as informed as you are about these issues and knows how to be a forceful advocate in labor, when, especially if there's an emergency, you may not be able to advocate for yourself!


This reminds me - one of the best pieces of advice we got was from a NICU director we met with before our twins were born. At the end of our visit, we asked her if there was anything else we should be asking her that we hadn't talked about and she recommended that DH and I have a conversation about where he (DH) would go if something happened and the babies and I had to be sent to separate places due to an emergency during delivery or something along those lines. At the time, we were envisioning the case where the babies would be sent to the NICU and I might remain in the OR; she said it's good to know what dad's plan is in such a situation before it's the heat of the moment. We talked about it and, as it turns out, I had an episode post-delivery where I needed some urgent attention due to a reaction to anesthesia (non life-threatening, but scary) and we did end up getting separated for a bit. We were both glad we'd had that conversation and were on the same page as far as a game plan and I recommend that everyone think through it a bit.
Anonymous
Post 08/08/2017 12:56     Subject: Advice From Mothers Who Almost Died
Anonymous wrote:
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.


Another problematic labor at WHC -- hemorrhage that required a blood transfusion (which I learned puts me in the category of women who suffered "severe maternal morbidity") and although I wouldn't say I almost died, I definitely feel like I got both top notch attention and care at WHC. I was a midwife patient who ended up with the OBs (transferred to them when I needed forceps), who were very impressive. Other than my (fabulous) nurse, who got a somewhat panicked look on her face when my blood pressure first tanked, no one seemed frantic or stressed out or even particularly worried.

One thing I really appreciated about WHC -- and they may do this at all hospitals, I don't know -- was that they had 2 or 3 meetings a day (called "huddle") where ALL the staff who were not actively catching babies met to talk about ALL the patients. So, even though I had never set eyes on my forceps OB before I was consulting with her, she was quite familiar with my case and situation. This is important because contrary to popular belief, your attending midwife/OB is never with you the whole time and -- gasp -- may even sneak in a nap or two, so when shit hits the fan, as it does, they might not be immediately available.

TLDR post labor, I felt fine. Now, after following all the Propublica stuff and considering a second labor, I DEFINITELY am going to be certain that I am delivering in a hospital that has its eye on MOM's health as well as baby's. I no longer live in DC, but I'd go back to WHC in a heartbeat.

+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.
Anonymous
Post 08/08/2017 12:39     Subject: Re:Advice From Mothers Who Almost Died
Anonymous wrote:
Anonymous wrote:So what are the best hospitals in the area to deliver at?


Does anyone know how Holy Cross is on this stuff?


I'm also really interested in this. Holy Cross is less than a mile away from our house, but I have no idea how good they are with high-risk pregnancies, deliveries with complications, etc.
Anonymous
Post 08/08/2017 11:41     Subject: Advice From Mothers Who Almost Died
Anonymous wrote:My 6 week post partum check up was over the phone. I couldn't believe it.


What?! That's crazy! My pregnancy, birth, and postpartum healing was basically as textbook as possible and I still wanted someone to make sure everything was healing and going back into place!
Anonymous
Post 08/08/2017 11:05     Subject: Re:Advice From Mothers Who Almost Died
Anonymous wrote:So what are the best hospitals in the area to deliver at?


Does anyone know how Holy Cross is on this stuff?
Anonymous
Post 08/06/2017 17:05     Subject: Advice From Mothers Who Almost Died
OH -- and make sure your partner or spouse is as informed as you are about these issues and knows how to be a forceful advocate in labor, when, especially if there's an emergency, you may not be able to advocate for yourself!
Anonymous
Post 08/06/2017 17:04     Subject: Advice From Mothers Who Almost Died
I think it's completely fair to take a list of questions to your OB and the hospital where you are planning to deliver about their protocols and preparedness, asking for their statistics, etc. You are the consumer and you have the right to know; both OBs and hospitals should also know you're asking because especially around here you can take your business elsewhere. Print out and take the linked article in with you to your next appointment and go down the list of questions one by one.
Anonymous
Post 08/05/2017 23:51     Subject: Advice From Mothers Who Almost Died
My 6 week post partum check up was over the phone. I couldn't believe it.
Anonymous
Post 08/05/2017 22:26     Subject: Advice From Mothers Who Almost Died
I had a uterine rupture during delivery at Georgetown. It was my first (have had 3 more since) and came from nowhere. All I can say is that if you are going to have a baby you are most likely going to be ok. But something goes wrong you don't wan to be at a community hospital like Sibley. My DD was in the NICU since we both almost died. I spent weeks ther and the amount of babies there from other hospitals was astounding.
Anonymous
Post 08/05/2017 10:17     Subject: Re:Advice From Mothers Who Almost Died
Anonymous wrote:
Anonymous wrote:
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.

