For Every Woman Who Dies In Childbirth In The U.S., 70 More Come Close

[umsami]

This is a sobering article.

Women who've gone through this offer the advice, if you hemorrhage, don't clean up after yourself--so they'll take you seriously.  ? 

 

https://www.npr.org/2018/05/10/607782992/for-every-woman-who-dies-in-childbirth-in-the-u-s-70-more-come-close

 

"A mother giving birth in the U.S. is about three times as likely to die as a mother in Britain and Canada.

In the course of our reporting, another disturbing statistic emerged: For every American woman who dies from childbirth, 70 nearly die. That adds up to more than 50,000 women who suffer "severe maternal morbidity" from childbirth each year, according to the Centers for Disease Control and Prevention. A patient safety group, the Alliance for Innovation on Maternal Health, came up with an even higher figure. After conducting an in-depth study of devastating complications in hospitals in four states, it put the nationwide number at around 80,000.

 

"It's referred to as the tip of the iceberg because for every woman we lose, there are lots of other women that we come very close to losing," says obstetrician Peter Bernstein, the director of the Maternal-Fetal Medicine division at Montefiore Medical Center in New York."

 

[Dmmetler]

I am one of the 70. HELLP syndrome at 22 weeks. My son died. I almost did. I at least partially blame the insurance company who made me switch to an OB practice because my regular GYN didn’t deliver at their covered maternity hospital. As a result, no one picked up just how major my rise in BP was from my pre-pregnant baseline, only noting it was slightly elevated at 20 weeks (at which time I was having headaches and seeing spots, which were largely blown off as “it’s close to Christmas and you’re a teacher. Sit down as much as you can, and rest up over the break”. I got horribly sick on Christmas Day, flew home the day after, and ended up being admitted to the hospital that night-and taken through triage straight to L&D and then to Maternal-fetal ICU. I am convinced that their fast response, and the choice of the nurse in triage to call the perinatologisf immediately, probably saved my life. 

[GoVanGogh]

Dmmetler, I am so sorry to hear about the loss of your son. 

I had HELLP syndrome. My son and I both almost died from it. It was a horrible experience. I am still shocked how little is know about HELLP or how few doctors know about it. 

[frugalmamatx]

I'm one of the 70 as well - twice over. First from losing over 50lbs in the first trimester due to Hyperemesis Gravidarum that was incredibly poorly treated. Secondly from a complication in delivery - turns out I'm one of the rare few who cannot take demerol and phenergen together without it causing me to lose the breathing reflex. But if they'd read my charts...they'd have known I had issues with Phenergen already. And I didn't even ASK for nausea meds in labor! All I asked for was to change postitions because my back {spinal issues} was killing me from laying flat. 

[hellen]

I'm one of the 70 as well.  My story is similar to the one in the article.  The ER misdiagnosed my gushing blood as a period.  The ER doctor even described it as a volcano.  Nevertheless, I was sent home.  A week later, I returned in hemorrhagic shock.  I had a very tiny piece of retained placenta that they found during surgery that caused the problems.  I didn't present as a classic case of retained placenta, but I wish I had.  

[ktgrok]

My sister wasn't close to death (although if she'd hit her head she could have been), but another case of them just not LISTENING to women. She was in labor and has a history of low blood pressure, as well as vagal reactions that actually almost have stopped her heartbeat. They gave her a walking epidural and, as could be predicted, it lowered her blood pressure. She TOLD the nurse that her blood pressure felt like it was very low, and that she was lightheaded. (remember, this has happened to her before in medical situations). They took her blood pressure and it was so low the nurse told her the machine (automatic blood pressure cuff) must be broken, it couldn't be that low. They then told her that she'd feel better if she got up and walked around!!!!! So they had her, complaining of low blood pressure and lightheaded ness, with a walking epidural, and a very low blood pressure reading, get up and go to the bathroom. She ended up passing out on the toilet and they didn't have a nurse strong enough to pick her up. Like I said, had she fallen and hit her head she could have seriously injured herself or worse. Her husband was screaming her name as she was unconscious and ended up being the one to lift her to the bed. After a few rounds of smelling salts and him screaming at her to wake up they finally got her conscious again. And realized that wow, yeah, her blood pressure WAS low. 

idiots. 

[Lady Florida.]

