How to Avoid Serious Health Threats When Having a Baby
A report from The Commonwealth Fund published in November 2020 showed that the United States has the highest maternal mortality rate among developed countries. Though most births in the United States occur without serious threats to the mother’s health, given this disturbing trend, it’s important to protect yourself as much as possible.
In my career of nearly 40 years as an obstetrician, I have delivered more than 6,000 babies and achieved a maternal mortality rate of zero. This rate of survival should not be shocking in a developed country, but data shows that there were 17 maternal deaths for every 100,000 live births in 2018. That rate is more than double that of most other high-income countries. Approximately 700 individuals die due to pregnancy and birth-related complications each year in the United States. Most of these deaths are preventable.
There are a few serious health threats women may encounter during pregnancy and birth. However, with awareness and proper medical care, there are steps that can be taken to intervene when these dangerous circumstances prevent themselves.
Excessive blood loss is one of the main causes of preventable death and damage for women who have just given birth. Measuring vaginal blood loss is simple, but often not required by hospitals. Some kinds of post-partum bleeding cannot easily be found. Several units of blood can pour into a flaccid uterus without detection. Proper training is required to find and treat blood loss in people who have recently given birth.
TIPS: Ask ahead of time what your birthing center’s protocols are concerning measuring and treating blood loss. Be sure they have those systems in place. If your blood type is rare, they should be prepared with plenty of blood to give you should you need it. It’s important that you check in advance.
High blood pressure during pregnancy can be a sign of pre-eclampsia, a potentially fatal condition for both mother and baby. Though this is a treatable disease, it’s important for doctors to monitor women’s blood pressure during pregnancy so that it may be detected if present.
TIPS: Magnesium sulfate is generally used to manage this disorder. Labetalol and hydralazine are both intravenously administered to treat high blood pressure. These medications worked 40 years ago and they still do today. They remain beneficial and safe. It’s important to monitor your blood pressure during pregnancy and know the potential signs of pre-eclampsia: high blood pressure, swelling of the hands and face, a persistent headache, change in vision, difficulty breathing, sudden nausea or vomiting after pregnancy midpoint, and pain in the upper right belly. If you suspect you may have pre-eclampsia, please see your doctor right away.
Saddle Pulmonary Emboli & Cerebral Congenital Aneurysm
The two most deadly emergencies in labor and delivery are saddle pulmonary emboli and cerebral congenital aneurysms. A saddle pulmonary embolus is fatal 99.9% of the time. Even if the clot is removed, there may still be uncontrollable disseminated intravascular coagulations and hemorrhage. The cerebral aneurysm rupture usually occurs during pushing. This could present as the worst headache ever and may be preventable.
TIPS: To detect a cerebral congenital aneurysm, and avoid fatality, pay attention to recurrent headaches. Just because headaches are frequent or long-term does not mean they are benign. They should never be ignored. If you are experiencing them, a CT scan or MRI is needed. Ideally, the aneurysm would be taken care of before giving birth. This does not need to be a fatal condition if treated properly ahead of delivery.
Avoid Problems by Interviewing Caregivers
You may be able to avoid serious problems by interviewing your caregivers ahead of delivery. My advice is to have input into your prenatal, delivery, and post-partum care. You might consider hiring a midwife or doula to advocate for you. Interview candidates until you find the ones you are most comfortable with. The goal is to be a part of your birth plan. Let those who will be caring for you have a chance to get accustomed to your needs or wants.