It Happens in the United States

No one expects a mother to die from childbirth.  But it happens, and it happens far too often, even here in the United States.  Every day nurses put on their scrubs and go to work not knowing what their day is going to be like, what assignment they might get, or what will walk through the door.  As a labor nurse, we hope for the Holy Grail—a multip in active labor who we could almost bet every dollar in our bank account will deliver easily and quickly and will present us with a pink and screaming baby.  There is a reason we love people who come to us in active labor.  Their labors are usually quick and uncomplicated, and the result usually ends with everything we work so hard for—a mom and baby who are both happy and healthy.  But that isn’t this story.

I was sitting at the nurse’s station when I heard a bunch of noise at the end of the hall.  On a labor unit, we frequently hear people screaming, and it doesn’t even make us blink.  But when it’s an emergency, somehow everyone just knows.  I ran towards the sound.  When I walked into the room, a mother was laying there, her legs still in stirrups.  Her head was turned towards the side, so I could see her face as soon as I walked through the door. I had only been a nurse for about a year, but I knew immediately we were in trouble.  The patient’s eyes were rolling into the back of her head and I could literally hear the blood hitting the floor beneath her.  Her baby was crying in the radiant warmer next to the bedside.  There were a lot of family members scattered throughout the room.  Someone was still taking pictures of the baby, oblivious to the fact that their wife/daughter/sister/best friend was hemorrhaging less than a foot away.  A scrub tech ran out of the room to open up the OR.  The doctor sat in front of the patient’s open legs, fervently trying to find the source of the bleed. With shaking hands, I managed to place another IV.  Someone ushered her family members out of the room. Someone took the baby to the nursery.  And before I knew it, the patient had been transferred in the bed to the OR, and I was left alone in an empty room.  Looking around, cables and monitor parts had been haphazardly thrown about, in an effort to get the patient to the OR as quickly as possible.  The floor was covered in puddles and puddles of bright red blood, glossy under the glare of flourescent lighting. I heard someone call a code over the intercom. In shock, I turned around quickly and slipped in the blood. Lying on the floor, I could feel it seep through my scrubs. I bounced up, went to the break room, and grabbed an extra pair of scrubs I kept in my locker. I went to the bathroom and changed, crying silently as I scrubbed the patient’s blood off of my hands and body. My insides were shaking.  Had that just happened?  I then stopped crying, splashed water on my face, and walked out of the bathroom so that I could go back and check on my own patient, the patient that was still pregnant and laughing and making bets with her family on when her baby would be born.

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To this day, I think about that mother and I pray that she at least heard her baby cry. Her face will forever be frozen in my memory, her head turned towards her crying baby.  I think about her newborn daughter, who left the hospital without her mother, and how inherently wrong that is. I think about a father raising a family on his own, and how their other small children must have wondered why their mother never came home.  I think about her parents, who left the hospital and went straight to a funeral home, as someone had to make decisions that inevitably had to be made.  As nurses, the only reason we come to work day after day after day is because we love what we do, and we want a healthy mother to go home with a healthy baby. That is the only thing we are working towards, the only thing we work for.

That was not my last experience with a maternal death. And I’ve witnessed countless close-calls, as we all have. If you are a nurse, know that we have to help these mothers, because they are coming in more and more sick, with more and more problems, and this is just not going away. We don’t talk about all of those close-calls, the mothers who go into DIC or the ones who end up with a hysterectomy. We don’t talk about all of the Hemabate, Methergine, and rectal Cytotec we’re giving. We don’t talk about the increase in the number of blood transfusions we are having to give. We have to share our stories, because no one knows what we do.

If you are a mother, know that this is not something that your physician or your nurse can fix alone. We all have to start working together to make sure that you and your baby leave happy, and healthy, and together. No one thinks that this is something that could happen to them. No nurse thinks this is going to be her patient. But it can happen, it does happen, and it is happening every day in the United States. Talk to your doctor about being healthy during your pregnancy. Unless there is a medical reason to be induced, wait for labor to start on its own. And if you’re the family that took a baby home without its mother, the nurse that took care of your mother/sister/daughter/best friend is not the only nurse thinking about you. You are on all of our minds.  Every single unexpected and crushingly sad delivery we see, you are the reason we work as hard as we do.  All of us remember all of you.  We do not ever want our patient or our baby to be the one with a bad outcome. Every nurse, every physician, every scrub tech and nurses aide and unit secretary all want a heathy mom and baby.  You are not forgotten, and you are why we will continue to fight for moms and babies.

 

Until my next delivery ❤

40 Reasons to go the Full 40


86 thoughts on “It Happens in the United States

  • July 9, 2014 at 4:59 pm
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    I can’t agree more. Anytime someone comments (after finding out I’m an L&D nurse) “Oh, you have such a NICE job…must be wonderful working in such a happy place!” They’re correct, of course…except for times like the situation you mentioned. Its hard for me to get students to understand that every patient who walks through the L&D door has the potential to become a disaster. And there’s TWO lives at stake.