Ddil almost died along with our youngest grandson when she had a placental abruption. She had no risk factors and no symptoms until she started bleeding. She was home alone with her then 2-1/2 yo. Fortunately her sister lived 2 minutes away. She called her and said "get over here now" then immediately hung up to call 911. As a nurse she knew that once she got on the phone with 911 she wouldn't get off and needed to get someone to take the 2 yo. He saw the blood and kept saying "mommy has a boo-boo".

She was helicoptered to a hospital in Orlando and thanks to the quick thinking of first responders as well as the medical staff at the hospital, she and the baby made it. It was terrifying.

Because of that and her age, her current pregnancy is considered high risk. 

[Kassia]

5 minutes ago, Lady Florida. said:

Ddil almost died along with our youngest grandson when she had a placental abruption. She had no risk factors and no symptoms until she started bleeding. She was home alone with our then 2-1/2 yo. Fortunately her sister lived 2 minutes away. She called her and said "get over here now" then immediately hung up to call 911. As a nurse she knew that once she got on the phone with 911 she wouldn't get off and needed to get someone to take the 2 yo. He saw the blood and kept saying "mommy has a boo-boo".

She was helicoptered to a hospital in Orlando and thanks to the quick thinking of first responders as well as the medical staff at the hospital, she and the baby made it. It was terrifying.

Because of that and her age, her current pregnancy is considered high risk. 

 

I almost died with my twin sons due to a placental abruption.  I was only bleeding internally and no one knew what was wrong with me.  It was awful and scary, but I am grateful we all made it.  

 

[SamanthaCarter]

Came very close to death from HELLP here too. They saw it coming thankfully. DS was term, so he was okay. I have over 24 lost hours of no memory after I first held DS. Three surgeries to repair me. For all the negetivity, I am truly grateful for modern medicine. 

[Murphy101]

Well most here know my birth stories. So this sounds about right in my crappy experience. 

Love my kids, but it’s mostly pure dumb luck me and baby survived each pregnancy. I sure wouldn’t attribute it to modern medicine bc that seemed lacking more often than not. 

 

[HS Mom in NC]

When I was pregnant with middle daughter at 40 weeks in early labor the placenta started tearing off, the midwife started transferring us to the hospital from our homebirth, then a few minutes later my left falliopian tube spontaneously ruptured (unknown to us.) We got to the hospital 10 minutes later, the placenta tore some more, they did a crash c-section, the placenta popped out, they yanked her out, noticed the continued bleeding, sewed my fallopian tube back together, and here we are, just fine.  We nearly died, but it wasn't malpractice. The system worked like it was supposed to and we're thankful to everyone each step of the way in the process.

[HS Mom in NC]

1 hour ago, StellaM said:

If the system is working as it should, why are the rates so much higher than those in comparable nations, like the UK ?

Are you replying to me? You may not be, but if you are,  I was speaking of my individual situation where the system was working like it should.  We knew at 11 weeks that part of the placenta had torn off the uterine wall, and there was a very small chance it could tear completely away at some point in the future.  We decided what we would do about that after consulting back up OBs.  The fallopian tube was completely unknowable beforehand or at the time because it's unheard of for one to spontaneously rupture, but they did what they could as soon as they realized what was going on. It wasn't because of a failure to the system in our situation.  This discussion is taking a turn where we talk about separating out sh!t happens situations that no one could predict or avoid from situations where the system fails to recognize symptoms of predictable, avoidable situations. Those are two completely different things and need to be addressed differently.  

[TravelingChris]

All three of my pregnancies had issues and furthermore, many other times there were warning signs but it wasn't until I was almost 50 that an orthopedist suspected blood clotting and it was confirmed.  I had problems in all three pregnancies with clotting.  I had to be rushed to ER because of sudden bad bleeding and giant clots a few weeks after my second pregnancies.  My left leg swelled up hugely in my third pregnancy but for whatever reason, they did not find the clot with the ultrasound.  I was getting clots from IVs and nurses said it was normal.  I had sudden lung pain the evening after my cast on a leg came off, and they did put me in ICU and gave me heparin all night and by mid-afternoon, my embolism wasn't seen.  No other follow up which doctors now can't believe.  Nor my story of giant swollen left calf either.  But I am alive and my one dd who did get the Factor V Leiden gene knows about it and so do her doctors.  She will be considered high risk when she gives birth (like I was too in my third pregnancy because of Antiphospholipid Antibodies and the possibility of neonatal cardiac issues due to other autoimmune issues of mine) and will be taking daily blood thinning shots during pregnancy.  She also can't use hormonal birth control just like I can't use any hormonal creme for problems with dryness or menopause treatments.

