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


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86 Comments on "It Happens in the United States"

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Lisa
Guest

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.

Kim
Guest

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.

Debbie
Guest

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…

Anonymous
Guest

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..

Lindsay
Guest

Why do you suppose there is an increase in this happening in the USA? I’d love to hear your thoughts on that.

Nurse Ratched
Guest
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… Read more »
Lindsay
Guest

WOW. That is a crying shame. All of it. Thank you for sharing your perspective.

KO
Guest

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.

Anonymous
Guest

Four reasons generally cited;
1. Increased ascertainment
2. Obesity
3. C section rate of 30%
4. Advanced maternal age.

karynd
Guest

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.

Lisa Lu
Guest

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.

Anonymous
Guest

Moms are older and the pregnancy exasabates older diseases such as high blood pressure ,type 2. Diabetes weaker muscles for pushing and induced labor.

Anonymous
Guest

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.

KerryLR
Guest
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… Read more »
Anonymous
Guest

You were induced for a good reason. Please don’t let this blog have u think otherwise. Polyhydraminos can cause abruption if the delivery is not controlled and hemorrhage because the uterus is stretched so far beyond its normal limits. You had great care!

Leigh Milich
Guest
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… Read more »
deleted
Guest
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… Read more »
Sara Hutton
Guest

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.

Anonymous
Guest

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.

Anonymous
Guest

Agreed. Most inductions are not malicious actions. The opinions in this blog need to backed by appropriate research.

Southern Fried OB
Guest

Sorry, that posted before I was ready- induction on a favorable cervix does not lead to hemorrhage.

Skipper McCormick
Guest

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….

Reenie Mayes
Guest
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… Read more »
Kelly Hardy
Guest

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.

older chicken
Guest

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.

Stephanie
Guest
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… Read more »
mamafawnlei
Guest
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… Read more »
Anonymous
Guest

Uterine atony

Anonymous
Guest
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… Read more »
Rian
Guest

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!!

Rian
Guest

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!!!

Jennifer S.
Guest
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… Read more »
Nea
Guest

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.

adorahmae
Guest

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.

Amy Courts
Guest
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… Read more »
Amy Courts
Guest

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.

Kathy
Guest

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.

Carrie
Guest

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.

Kathleen Dobbs Hawkins
Guest

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…

Stephanie
Guest
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… Read more »
Anonymous
Guest

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.

Joelle
Guest

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.

Brianna
Guest
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… Read more »
Kathleen Dobbs Hawkins
Guest

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.

HouseWifeGiggles
Guest

completely heartbreaking but it’s childish to think it doesn’t happen. Thankfully there are nurses such as yourself out there.

jaznajalil
Guest
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… Read more »
Anonymous
Guest
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… Read more »
Alicia
Guest
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… Read more »
Marie
Guest
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… Read more »
Anonymous
Guest
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… Read more »
ChristineH
Guest

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.

Lindsey
Guest
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… Read more »
Melissa
Guest

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.

Anonymous
Guest
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… Read more »
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[…] serve, and for the profession that so strongly defines us?  With one of my first experiences with maternal death, I realized early in my nursing career that we have so much work to […]

Anonymous
Guest
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… Read more »
Angelica
Guest
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… Read more »
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