Twin gestations are at a higher risk for PE. I'm sorry, but if her doctor stopped paying attention to her test results, how is that the fault of the "natural birth movement"? That's just a medical practitioner who got lazy.

She attributes it partially to the fact that she was so healthy throughout pregnancy they weren't on top of things toward the end. I'm not her or her doctor, so I can't tell you more than that. But it's her opinion of her experience.
Anonymous
Post 08/05/2017 10:07     Subject: Advice From Mothers Who Almost Died
Anonymous wrote: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


Your BP was not "slightly elevated" if you were kept for observation for an hour.
Anonymous
Post 08/05/2017 07:40     Subject: Re:Advice From Mothers Who Almost Died
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?


Agreed my doctor's office accidentally scheduled my 6-week postpartum visit for 3 weeks post partum ( and I was in such a stressed-out haze from having a kid in the NICU that I I didn't catch that mistake) so I was really grateful that I got to go in early and get a health check up and also do the postpartum depression screening because I totally flunked that and it was good to get into therapy early vs waiting 6 weeks to get help)
Anonymous
Post 08/04/2017 15:14     Subject: Re:Advice From Mothers Who Almost Died
I have been there - see my story below. I can tell you that there is a difference between bad judgement and negligence. You can do your research to protect yourself from negligent practices. But if you are the chosen 0.001% nothing will protect you because doctors are humans. My advice is stop worrying about the things you cannot control but also follow the advice of the article, if you feel off do not shy from the emergency room you are just wasting precious moments.

After delivery of my second in 2016 my placenta would not detach for a good hour while my doctor was tugging at it and doing everything she can. It finally came out. It was checked and we did not think much of it. I was discharged 2 days later with my baby and was recovering way better than the first time.

One evening two weeks postpartum, I started Hemorrhaging . My husband called my OB emergency line as I stood in a bloody shower (and bathroom and living room - I even remember my two week old baby's clothes were smudged with blood as my husband was holding her). The on-call doctor told us depending on the amount I should either go to the emergency room or she can send a prescription to be picked up. We loaded our two kids in the car and off to Holy Cross. Fifteen minutes later, I was wheeled to the reception (still bleeding everywhere) and immediately given a bed. I was starting to fade (I remember telling the nurse that I think I am going but I was really hoping to be at my 2-week old daughter's weeding one day). He tilts my bed up so more blood can go to my head, attached an IV to each arm and put pressure on both IV bags ignoring the nurse in the next curtain asking him to leave for X-ray with the response not now.

Two bags of blood (but still severely anemic), one emergency D&C, and 3 additional days of hospital stay later I did make it. Surprising, I am expecting my third and with the same practice and I would love it if I had the same doctor that helped me deliver #2. Nervous about delivery? yes, but I have no doubt at all about the practice or its doctors.
Anonymous
Post 08/04/2017 15:03     Subject: Re:Advice From Mothers Who Almost Died
Anonymous wrote:
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.

Twin gestations are at a higher risk for PE. I'm sorry, but if her doctor stopped paying attention to her test results, how is that the fault of the "natural birth movement"? That's just a medical practitioner who got lazy.
Anonymous
Post 08/04/2017 14:39     Subject: Re:Advice From Mothers Who Almost Died
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.


Different PP here - I think the pp meant something different than unmedicated. I think of the "natural birth movement" as the homebirth/birthcenter/CPM/direct entry midwife community that is against the "medical midwifery"/hospital birth model of care. It's the Skeptical OB vs. Ina May Gaskin.