[Guest]

On 5/11/2018 at 8:39 AM, Lady Florida. said:

Ddil almost died along with our youngest grandson when she had a placental abruption. She had no risk factors and no symptoms until she started bleeding. She was home alone with her then 2-1/2 yo. Fortunately her sister lived 2 minutes away. She called her and said "get over here now" then immediately hung up to call 911. As a nurse she knew that once she got on the phone with 911 she wouldn't get off and needed to get someone to take the 2 yo. He saw the blood and kept saying "mommy has a boo-boo".

She was helicoptered to a hospital in Orlando and thanks to the quick thinking of first responders as well as the medical staff at the hospital, she and the baby made it. It was terrifying.

Because of that and her age, her current pregnancy is considered high risk. 

This is what happened to me, though my baby did die. Testing for another pregnancy revealed that I have a blood clotting disorder. I had heparin shots throughout that pregnancy (my youngest child). 

[Guest]

Quote

 But I am alive and my one dd who did get the Factor V Leiden gene knows about it and so do her doctors.  She will be considered high risk when she gives birth 

If you don’t mind sharing, at what age and theough what method did you learn that your dd carries the gene? This is in the back of my mind as something my dd should investigate at some point before she has a pregnancy. 

[TravelingChris]

One real issue that we have in our country that Britain does not have is really rural places and lack of medical care in those places. I live in a state with many rural counties that have no hospital at all.  

[happypamama]

I am one of those who nearly died. After being diagnosed with preeclampsia without severe features, I was (properly) sent home on BP medication. If I hadn’t checked my BP at home out of curiosity, I wouldn’t have realized that my preeclampsia had escalated in a short period of time, and it’s extremely likely that I would have had a stroke or died. When I was admitted to the hospital, my systolic was 200, and I had NONE of the typical preeclampsia hallmarks such as headache, swelling, liver pain, or visual disturbances. Nobody screwed up. Nobody missed anything. They all did exactly what they were supposed to do, and because of that, although my son didn’t survive (nobody screwed up or missed anything with him either; it was just bad luck), ladies, I am a SURVIVOR!  I am here to celebrate Mother’s Day, and I work hard to help other moms know the symptoms of preeclampsia, eclampsia, and HELLP and to help them advocate for themselves and their babies.  

 

ACOG has recently started a new trend, which is a fourth trimester concept. This is really great!  Preeclampsia, for instance, can strike up to six weeks postpartum, even if you never had it before.  Many women are dismissed from the hospital and not seen again until their six week checkups. They aren’t getting blood pressure checked, aren’t getting real questions about PPD, etc. I’m so glad ACOG is noticing and trying to do better. 

 

(May is Preeclampsia Awareness Month. Knowledge saves lives!)

[freesia]

I hemorraged severely after my second.  It was internal, so, while I was complaining of pain (after not complaining during a natural birth) it took a while for them to realize what was going on.  I have no doubt that I would have died in years past.  I also hemmoraged with my third and I can't remember with my fourth (but I think I would remember). 

On the birth outcomes--well I had awesome care in Canada when pregnant with my first and was on bedrest for pregnancy induced hypertension.  I had weekly visits with nurses and daily check ins.  I never got pre-eclampsia.  When I had Gestational Diabetes, also in Canada I had exceptional care--weekly visits to a GD clinic with nutritionists and appts with the endo weekly while there.  When I had GD during the next pregnancy in the US I was sent to the endo, who gave me insulin and I never saw him again.  The organized care with High Risk pregnancies in Canada was incredible (and so easy to access and no surprise bills).  To me, that would influence the outcomes.  And, as my dh was in grad school with my first pregnancy, it is unlikely we would have been able to access/afford that level of care in the US due to our pitiful income at the time (which became non-existent when I went on bed rest).

[Melissa in Australia]

1 hour ago, TravelingChris said:

One real issue that we have in our country that Britain does not have is really rural places and lack of medical care in those places. I live in a state with many rural counties that have no hospital at all.  

I live in a Country that has vast amounts of rural areas with not so much medical facilities. It is 100 km to the nearest hospital that delivers babies from where I live. But maternal deaths are much lower than USA

i think the big difference is universal health care. Countries with universal health care have better maternal health, less maternal deaths and a general longer life expectancy 

[umsami]

4 hours ago, Quill said:

If you don’t mind sharing, at what age and theough what method did you learn that your dd carries the gene? This is in the back of my mind as something my dd should investigate at some point before she has a pregnancy. 