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    • July 11, 2014 at 11:33 pm
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      I couldnt agree more! I was recently talking to a fellow RN from another unit at the grocery store and after finding out what unit I worked on told me “oh you have a cake job, all you guys do is rock babies”! ……They have no idea what it takes to be a L&D nurse. We have to be an advocate for your patient, to keep two lives safe and try to give your patient the best experience possible, and always be ready for plan B. Its a tough job, but so rewarding.

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    • September 6, 2015 at 3:05 pm
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      I actually oriented a nurse who had been “out of the business” for 25 years. She thought that L&D would be the best fit for her because she loved to rock babies! She lasted 2 weeks. Her biggest complaint was that we didn’t get to eat lunch on a regular basis!! She had such unrealistic ideas about what we actually did. I hope she found her ideal job…

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      • September 6, 2015 at 4:24 pm
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        I’ve been L$D nurse for over 30 yrs and 20 yrs ago we didn’t rock babies as a routine..We had the same emergencies, near misses and deaths, both maternal and fetal as now..We did a few emergency C/S with local..as no CRNA present. Don’t know where this ex L&D nurse worked 20 yrs ago ..but clearly was VERY low census if that is all she remembered..

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  • July 9, 2014 at 5:23 pm
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    Why do you suppose there is an increase in this happening in the USA? I’d love to hear your thoughts on that.

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    • July 9, 2014 at 5:28 pm
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      We induce a lot of people. We frequently give them a lot of drugs to induce labor (which can contribute to PPH). And mom’s are more sick. We see more and more mom’s with comorbidities.

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      • February 11, 2015 at 9:20 pm
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        Do you think you could make a post about the comorbidities? As someone who’s thinking about having a baby, I just want to cover my bases and see what I need to do to make sure I have a safe delivery.

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    • July 9, 2014 at 6:53 pm
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      I personally believe it is happening more because of the advancement of medical technology and care. Women who, only 1 or 2 decades ago, would have never conceived in the first place or who would have miscarried are now successfully conceiving and carrying pregnancies to viability. To what end, though? Not to mention, the illegal drug problem has proliferated immensely, and we have meth users and crack users coming out of our ears. I don’t even blink any more when I get a patient with a tox screen that’s positive for multiple drugs. It’s ABNORMAL for me to take care of a patient who has a planned pregnancy, a committed partner, is educated, and who is not using drugs of some kind (tobacco included…nicotine withdrawal in a newborn is THE WORST). I am so used to taking care of high risk patients that I forget what low risk looks like. Every shift at work there is a crisis, and I don’t even work at a tertiary center any more. Maternal deaths AND neonatal deaths are increasing, and it’s terrifying. I am scared every day that I clock in, and exhale a sigh of relief when I clock out and nobody has died. That is not an exaggeration.

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      • July 10, 2014 at 12:41 am
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        WOW. That is a crying shame. All of it. Thank you for sharing your perspective.

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      • July 10, 2014 at 3:16 pm
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        So true!! The other night I had a naturally laboring mother come in who contracted on her own, broke her water on her own, couple hours later we pushed 3 times and we had a baby! Not until then did I realize that I didn’t have Pitocin in the room because I’m so used to 99% of my patients getting pitocin and it’s already hanging. Really made me take a step back and realize the incredible amount of patients we induce or augment. Pure craziness.

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    • July 10, 2014 at 2:50 am
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      Four reasons generally cited;
      1. Increased ascertainment
      2. Obesity
      3. C section rate of 30%
      4. Advanced maternal age.

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      • July 11, 2014 at 5:28 pm
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        I was healthy, not obese, every single pregnancy indicator was that everything was perfect but they wanted to induce because I was 34. Thankfully I went into labor the day before inducement (only 5 days over), but inducing really is pushed.

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      • February 12, 2015 at 1:26 pm
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        Not all advanced maternal age pregnancies are problematic. I was a 40 year old primip 5 days post dates, my water broke when I was at the hospital for an NST, I delivered a healthy baby girl 12 hours later without augmentation.

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    • July 10, 2014 at 7:25 pm
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      Moms are older and the pregnancy exasabates older diseases such as high blood pressure ,type 2. Diabetes weaker muscles for pushing and induced labor.

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    • September 6, 2015 at 2:54 pm
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      Part of it has to do with the epidemic of maternal obesity and diabetes– these women present to labor with many problems and complications and higher risk, whether vaginal delivery or c section.

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  • July 9, 2014 at 6:03 pm
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    This hits a little close to home. I was induced (I had polyhydramnios) and hemorrhaged pretty bad. Baby’s heart rate dropped scary low several times the whole labor. He was born with a vacuum and he was blue and not crying. The doctor was pulling huge clots out my uterus and nurses were giving me rectal cytotec and more pitocin. It was very scary. I will never forget the look on everyone’s faces when they saw the pool of blood on the floor. Thankfully, baby and I are perfectly healthy a year later. It could have been a much different outcome for both of us and not a day goes by that I don’t think of that. I am so thankful I had such an amazing delivery team! I hope I never have to be induced again..I still have nightmares about it. Thank you for sharing, its good for people to know the reality of this.

