The Impact of Maternal Mortality on Healthcare Providers

At the AWHONN Convention in New Orleans this year, I was able to attend a presentation given by Dr. Betsy Kennedy and Dr. Suzanne McMurtry Baird called When a Mother Dies: Supporting Families and Care Providers. The presentation discussed how healthcare providers can better support families who are impacted by maternal mortality, and addressed the emotional impact maternal mortality has on healthcare professionals. It was the first time I have heard someone openly talk about how the death of a mother impacts us, as providers.

We have all experienced adverse events. And as we all know, holidays and weekends and even the worst possible outcomes do not negate the fact that people do not stop needing the care we provide. We don’t really have time to grieve before we take a deep breath and resume taking care of our patients again. Any time I have ever experienced an unexpected outcome, it never fails—I feel this unanticipated surge of strength rise inside of me. It silences any cries that attempt to bubble up inside of me. This obligation weighs heavy on me, more so than I knew. I feel driven to “keep it together” for my patients and their family. Sometimes, I’ll escape to an empty room and I’ll try to catch my breath. Sometimes, I have trouble breathing on my drive home.  But I never allow myself to shed a single tear. I will walk through my door and I’ll be greeted by my family, who will remain unaware of any events that happened during my shift. My husband will hear that I had a “horrible day,” but any story I have witnessed will stay with me.  My husband won’t hear about it because I’m not allowed to talk about it, and it doesn’t matter, because he wouldn’t understand anyway. There is only one point where I allow myself to cry after an unexpected event: after everyone is asleep, like a ritual, I take a bath and cry alone in a tub full of warm water. And when I step out of the bathtub, I leave my tears there, swirling around in my bath water. I bury any grief deep inside of me, so afraid to breathe a word for fear I’ll start screaming out every injustice and I won’t be able to stop.

The presentation validated my feelings of grief. Looking around the room, I saw pain so plainly portrayed on the faces of every single person in the room. As the presenters talked about caring for a woman’s body after death, another nurse in the audience raised her hand and offered her own personal insight: she mentioned that if the patient’s mother was present, we should offer her the opportunity to care and prepare her daughter’s body after death. This can be therapeutic for them, she said. The entire room went silent. Both presenters audibly choked up. Of course, her advice made perfect sense. After all, we encourage a mother to care for her dead baby after they experience a stillbirth, so why wouldn’t we encourage a mother to care for her adult daughter if she dies after giving birth to her own child? We all cried because it’s sad and it shouldn’t be true and we don’t understand why this is even an issue. And I cried because I realized that even when talking about how we cope with grief as a healthcare provider, it was so evident that in our hearts, we were all still thinking of how to better serve others.

I cried silently for the remainder of the presentation, as did most of the people in the room. I shot the following video a few hours later. The lighting is bad, the angle is worse, but my message is pure —we have to work together to find a way to address maternal mortality. In the video, through tears and notifications of text messages and work e-mails, I mentioned my own mother, who is also a nurse. A few weeks before the conference, a friend contacted me to tell me that her cousin had decided to become a nurse, and she thought her cousin would have the opportunity to shadow my mom. She was excited about this because my mother had taken care of her cousin when she was born prematurely and admitted to the NICU. Her family had always remembered the care my mother had provided all those years ago, because they were grief stricken—they unexpectedly had a NICU baby and her mother had died during childbirth. I felt suffocated by the beauty and sadness of it all, thinking of my mom taking care of a baby whose mother had died giving birth, and then years later, thinking of my mom helping her become a nurse who would maybe provide the same care in the same situation. Of course, my mother had never told me that story, even though I knew the family pretty well. But when I mentioned this to my mom, she immediately knew her name and what room number her mother had been in.

Throughout the presentation, I thought of my friend and her family and I thought of the care we provide as nurses. I couldn’t help but think that after all of these years, we’re not any closer to ending maternal mortality…in fact, our rates have only increased and now I have my own stories buried deep within me.

The healthcare profession is so deeply embedded in our core. We don’t even understand the full extent of our power as nurses, power to impact a patient, power to impact a population. I don’t know where to start or when it will end, but I know that we have to give a voice to the problems that impact us, and most importantly, the problems that impact our patients. Think of everything you know to be true, everything you have witnessed and lived through. Whatever stories you have hidden within, know that they are validated, even if we don’t speak of them. Let these stories propel you forward. Let these stories drive you to do great things for our nursing profession and for the patients we dedicate our lives to. Alone, we can change everything for the people we care for. Together, we can change everything ♥

Until my next delivery ❤

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