I have Prothrombin II mutation (another blood clotting disorder).  I found out after my third pregnancy because my bio dad found me and contacted me about it after he was in the hospital for clots.  It probably played a part in a few of my miscarriages, but who knows.  DH has Factor V Leiden.  My kids have sadly inherited both.  I found out through 23 and me and had it confirmed through my internist doing blood work.  I've been told that DD should not use hormonal birth control.  

[Murphy101]

3 hours ago, Melissa in Australia said:

I live in a Country that has vast amounts of rural areas with not so much medical facilities. It is 100 km to the nearest hospital that delivers babies from where I live. But maternal deaths are much lower than USA

i think the big difference is universal health care. Countries with universal health care have better maternal health, less maternal deaths and a general longer life expectancy 

 

This. Many 1st and 2nd world countries have rural issues and most of them have healthier maternal/fetal outcomes that the states. 

[TravelingChris]

But we basically have universal care for pregnancy and also kids in my state and it is still higher.  Also, our lifespan is the same as countries with universal healthcare.  My dd went to a country with universal healthcare and got very bad care overall and could have died easily because of the hesitancy to prescribe expensive medicines that keep her alive and out of hospitals.  One wasn't an expensive medicine but again not in the very controlled pharmaceutical system.  I would probably be alive but much more disabled in some of the universal care systems.  Every country's plan has good points and bad ones.  

In Belgium, for example, they use xrays with more radiation.  That might be bad for someone but it was very good for me- US low radiation xrays misdiagnosed me with a very serious lung disease but the Belgian higher radiation properly found I have no such thing.  Belgium prescribes anti-coagulant medication with leg fractures, US doesn;t and has more clotting deaths but maybe less hemorrhaging deaths.  Choose your poison.

[Jennay]

On May 11, 2018 at 8:40 PM, HeighHo said:

I didn't die from the birth, but the downstream effect of the folic acid poisoning from the prenatals nearly did me in, and will definitely shorten my life. Everyone that is pregnant should be screened genetically for MTHFR cycle and B12 mutations, as the overload of folic acid in that prenatal is going to give you severe problems if you have the wrong mutations.  Right now they are saying that 30% of the population is impacted by the MTHFR mutations, about 10% have double mutations that are going to cause enough genetic damage in combo with the folic acid overdose that you may not get to see the baby grow to adulthood.  Be very careful; folic acid free prenatals are available to those that need folate instead of folic acid, or those that get sufficient folate from diet to protect the baby from neural tube defects.  

The baby started choking after the nurse gave him to me and left.  I couldn't reach the call button -- my newly stapled incision wouldn't let me move my body in the necessary contortion. Painful, very painful to get 'er done, and he was done coughing up the mucus by the time she returned so she cleaned him up and gave me my painkiller.  I learned to make sure I could reach that button easily.

They (the doctors) knew I had MTHFR after numerous M/C and the treatment at the time was to take mega doses of folic acid,B6, and B12.   I have since switched doctors and now take the methyl forms and seem to be fine but I am scared about what could damage could have been done.  What genetic damage does the overload in folic acid cause? How do you know if you have genetic damage? I am compound heterozygous.  I am scared to google....

[Murphy101]

6 hours ago, TravelingChris said:

But we basically have universal care for pregnancy and also kids in my state and it is still higher.  Also, our lifespan is the same as countries with universal healthcare.  My dd went to a country with universal healthcare and got very bad care overall and could have died easily because of the hesitancy to prescribe expensive medicines that keep her alive and out of hospitals.  One wasn't an expensive medicine but again not in the very controlled pharmaceutical system.  I would probably be alive but much more disabled in some of the universal care systems.  Every country's plan has good points and bad ones.  

In Belgium, for example, they use xrays with more radiation.  That might be bad for someone but it was very good for me- US low radiation xrays misdiagnosed me with a very serious lung disease but the Belgian higher radiation properly found I have no such thing.  Belgium prescribes anti-coagulant medication with leg fractures, US doesn;t and has more clotting deaths but maybe less hemorrhaging deaths.  Choose your poison.

 

In my state, the thresh hold for income to get state pregnancy and child medical is actually rather high. (Or should I say low? Anyways. You can make a low income by anyone standards and still not qualify.)  It is very common for women to not have insurance for themselves/pregnancy or their children. I was one of them for many many years. 