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  • July 9, 2014 at 10:11 pm
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    Maternal deaths are awful! In 23 years as a labor nurse, I’ve only had one , but I think it will stay with me forever. It was 8 years ago and I still think about it every day. Even though there was nothing else I could have done,it’s still hard.
    The proliferation of inductions comes from the thought that we can control everything in life, that there should be no pain or discomfort. If someone is just uncomfortable in the last trimester, they think they should be delivered this instant. The advances in the care of preemies in the last 20 years means that early babies do better now. Early in my career, babies at 32-34 weeks didn’t usually make it. If they did, there was usually some residual problems. The bottom line on viability was 28 weeks, now it’s 23 weeks. Until a few years ago, there had to be a medical reason to induce or insurance wouldn’t pay. Only recently has the research proven that late preterm infants-ie less than 39 weeks-still have significant issues. Inductions sometimes force our hands into issues and c sections. Please wait for spontaneous labor!
    Sorry this is so long!!!!

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    • July 10, 2014 at 3:23 am
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      Spontaneous labor is always ideal but not always appropriate. The physician who cares for the patient for 39+ weeks prior to the patient coming to the hospital most definitively has the patients best interest at heart. If it is not, he or she should find a different profession. Please keep this in mind when you offer advice that may both cause a women to go against the physicians advice or distrust her physicians decision making knowledge. Most of the physicians have gone thru all of these situations not once, but multiple times in the span of their career. We don’t forget either.. We live it with our patients, not just in the hospital.. But long after they leave.. It’s usually a life long relationship. Not just a day..

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      • July 10, 2014 at 5:18 am
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        I’m in no way giving advice. You may be the best physician, with the best intentions, and you may be current on all of ACOGs recommendations and so forth. But we ALL know that not every physician is like that. And that’s why I only talked about elective inductions. ACOG has not recommended poly, SGA, LGA, and on and on for a while now, but I still know people who were induced prior to 39 weeks for these reasons. And unfortunately, some physician’s are guided by the fear of a bad outcome and a lawsuit, and they’d rather take the “safer” route and deliver on the side of caution. And then there’s just patient’s that beg and beg and beg and wear a doctor down!!!! I can tell you, I don’t think there’s any OB doctor out there that is doing this for the glory. I know that you all HAVE TO truly love it, because you’re the ones with the 24 hour schedules that no one can control. I get that. But seriously, this is out of control. I’m not blaming a doctor, or a nurse, or a patient. We have got to collaborate all together…and we have to include the patient. Because what we’re doing is not working. Our mortality rate is going in the wrong direction! I don’t feel like I’m offering any advice, and my encouragement is no different than #gothefull40. The only difference is that I’m telling the stories to go with it. And I’m just getting started! lol but don’t worry, my next one will be happy. <3

        p.s. OBs are dear to my heart!

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      • September 16, 2015 at 4:20 am
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        My doctor induced me so that he could go on vacation. I saidi wasn’t comfortable with that, I was only 38 weeks,and they said fine, but I had to sign a paper stating if anything was wrong with baby he wasn’t liable,that other doctors wouldn’t know me and my baby could be harmed because of that etc. Basically scared me into being induced. He induced 4 women the day before me,and 5 other women the day I was induced.

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  • July 9, 2014 at 11:58 pm
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    I think a lot of the issues are from sicker moms and older moms. Also polyhydramnios is a medical induction sice SROM increases the risk of cord prolapse or abruption so is preferably done in a controlled setting. Please stop making people even more afraid of being induced! The long laboratory and chorioamnionitis is the problem, not the induction.

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  • July 10, 2014 at 12:00 am
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    Sorry, that posted before I was ready- induction on a favorable cervix does not lead to hemorrhage.

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  • July 10, 2014 at 2:30 am
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    Scary hemorrhage is usually an issue for the postpartum floor, but as an ER nurse (who is also an old ob nurse) I am seeing more and more postpartum hemorrhages further out than normal. Up to 6 weeks out! I don’t know if there is a link to inductions with this, but certainly something to think about when sending these Mamas home with discharge instructions and what to watch for….

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  • July 10, 2014 at 4:33 am
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    It unfortunately happens and too frequently. It tears at our hearts and minds…what could have been done differently during prenatal or labor or surgical care, we ponder. But once we had what was an amniotic emboli during a c-section. We coded her and ar least six of us nurses raced constantly about procuring whatever the anesthesiologist and then the code team deemed necessary. And WE SAVED HER!!!!! What an unusual success in this case!!! Mother and baby eventually went home!!!! I do recall a few DIC cases tearing up and down to the blood bank so many times we had foot arch pain for days. And finally telling the blood bank “give me anything thats red” bless their hearts they were trying too!!

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      • July 10, 2014 at 6:27 am
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        Wow! Reading all these comments is a little overwhelming.
        I myself had 3 totally different births. First was an emergency csection, second was induced, and third was natural (almost in the lift it was so fast) then followed the last one up with a postpartum haemorrhage, and I was only 24 years old and perfectly healthy. Such a scary thought what could have happened in each of these circumstances had I not been in amazingly capable hands. I am forever in the debt of my midwives for keeping me and my babies safe, I sure did put them through a tough time. Thank you so much for the incredible work you do every day! xx

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  • July 10, 2014 at 11:19 am
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    My best friend, who was also a labor and delivery nurse and coworker of mine, died on our unit March 9 from a postpartum hemorrhage/DIC. She left behind her newborn daughter and a 15 year old son. She was active duty Navy at the time. It was a completely life changing experience. It’s true, most people think we have the happiest jobs in the world, but when things go bad they can go horribly wrong. I will never forget that day in the OR. I just hope to be able to carry on her memory and legacy.

