Know the Signs
No one really wants to talk about the risks of maternal mortality. As a birth doula, I am so excited to encourage moms and help them feel empowered about their births—NOT make them fearful. However, the statistics for maternal deaths in America and my own experience make me feel obligated to tell moms about the signs of some of the most common reasons for maternal mortality in America, as about 60% of the time, these deaths are preventable.
Here are some facts about maternal mortality in America:
According to the CDC, approximately 700 women a year die from complications having to do with pregnancy in the United States.
More American women are dying of pregnancy-related and postpartum complications than any other developed country. Only in the U.S. has the rate of women who die been rising. In every other wealthy country, and many less affluent ones, maternal mortality rates have been falling.
American women today are 50% percent more likely to die because of pregnancy-related health issues than their mothers were.
“American women are more than three times as likely as Canadian women to die in the maternal period (defined by the CDC as the start of pregnancy to one year after delivery) and six times as likely to die as Scandinavians. In Great Britain, the journal Lancet recently noted, the rate has declined so dramatically that "a man is more likely to die while his partner is pregnant than she is."
The three leading causes of maternal mortality in the U.S. are:
Blood clot in the lungs (pulmonary embolism)
Hypertension (high blood pressure)
Blood loss (hemorrhaging)
My story
Three years ago, I gave birth to twins in the hospital. I had a smooth, vaginal delivery with no complications. Within an hour or two, I felt shortness of breath. The next morning, it was still challenging to get a deep breath and I felt like something was sitting on my chest. When I’d bend down, I felt like I was going to pass out. By the grace of God, I had read an article just ONE WEEK prior about Serena Williams’ birth years before. The article had showed up on my social media newsfeed randomly, even though her birth was years before mine. She had a history of blood clots and after her c-section, she felt shortness of breath and alerted the nurses and doctors that it was probably a blood clot. They did not believe her and delayed a CT for hours before she demanded they perform one—sure enough, there were blood clots in her lungs. I truly believe God put that article in front of me for a reason, because as I sat in that hospital room hours after giving birth and being told I was probably just having anxiety, I remembered that article and pushed back and said I was not comfortable with what I was feeling.
Within minutes, I was gasping for air and couldn’t see anything—my vision went black. They put an oxygen mask on me and finally took me down for a CT—the OB seemed reluctant, but said we could do it to “rule it out.” Within an hour, it was confirmed that I had two blood clots in my lungs, AKA pulmonary embolism. PEs are one of the leading causes of death in pregnancy and postpartum. That same day, I was being taught how to inject blood thinners into my abdomen. Two days after leaving the hospital, I was at my first of many visits at the anticoagulation clinic, being told signs of a stroke, in case the clots came loose and went to my brain. Instead of soaking in the newborn bliss, I was terrified to go to bed at night for months, thinking the clots in my body might kill me. I was afraid I would suddenly drop dead at home and my four small children would be left alone for hours before their dad came home. But three months later, after a follow-up CT, the clots were gone. Despite that, I lived with the trauma for about another year and a half. Anytime I felt shortness of breath, I feared I had clots again. I even went to the ER once.
I’ve read many stories of moms dying in pregnancy or after birth from a pulmonary embolism and I wonder why I lived and they didn’t. It is a devastating thing and about 25% of the time, there are no symptoms—the clot will just suddenly take a person’s life. I don’t say this to cause fear, but to help others realize 75% of the time, there ARE symptoms. I had never heard about blood clots in my life until reading that article about Serena Williams. My OB had talked about the risks of hemorrhaging with twins, but NEVER about the risk of clotting. Too many people have never heard of this and the most common symptom, shortness of breath, can be too easily dismissed. I feel a deep obligation to inform expecting mothers of the symptoms of pulmonary embolism because the chances increase due to the increased hormones during pregnancy and postpartum. The risk runs from pregnancy through 12 weeks postpartum. I had no previous history of clotting and have since been tested for clotting disorders and have none. This can literally happen to anyone, but having the knowledge beforehand can make all the difference.
Other symptoms of a pulmonary embolism:
Sudden shortness of breath (most common)
Chest pain (usually worse with breathing)
A feeling of anxiety
A feeling of dizziness, lightheadedness, or fainting
Irregular heartbeat
Palpitations (heart racing)
Coughing and/or coughing up blood
Sweating
Low blood pressure
The moral of the story is knowledge is power. If 60% of maternal deaths are preventable, listen to your body! Know the symptoms of these most common issues. Don’t live in fear, but speak up if something makes you uncomfortable and listen to your God-given intuition! Educate yourself, pray for peace and wisdom should a situation arise, and trust that God holds you in His hands.