It’s hard to find a Obgyn who will accept state insurance. So the few who do have a huge number of patients.  Whereas in most countries with genuine universal healthcare, they often have more doctors and facilities available.

And I can’t say this enough. Having insurance does not equal having actual healthcare. 

And lastly, these numbers aren’t separating out those with insurance or without. Or rural vs city. And comparing like to like in other countries. Over all, no matter who or where you are, if you are having a baby in the United States, that alone ups your chances of a negative delivery outcome. And it’s outrageousness that our nation has no excuse for and should raise one heck of a ruckus to demand better. Why aren’t we? Why is this acceptable in our country? Why aren’t we fighting now, even if we survived and are done, for the sake of our daughters?

[Happy2BaMom]

7 hours ago, TravelingChris said:

But we basically have universal care for pregnancy and also kids in my state and it is still higher.  Also, our lifespan is the same as countries with universal healthcare.  My dd went to a country with universal healthcare and got very bad care overall and could have died easily because of the hesitancy to prescribe expensive medicines that keep her alive and out of hospitals.  One wasn't an expensive medicine but again not in the very controlled pharmaceutical system.  I would probably be alive but much more disabled in some of the universal care systems.  Every country's plan has good points and bad ones.  

In Belgium, for example, they use xrays with more radiation.  That might be bad for someone but it was very good for me- US low radiation xrays misdiagnosed me with a very serious lung disease but the Belgian higher radiation properly found I have no such thing.  Belgium prescribes anti-coagulant medication with leg fractures, US doesn;t and has more clotting deaths but maybe less hemorrhaging deaths.  Choose your poison.

 

While I have empathy for your personal experience, it does not change the fact that the U.S. spends far more on health care than any other high-income country (all of whom have some form of universal health care) and, by many measures of societal health, we have worse outcomes. 

My focus has shifted to directing my kids to develop skills/education/languages they can use to obtain employment in other countries that offer health care. They might need it in their generation.  Premiums are expected to rise at least 10% this year at dh's work. On top of the gazillion-+ percentage raises we've endured over the last many years. 

[lexi]

I’m a HELLP survivor as well. My doctor missed it and all my calls and complaints about horrific back pain and sudden swelling were completely dismissed. Even at my appointment she blew off all my concerns. 

A few days later I was having trouble breathing and couldn’t stop vomiting. My poor hubby rushed me to ER where they discovered my blood pressure was sky high and my liver was hugely swollen. 

It was a total mess and I lost all respect for that doctor. Even afterward she did not take adequate time to explain what happened and she showed zero compassion. Ever since then I’ve had wonderful midwives who monitor me very closely and I’ve had much better outcomes. I appreciate that they listen to me and take me seriously. 

 

[Murphy101]

1 hour ago, happysmileylady said:

I thought of this thread when I heard a commercial (PSA?) on the radio yesterday.   It presented a statistic that 1 in 3 of the mother’s giving birth at the local hospital (which is the only one in the county) tested positive for illegal drugs at the time they were giving birth.  That statistic is horrifying to me.  A third of pregnant women in this area are doing drugs while pregnant?!?!  I live in an area where the opioid epidemic is a big issue, but I never imagined that a third of pregnant women are doing drugs. I can’t imagine that giving birth while high on heroin contributes positively towards the maternal death rate. 

 

One, the opioids epidemic is predominately prescribed medications.  A prime example of insurance not meaning healthcare.  So many people can't afford solutions for so many reasons, so they take pain medication hoping if they can get enough work done eventually they can get solution based medical treatment.  

Two, the opioids epidemic, or drugs in general, is not an American exclusive problem.

This does not account for our higher mortality rates.

And it smacks of implying certain people deserve their lack of care and justifies as a do nothing excuse.

[Katy]

12 minutes ago, Murphy101 said:

 

One, the opioids epidemic is predominately prescribed medications.  A prime example of insurance not meaning healthcare.  So many people can't afford solutions for so many reasons, so they take pain medication hoping if they can get enough work done eventually they can get solution based medical treatment.  

Two, the opioids epidemic, or drugs in general, is not an American exclusive problem.

This does not account for our higher mortality rates.

And it smacks of implying certain people deserve their lack of care and justifies as a do nothing excuse.