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  • July 10, 2014 at 11:49 am
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    I have a question, what do you believe is causing this sickness in moms and babies? I’m very much considering having a third, but I’ll probably be 37 if we decide to, and as I have 2 babies already, I’m carefully considering and would like to know from someone in the trenches what causes these tragic outcomes. I’m currently 35, and overweight but on a program (weight watchers) to lose it all before even considering adding to my family. Just curious. God Bless you in all you face everyday.

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    • July 10, 2014 at 12:08 pm
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      Most mom’s are fine, even if they are overweight or AMA. Being overweight less to more problems. I think you are doing the right thing…trying to lose as much weight as possible first. Talk to your OB about it to. We see more and more hypertensive patients, diabetic patients…but the key is to be proactive. I’m in your same boat…I need to lose weight before I have a third. But I needed to lose weight before I had my second. I just counted every carb I put in my mouth! Lol I still ended up diabetic. I’m just going to try to get as healthy as I can…let me know how it goes! <3

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  • July 10, 2014 at 8:38 pm
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    I’m a little confused as to how being healthy or not relates to postpartum hemorrhage. I was 26 when I had my first child. I was at an ideal weight for my height (132 at 5’6″) when I got pregnant. Gained 22 lbs and labored at home until I was advised by the midwife to go to the hospital. My son was born in 5 pushes about 45 minutes after my water broke. I had no medication during the labor/delivery process, but was given IM pitocin after delivery. Four hours later I hemorrhaged in mother baby. I knew it was serious by the frantic activity of the 7 or 8 nurses around me. I was given IV pitocin, cytotec, and then hemabate which finally controlled the bleeding. My hematocrit was 21.7 6 hours later. My midwife and the doctor never did figure out why I hemorrhaged though I could tell at subsequent visits that it bothered my midwife. With my second I had a healthy pregnancy and delivery but found later that I was given hemabate by a different midwife immediately after delivery of the placenta as a “precaution”. My last delivery I hemorrhaged immediately post-partum and went into shock, but not before having a horrific, un-medicated uterine exploration. Again, no cause was found for the hemorrhage. I was never told that there was anything I could do to make myself “healthier” or less likely to bleed after delivery. I never had any “interventions” in my deliveries and was never induced. If there is something I could have been doing to keep myself from going through that fear of leaving my children motherless, I’d love to have known about it. What weren’t they telling me? I’m pregnant with a fourth, unexpected, baby and have been advised that I’ll get hemabate immediately following delivery of the placenta as they are certain I would hemorrhage again. All I have ever heard is “it’s just something your body does” or “hemorrhage is the most common complication of delivery.” As though it happens all the time and isn’t really something preventable…

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    • July 10, 2014 at 8:43 pm
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      I was linking it to maternal mortality in general. Anyone can hemorrhage, healthy or not. The best thing going for you is that you and your physician are aware of your history. That is so important because your doctor will prepare for your delivery. If you are anemic, talk to him about things you can do to help prepare your body. xx

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    • July 11, 2014 at 6:32 pm
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      Please see a hematologist asap!! Your story is eerily similar to mine. I nearly hemorrhaged to death with my first delivery. I had two unrelated surgeries and hemorrhaged both times. The surgeon sent me to a hematologist who ran every test he could think of. We discovered I have an extremely rare bleeding disorder called grey platelet disorder. I have had three spinal surgeries since and had no abnormal bleeding. I have enough platelets (usually) but they do not work properly in the complicated cascade of blood clotting. Whenever I have any procedure or surgery, I must have three units of platelets before, three units 12 hours later, and then two to three units daily for the next three to five days. Most medical personnel (including doctors) have never heard of it. I’m not trying to diagnose you but I would urge you to see a hematologist asap! God bless and protect you and your precious baby.

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  • July 10, 2014 at 9:15 pm
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    I’ve been working at a labor nurse for 11 years, and I have seen my fair share of fetal demises, severe hemorrhages, neonatal codes, and even had a low risk patient who’s baby experienced an sudden cardiac arrest while she was in the middle of an unmediated, natural, spontaneous labor.

    I though that was the hardest thing that ever happened…until this past year. My young, healthy sister passed away due to complications of her pregnancy and delivery at 24.5 weeks. She developed an infection, abrupted, and simultaneously was hemmoraging and in DIC. She lived 5 days on life support receiving the highest levels of care available, including ECMO. She received countless units of blood products, but it wasn’t enough.

    I haven’t really been able to do L&D since then (focusing more on mother baby care at work these days) not sure if I will ever find my love for L&D again. It’s still unbelievable to me that mothers die in childbirth in 2014, even with all the near misses I’ve seen over the years. It’s so horribly tragic.