 

Eh, illegal drugs implies it is not simply the opioid epidemic, even if the PP conflated the two in her mind. And while "the majority" may start on prescription pain medicines, most aren't starting an addiction on Vicodin, but on Oxycontin prescribed to someone else. When they run out of that they turn to illegal drugs.  It's drugs laced with cheap and deadly Fentanyl that kill people, not Vicodin.

There is also a huge difference between people who get a physical dependence on pain medicine for a legitimate medical problem and recreational users who develop an addiction (emotional dependence) as a way to self medicate psychiatric problems. IME very few people with psychiatric problems and emotional addictions who've tried Fentanyl want to get clean. Most of them don't care if they die, even when rehab is free and their children are taken from them.

I honestly don't know what can be done with people like that without reinstating federal funding for psychiatric hospitals and getting people through detox, rehab, and months of inpatient treatment on an involuntary basis.  I've known too many parents who chose addiction and death over their own kids, even after court-ordered free rehab.

Having taken care of some of the babies born with NAS, it doesn't surprise me at all that in some areas 30% of kids test positive for illegal drugs. I still get surprised by how many babies get abandoned at the hospital once their parents are told social services has been notified of the mother's drug use though.

[Murphy101]

I don't no know that it matters when or how someone got addicted.  No one grows up thinking, gee I wanna be strung out and dead by 30.

I completely agree we need better mental health services, or even to have some at all pending the locale, but there's much that we do know about mental health already that could be alleviated with better social policies aside from healthcare in the strict medical sense.  Better work and family and education policies for starters.

[Mimm]

My SIL almost died last year. She hemorrhaged and ended up needing an emergency hysterectomy. She spent the first day of her son's life in the ICU.

I suspect everyone here either almost died or knows someone who did.

[Lady Florida.]

7 hours ago, Mimm said:

My SIL almost died last year. She hemorrhaged and ended up needing an emergency hysterectomy. She spent the first day of her son's life in the ICU.

I suspect everyone here either almost died or knows someone who did.

In the situation with ddil which I mentioned upthread, she spent the first day and a half in a different hospital from our grandson. They're close to each other and it was actually a good thing, but it was still stressful. She was helicoptered to the regional hospital and after an emergency c-section he was moved over to the children's hospital as soon as he was stable enough to make the approximately one block trip. Almost 2 days later, when she was stable, they moved her to the hospital where he was.

[kbutton]

I believe the article mentioned that one reason for this problem is that healthcare providers are constantly not expecting problems (and this goes well beyond pregnancy--read up a bit on how many people die of cardiac aneurysms even when THEY KNOW and THEIR DOCTORS KNOW that they have a cardiac aneurysm, and then read about stats of how many people don't know they have them because doctors assume it's an early heart attack...heads are placed firmly in sand, if not the buttocks). If you think your patient won't be the statistic, then you aren't going to be as proactive, IMO. In my case, no one wanted me to have pre-eclampsia because it was a second pregnancy with the same father, and I didn't have it with my first. So, I guess my body was supposed to read the stats and obey.

I had what was then considered subclinical pre-eclampsia. I think guidelines have evolved, though maybe not US guidelines. I definitely met the updated criteria from what I've read in recent years. At any rate, my worst symptoms happened at home and leveled out, and it was implied that I had made them up. Worse, one doctor in the practice (to the embarrassment of the other doctor) that a family member more than well-qualified to take my blood pressure might have been mistaken. Hugely insulting. Anyway, I went from what would've been considered low BP for even a non-pregnant woman to spikes that made my head pound and made me sick. Then it leveled out to just being "high." I gained numerous pounds of water weight overnight that stayed. I hemorrhaged after delivery, but it wasn't gushing out--it was staying inside and not allowing my uterus to clamp down. I would have one vague symptom, it would resolve, then another vague symptom. It just cycled like that until suddenly I had all the symptoms closer together (and a nurse went the extra mile to notice), and by then, it was an emergency. A resident cleaned out the clots, but I was almost wheeled to surgery. Fun stuff. 

My BP has never been stable since then. My primary care doc thinks it's white-coat-itis and has never even asked my pregnancy history (more heads in the wrong places). I have unexplained liver enzyme issues. Apparently it's nothing...

[Murphy101]

I can completely understand why a mother wouldn’t go see her baby after she knew CPS was involved.

Why would they want to visit/hold a baby they knew they were never going to take home?

And the shame of knowing it was their weakness and decisions that led to their baby being in NICU can’t help encourage them to feel worthy of love from anyone.

I think it’s terribly sad.

[caedmyn]

55 minutes ago, Murphy101 said:

I can completely understand why a mother wouldn’t go see her baby after she knew CPS was involved.

Why would they want to visit/hold a baby they knew they were never going to take home?

And the shame of knowing it was their weakness and decisions that led to their baby being in NICU can’t help encourage them to feel worthy of love from anyone.

I think it’s terribly sad

 Why are you assuming they'll never take their baby home?  At least here, they have to go through a rehab program and then they regain custody.  Someone I know is going through the process right now.

[Murphy101]

40 minutes ago, caedmyn said:

 Why are you assuming they'll never take their baby home?  At least here, they have to go through a rehab program and then they regain custody.  Someone I know is going through the process right now.

 

Because they lose custody. You don’t usually take home a baby you’ve lost custody of.

I am not assuming anything other than that.  Many addicts presume they will not get to take their baby home. And they often presume it bc that’s what they are told, have seen happen to others, or bc they simply don’t feel they deserve or are able to keep their baby.  

Why do you presume an addict will regain custody? Many (most?) don’t. And if they do, it might be a very very long process with long separation(s). Here, it’s rarely just go through rehab and get the baby back. 

[Katy]

3 hours ago, Murphy101 said:

I can completely understand why a mother wouldn’t go see her baby after she knew CPS was involved.

Why would they want to visit/hold a baby they knew they were never going to take home?

And the shame of knowing it was their weakness and decisions that led to their baby being in NICU can’t help encourage them to feel worthy of love from anyone.

I think it’s terribly sad.

 

If they WANT to go through rehab, they can absolutely get cleaned up FOR FREE before their baby is released from NICU.  Most do.  Most of those kids never go into foster care.  The ones who abandon their babies have decided to choose drugs and death over their children.

2 hours ago, caedmyn said:

 Why are you assuming they'll never take their baby home?  At least here, they have to go through a rehab program and then they regain custody.  Someone I know is going through the process right now.

 

Here they don't even lose custody until they abandon their child and refuse rehab.  Most infants with with NAS are in the NICU for far longer than rehab takes, and in many cases the programs these women are offered they are allowed to have their babies with them at least part of the time if they are doing the work.

1 hour ago, Murphy101 said:

 

Because they lose custody. You don’t usually take home a baby you’ve lost custody of.

I am not assuming anything other than that.  Many addicts presume they will not get to take their baby home. And they often presume it bc that’s what they are told, have seen happen to others, or bc they simply don’t feel they deserve or are able to keep their baby.  

Why do you presume an addict will regain custody? Many (most?) don’t. And if they do, it might be a very very long process with long separation(s). Here, it’s rarely just go through rehab and get the baby back. 

 

They aren't told that.  They are told if they do the work and get and stay sober and arrange a safe place for a baby to stay (in the care of a sober relative) if the child is released before they complete rehab then the child isn't put in foster care at all.  The social workers just need to see the baby is not in immediate risk.  Beyond that the addiction is treated like the medical problem that it is. And the government treats parenting as a constitutional right.  So the courts pay for everything, including detox, rehab, outpatient rehab, apartments and/or short term living situations if necessary, subsidized daycare, and many other things like free transportation to and from doctors visits, and even having children transported to visit you in rehab three times a week if they are released from the hospital before you get out.

The real problem is that if you didn't grow up in a stable environment (and most addicts didn't), then it's not just a physical dependence from trying a super addictive drug.  It's your method of dealing with emotional stress by blitzing yourself out enough that you don't have to feel anything. And the newer drugs are so effective that you DON'T have to feel anything but slight euphoria.  And when you feel emotional pain and you don't want to deal with it and know you don't have to if you just go back on drugs, many people actively choose to go back on them.  And in most cases their childhoods were worst nightmare scenarios. And in my experience, many of these parents were introduced to the drugs by their own parents.

[Melissa in Australia]

here in Ausralia drug use is not a factor in removing children. The parents can take whatever and their children will not be removed. The babies are treated for their addiction when they are born and handed right back to their parents. the children are only removed because of the extreme neglect that happens because of their parents drug addiction not the drug use.  So the children are further damaged , because it is a known fact that extreme neglect causes more brain damage on a baby than drug use in-utero.