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      • September 6, 2015 at 4:32 am
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        It amazes me too that when pt comes in by ambulance without an IV!!! They will have a nasal cannula. Like they have a problem oxygenating! I remind the medics of the number 1 complication of delivering a baby. Almost twice the blood supply when pregnant with huge uterine arteries. A woman can exsanguinate quickly. We had a pt recently, we thought for sure was not going to make it while in DIC. She was hemorrhaging to death. She was a surrogate. No other risk factors. Emergent C/S went without complication. Then after the close, she started pouring blood. opened her back up, eventual hysterectomy, and still bleeding. Intubated, central line. 60 units of blood products, factor VII, factor VIII, DDAVP and Amicar. Pt went home with her baby!!!! UNBELIEVABLE!!! We probably had 25 people in that OR. Folks from the MAIN OR, RRT, Scrub Techs, 3 Anesthesia personnel, an Intensivist and finally Gyn Onc. There were some other extenuating circumstances that added to the situation, but damn, she survived! Of course we all have PTSD now!

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  • July 10, 2014 at 9:46 pm
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    Being a mother/baby RN and also being one of those scary pts to my co workers, my liver ruptured and I went into DIC with an ICU stay of 5 days and hospital stay of two weeks total… This is a great article… And I was one of the healthy ones that did everything I could to make myself and my baby healthy! Thank God I was healthy or I wouldn’t be here and neither would my son! Great article thanks for sharing!!

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    • July 10, 2014 at 9:49 pm
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      Also my mom can’t be a L&D RN anymore and works with me on the mother/baby floor instead…scared her that her daughter almost died…believe I’m one of the lucky ones!!!

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    • July 10, 2014 at 9:49 pm
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      It’s the nurse curse! I wrote a post about that, but I haven’t published it yet. So glad you and your baby are here and healthy. Xx

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  • July 11, 2014 at 12:43 am
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    One of my dream jobs is L&D- even knowing that I may one day have to encounter death when it should be a time of rejoicing in a family’s life (I’m an RN in my 4th year of working- worked in/ with long term care, rehab, handicapped patients, and currently pediatric home health). I was induced at 39w6d due to PIH that stopped responding to meds. I was thankful for the Dr I had. He inserted laminaria rods around 2pm the day before my induction and I went from about 1 cm to 4-5 cm when they removed the rods that evening around 8pm. My contractions had also gone from irregular to regular every 6 to 8 mins. The next morning they broke my water and started the Pitocin- which did nothing other than make me have horrible contractions, lower baby’s heart rate and cause my BP to continue to rise because my daughter was face up (head down though thankfully). They told me after 6.5 hrs on Pit that with my BP being that high that I needed to either have Mag or an epidural. I remembered from NSG school how sick mag made people so I wanted to try the epidural first. I had my husband and the nurse help turn me every half hr to 45 mins after the epidural and a few hours later baby decided to rotate and I had my baby after 3 pushes (pushed for 6 mins). I also had a NICU team at my delivery due to meconium being present when they broke my water and my OB was worried about my daughter possibly aspirating. Thankful my daughter turned out fine- born with an Apgar score of 9 (she’s 15 months and healthy as can be and super smart).

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  • July 11, 2014 at 3:14 am
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    I consider myself very lucky. I developed HELLP syndrome and delivered by emergency induction at 30 weeks, 3 days. My platelet count was too low for a C-section or even a epidural. My wonderful L&D nurses helped keep me calm even while my liver shut down and never left me. I had 15 hours to try to deliver and thank goodness, he came in 14.5 hours before a C-section was the last option. I was able to go home (although weak and anemic) 2 days later.

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      • July 11, 2014 at 4:55 am
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        Thank you. My family couldn’t believe I was on Facebook between contractions. haha It kept my mind off the pain…I wasn’t told how sick I was although my family was. My son stayed 70 days in the NICU and now is a happy, healthy yet wild 2 1/2 year old. :D

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  • July 11, 2014 at 5:03 am
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    I was recently induced at 42w5d due to low placental function and I was terrified of being induced. I was a L&D nurse and had seen the unimaginable before. I consider myself very lucky that I had an uneventful, easy and pain med free birth even on pitocin. but even now if I have another having to be induced is a great fear of mine. It breaks my heart to see that maternal death is rising.

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  • July 11, 2014 at 3:47 pm
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    Wow.

    This post acutely strikes a cord of terror and comfort in me. Odd.

    After an otherwise healthy (and utterly enjoyable) first pregnancy, I was induced at 41w3d. I had measured small throughout the pregnancy, and at 30 weeks began having braxton hicks contractions. I spent an evening hooked up to an IV for dehydration, was given a couple shots in case I delivered early, and was put on modified bed rest from weeks 30-37. I continued to have bhx – and often, the contractions, though painless, would last for 90 seconds to 2 or 3 minutes, and my abdomen would get VERY hard. Because of that – and because I’d done *some* reading up on induction (and was planning a 100% natural, drug free L&D – in large thanks to the simple fact that of my three sisters’ 11 kids, only ONE was born vaginally, the rest by CS) – I was hoping to avoid induction.

    Despite my history of hard and long bhx, my nurse-midwife still recommended induction. They wanted to use cytotec, but I’d read that a) it was contraindicated for induction, and b) that of all possible methods, it was the most likely to do irreversible damage. I.e. it could send me into a tailspin of extremely hard, extremely long, extremely dangerous-to-baby contractions that could lead to uterine rupture or atony, etc.

    Anyway, long story short: I was induced with pitocin. Water broke naturally 5 hours into labor. Despite having specifically requested throughout the day that “once active labor beings, I’d like the pitocin turned down or off,” my nurse and midwife (a different midwife than who’d done all my prenatal care) insisted it stay on, and at 14. 90 minutes after my water broke, I was being wheeled off to OR for an emergency CS when FHR dropped and couldn’t be recovered. He was born delivered 7 minutes later with a knot in his cord, but perfectly healthy.

    Because I hadn’t gotten an epidural (against my nurse’s nagging me to get one), they put me under general for the CS. I woke up 2 hours later, ready to hold my son, but with the distinct feeling of gushing between my legs. At the moment I asked why there was gushing, my doula noted that my lips were turning blue, and nurses were ushering my husband and son out of the room and a team was pushing me back to OR.

    5 Hours and 23 blood units later, I was in ICU without my uterus. 17 hours after he was born, I held my son.

    Uterine atony. “We don’t know why it happened.”

    But….I do! My uterus was bone tired! It was the muscle that had done the proverbial 10 hour wall sit, and it just snapped!

    Thank God I was as healthy as I was throughout pregnancy. I was a runner and did yoga near daily up until the day I delivered. My healthy heart allowed them to try for as long as they did to save my uterus, without rejecting the blood transfusions, or going into cardiac arrest.

    But I still can’t have any more babies. And I still wonder whether it could have all been prevented by just letting him come naturally. They were afraid he was a gigantic baby, and my body wouldn’t let him out. He was 7lb 8oz. And maybe, given my sisters’ histories and the knot in his cord, the CS was inevitable. I don’t know.

    But the point is… it kills me to know that my story wasn’t nearly as exceptional as I once thought. There are too many of us. Too many fathers like my husband going home a single parent. Too many women barred from future pregnancy. Too many.

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    • July 11, 2014 at 6:14 pm
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      You are so lucky to be alive. I’m so glad it wasn’t you in the story. You are the case that we all would have been praying for. And let me say thus in case any preggo’s are reading this…any induction medication in labor can be bad if poorly managed. But prostaglandins like Cytotec and Cervadil can be really beneficial for an unriped cervix. I’m so glad you are here!

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  • July 11, 2014 at 3:50 pm
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    ps: What’s oddly comforting is knowing that I’m not a forgotten nothing. My nurse came into my ICU room the day after, in tears over what had happened. And there is comfort in knowing some of you are as devastated as us to see things play out the way they do.

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  • July 11, 2014 at 7:53 pm
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    This post made me cry, I was a labor nurse for many years and saw this more than once. No one knows what we do, the average person thinks it’s all happy. I agree with you, everyone needs to understand what we do. I think of those we lost and those we nearly lost often. Childbirth is not easy nor is it always a perfect outcome. Inductions unless medically necessary are not the way to go.

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  • July 11, 2014 at 11:21 pm
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    I hemorraged after birth. I have no medical issues and I am a healthy weight. Planned pregnancy with everything done by the book concerning what you should and shouldn’t do. Got pregnant right away with no scientific interventions. Never been a smoker, etc. But I hemorrhaged badly and had to be given Pitocin injections and Cytotec was lined up to give me next. None of the possible reasons people discussed apply to me, but yet it happened. And now this article has scared me into thinking I shouldn’t have another baby because it could end like this.

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    • July 11, 2014 at 11:42 pm
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      The best thing about this is that you know you hemorrhaged. Just talk to your doctor and be prepared. There are things you can do to get your body ready for a pregnancy. Bad hemorrhages you get lots of meds and end up with a blood transfusion. Just talk to your doctor and take their advice xx

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    • July 13, 2014 at 7:12 am
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      I wouldn’t let your fear stop you from having a second baby. Not every woman has repeated hemorrhage with subsequent pregnancies. I would address your fears though. I don’t think enough attention is given to the potential PTSD from a traumatic birth…

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      • July 14, 2014 at 12:20 pm
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        I can testify that your right about the lack of attention given to PTSD after traumatic birth. When I hemorrhaged after the un-medicated birth of my third child, a uterine exploration was performed without sedation or pain meds. If you’re a L&D nurse, you probably already know that there was blood everywhere, nearly up to the doctor’s elbow. It was absolutely horrific. I actually put my mouth on the nurses arm who was holding my arms down to help me stay laying back against the bed and realized just in time that I definitely couldn’t actually bite her despite the pain! My midwife did not even seem phased by how concerned I was about how I was feeling at my follow up appointments. I suffered with PTSD for nine months before I was able to regain some control and didn’t feel “normalcy” returning until more than twelve months later. I still almost cry when I think or talk about it and it has made my current pregnancy much less joyful than it should be. The good news is that it seems like more people are realizing the possibility and others are talking about their own experiences.

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      • July 23, 2014 at 4:59 am
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        I have PTSD from a uterine inversion with my second. I had no idea it was even a possibility. I wish it was talked about more!!! I am so glad I was in nursing school right after her birth and was told to see a counselor.

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        • March 31, 2016 at 3:05 am
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          I just had an inversion three weeks ago after a normal pregnancy and delivery. It’s so hard to cope with when there is such little information available and no one talks about it.

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  • July 12, 2014 at 12:10 am
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    Man this story hits home. This was almost me.
    My water broke with my second child and after 12 hours of nothing going on the doc on call started pitocin. A few hour later, still nothing. They kicked it up and like a train I was hit with contraction after contraction. Finally my little one was born. About 15 minutes later I heard the sound of blood dumping on the floor and was rushed to the OR. Conscious for my entire duration in the operating room. I. Was. Terrified. For 12 hours I thought I would never hold my baby or see my other daughter again. I wouldn’t close my eyes for fear I would never open them again.
    When I was in recovery after a hysterectomy I though that was it- I could see my baby and my husband and start to put this behind me. They wheeled me from recover track to the OR, I was still bleeding and they had absolutely no clue where it was coming from or how to stop it. I (and my husband) was transported to another hospital and left my baby, hours old, in the care of the NICI nurses.
    The second hospital prepared me for embolization. Thankfully, they were able to stablize me and avoid another procedure. I spent a day in the ICU and around 36 hours after my daughter was born I finally got to hold her. So very thankful for the medical staff who attended to me and my family.
    I never got answers on why this happened to me. “Uterine attony, It just happens”, I was told. Two words just don’t seem like enough of an explanation.

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  • July 13, 2014 at 7:35 am
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    so sorry for your traumatic birth. I know that is frightening. And you’re right, it’s not enough of an explanation. But we don’t always get them….what I have noticed, observed or come to believe…is that God gives us experiences in life and yes, childbirth, that we NEED in order to best mother/parent/nurture that particular child. That things worked hard for, things sacrificed or suffered ….that those are the most treasured and loved things in our life….keep the faith. Your children are blessed to have you as their mother.

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  • July 15, 2014 at 4:25 am
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    completely heartbreaking but it’s childish to think it doesn’t happen. Thankfully there are nurses such as yourself out there.

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  • July 22, 2014 at 1:55 pm
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    As a surgeon, and a recent first- time mum…I have been both on the bed and beside it…. I have often had to do what you did…. change my bloody scrubs while tears flow…. tears for a stranger, or sometimes for a patient I’d come to know and like….

    Couple of months back, when I was in labour….the lady in the next room passed away during delivery…. As I was wheeled out elated and relived, with my miracle beside me…. I witnessed utter misery in the eyes of a new gradmum who had just lost her child while she was bringing her own into the world…. It was heart- wrenching and humbling….

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  • July 23, 2014 at 1:08 am
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    Thank you, just thank you! I’m a lucky one, I “survived”, but I deal with the trauma on a daily basis. I think of my experience constantly. Just one of the things I deal with is the thought of being forgotten. Your words have helped me so much! There are two nurses in particular who provided me with such wonderful care and I have a deep longing to see them, to hug them and to thank them. I already sent a thank you card to one, but I really want to see them. Have you ever had patients who nearly died come back to visit months later?

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    • July 23, 2014 at 1:13 am
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      Personally, no. We have patient’s who have almost lost their baby come back and visit, but I’ve never had a patient…

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  • July 23, 2014 at 5:05 am
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    I loved this post on so many reasons. First of all I am an aspiring l&d nurse. Buy also because I am one of those moms who survived. I had a uterine inversion 5 weeks before I started nursing school, so I relate to this way too much. However, for the first time I was able to read his as a nurse rather than the patient. I truly hope that I can be a labor nurse, but know I still need time before I could possibly deal with an emergency. But the fact that I could read this without horrible flashbacks gives me hope!!!

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  • August 24, 2014 at 8:25 pm
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    Thank you for your blog. I had a baby @ 30w/3 day due to PIH & HELLP & then had the same with twins @ 34 wks. Had a transfusion that time. My husband had gone home & would not have known a thing as it happened later & not at birth. The L & D nurses kept me very comforted with the whole thing, both times. They run the hospital.. I remember reading about a woman in NY who died right after having twins in 2011. Heartbreaking. I think about her often. I know the model Christy Turlington has a charity for mothers for situations like this, What can we do to help?

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  • October 12, 2014 at 1:59 am
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    I was induced 5 year ago with cervidil and my doc gave me cytotec after I delivered. Although my physician never said anything about my bleeding, I knew it was more than it should be. I work at the same hospital I delivered in(in the pharmacy) so I do know why he gave it to me. A few years ago(after I had my daughter) we had a mother die after refusing a blood transfusion numerous times because of religious beliefs. I was there while she coded and also again later when she was in the OR for assistance even though we all knew she would not survive. I will never forget how heartbreaking that was for all involved, especially her family. I have a great appreciation for LD nurses and I don’t believe everyone has any idea what you all do and how much you all deal with on a daily basis. So, to all nurses out there… thank you for all you do!!!

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  • November 24, 2014 at 9:08 pm
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    I’m sure you have seen the news story circulating the internet over the past week, of the mother who developed an amniotic embolism and was faced with chosing between her baby’s life and her own. She chose her baby, and she lost her life shortly after his birth.

    I cried my eyes out. And still continue to.

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  • February 12, 2015 at 12:51 am
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    WOW. This article is like a scene from my L&D room almost a year ago. I thankfully was a close call. I was 27, 6’1″, and 145 pounds when I got pregnant. I gained only 23 pounds with my pregnancy. Ate healthy. No issues. Valentine’s Day morning, my water broke at 7AM. No active labor. I hung around the house for a few hours before heading in just to be checked out (my OB had advised me to head to the hospital immediately if my water broke so I figured it was time). I had Pitocin pushed on me after an hour of walking and no real progress. It was started on a low dose and an hour later with not much progress, it was upped. I then went from a 2-10 in an hour. When I started pushing, my little one’s heart rate got a little out of whack so they watched it closely for the first few minutes and it calmed down. Within moments of delivering, my uterus inverted and within 10 minutes I was rushed to the OR, put under, and given 2 units of blood while the DR fisted my uterus back in place. I have always felt that the pitocin may have contributed to my birth complications but never really did the research. Looking back – I’d have listened more closely to myself. I’d have thought more about what I learned during my natural birthing class. And I would have waited longer at home. Thank you for this article and for sharing that this DOES happen. I was naive to think that it would never happen to me! And it did.

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  • February 15, 2015 at 6:34 am
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    As an L&D nurse I just want you ladies who are lucky to be alive to know that we never forget you and talk about you often amongst ourselves. We learn from you by sharing your stories that have shaped us into the nurses we are today. Your cases are what we never want to happen. All I ever want is a healthy mom and healthy baby.

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  • February 17, 2015 at 12:12 am
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    My last pregnancy after having 1 c-section and a VBAC, my doctor wanted to give me a schedules C-section. I said no. My water broke around 1 am Thursday morning and I didn’t give birth to my daughter until Saturday around 3 am. I fought to not get induced. I told the doctor that I know my body and no I will not have a C-section or get the epidural. Eventually after being in the delivery room for so long the doctor did eventually induced and I finally decided to get the epidural for the pain. But had it not been for the caring nurses who did what they needed to because they knew I refused o get another c-section, the doctor would have given me a c-section. Without the doctors consent, the nurses put an oxygen mask on my face. changed my position with they noticed the baby was uncomfortable. with their help I gave birth to my third baby without going under the knife. Yes I will admit that my labor was long and I was very stubborn, but I knew my body well and sometimes we have to go with our guts. Thanks for sharing this blog.

    Reply
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  • September 6, 2015 at 3:52 am
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    It isn’t just the nurses that cry and pray for the delivery of healthy babies and mamas being able to go home with their babies. I’m a medical technologist, work in the lab. I was working evening shift on a Thursday night and a girl came in, she was only 3.5 years older than me, first baby, beautiful little girl and after delivery she went south with hemorrhaging. I stayed over that night helping the overnight tech, we stayed in the blood bank just getting any product to save this girl’s life. I got home around 6am Friday morning and cried my eyes out. I had so much energy or adrenalin from working on this girl all night long that I sat on the couch for an hour before I was able to move. My kids and parents woke up to find me still on the couch with no sleep wide awake. I went into work everyday asking about that patient, making sure she was still here, making sure that we were prepared for anything that was needed for her. I have since forgotten her name, and about a week after delivery she was shipped to a different hospital more equipped to take care of her but there isn’t a day that doesn’t go by that I don’t say a silent prayer for her. She too had a hysterectomy so no more babies for her, and that’s sad, maybe she wanted more, but she’s here to help raise her beautiful daughter.

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  • November 16, 2016 at 9:07 am
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    I had my second baby almost 2 weeks ago. A difficult and traumatic first birth made me horribly anxious but the midwives I had were fantastic. I was induced due to dates (I was 10 days over and no signs of imminent labour) and everything started well. The broke my waters, and 3 hours later started Pitocin to establish regular contractions. I only had a low dose, but the contractions were soon coming back to back and I had an epidural. I pushed my baby out after 5 hours of labour and she was beautiful. I got to hold her for 90 seconds before I asked my partner to take her because I was feeling weak and didn’t want to drop her. Then I started feeling nauseated and lightheaded, then I started going deaf. I felt a huge splash and said to my midwife ‘that’s blood isn’t it’ and then I was suddenly being worked on by about 10 different people. I had a partial uterine inversion, I was losing blood so fast and noone could get my uterus back into place. I ended up being raced to theatre, my partner standing alone in a room full of blood, holding our baby girl. I woke up the next day in the ICU of a different hospital. They had to surgically replace my uterus, I lost 4.3 litres of blood and nearly died. My mother and my (pregnant) sister were terrified. My partner was distraught. Our baby was in the first hospital being cared for by nurses. Our 3.5 yr old son was on his 3rd sleepover in the row at nannas house. I felt like someone else. I opened my phone to take a photo of myself to see what I looked like and my partner had taken some photos of our baby on my phone so I could see her. I cried until I was transferred back to be with her 2 days later.
    I was lucky. I survived, although it was close. 6 days later, I went home to my family. I won’t ever forget the staff I had in hospital, the midwives who made my daughters birth wonderful and the way they helped us when it went wrong.

    Reply

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