 

Personally I wish very strongly that people who chose the lifestyle of using drugs should be temporarily sterilized. I really think there should be a public discussion in the wider community about this instead of all the awful discussions that are happening in my part of the world about making all drugs legal so the poor users won't feel stigmatised.

 

 

 

[Katy]

8 hours ago, happysmileylady said:

My questions about drug use and giving birth aren’t so much about kids being taken away, but rather, how does having drugs in the system affect the birth process. Like does having x drug in the system increase the risk of Y complication?  Is a doc less able to recognize signs of a problem if a woman’s body is sluggish or stimulated by XYZ drug?  For having ABC drug mean the labor hormones are affected?   Is the baby less stimulated to do what he/she should because of the drugs?  Are docs assuming babies are in danger and performing procedures, when maybe, baby is just high?  Can do a even make good decisions when their evidence is clouded by an already medicated mom who has had unknown doses of said meds?

 

I've tried to do extensive research on this, but it was difficult to find any published information on combinations of drugs, and most addicts aren't discriminating about what to use. I think that what generally happens is OBGYNs rely on experience and anecdotal advice.  Generally if labor goes very fast and there's any other indication that something is off - pupils, vitals, creepy dynamic between parents, no prenatal care, etc, the doctors are going to have the cord blood tested for exposure.

Meth especially has a reputation for causing extremely fast labor.  Stimulants also seem to trigger early labor and prematurity, but it's difficult to know for sure, because addicts rarely get prenatal care. Most have no idea when they conceived or who the father is.  In the words of one social worker, "It's never the first person they say it is.  It's never the second person either."

Addicts also tend to not eat regularly, so its difficult to determine from low birth weight how much is due to starvation and how much is due to drug use.

IME the women who are addicts are aware they're not going to get drugs for a couple of days so they frequently do drugs on the way to the hospital. These tend to be the same women that lose multiple children to foster care.

There are many different symptoms seen in kids.  Google "Neonatal Abstinence Syndrome" and you can see what the symptoms are.  Some drugs are pretty obvious because withdrawal causes immediate seizures within hours of birth.

[Katy]

47 minutes ago, happysmileylady said:

So that’s another question, are conditions that pregnant women experience that contribute to maternal death rates not being caught when they could be treated because addicts are not being seen by docs at all?  

 

Probably.  But when a mother comes into a hospital and she has every class of drug that constitutes child abuse in her system and then she goes into seizures or anything else that causes death, that death is likely going to be attributed to drug use, not complications of childbirth.

Here's one study with respect to pre-eclampsia alone: https://www.ncbi.nlm.nih.gov/pubmed/20227162

[ktgrok]

8 hours ago, happysmileylady said:

So that’s another question, are conditions that pregnant women experience that contribute to maternal death rates not being caught when they could be treated because addicts are not being seen by docs at all?  

And they are purposely avoiding care to avoid being locked up. Also, even if they try to get care, many/most OBs won't take them as patients. And many rehab/treatment centers won't take them while pregnant. And going off the drugs cold turkey is actually NOT advised in the case of opiates, it can kill the baby in utero to go through withdrawals. What they need is specialized care, involving continued but controlled opiate doses, until they give birth. There was a series on it on public radio locally last year...the OB discussing it was one of the only ones in the state who would see these women. 

[TravelingChris]

On 5/14/2018 at 6:24 PM, Murphy101 said:

 

One, the opioids epidemic is predominately prescribed medications.  A prime example of insurance not meaning healthcare.  So many people can't afford solutions for so many reasons, so they take pain medication hoping if they can get enough work done eventually they can get solution based medical treatment.  

Two, the opioids epidemic, or drugs in general, is not an American exclusive problem.

This does not account for our higher mortality rates.

And it smacks of implying certain people deserve their lack of care and justifies as a do nothing excuse.

NO, The Opioid epidemic is not predominatly prescribed medicine.  The problem is heroin and fentanyl and other much more addictive opioids.  Check your statistics.

[Melissa in Australia]

5 hours ago, Ktgrok said:

And they are purposely avoiding care to avoid being locked up. Also, even if they try to get care, many/most OBs won't take them as patients. And many rehab/treatment centers won't take them while pregnant. And going off the drugs cold turkey is actually NOT advised in the case of opiates, it can kill the baby in utero to go through withdrawals. What they need is specialized care, involving continued but controlled opiate doses, until they give birth. There was a series on it on public radio locally last year...the OB discussing it was one of the only ones in the state who would see these women. 

Here a pregnant heroin user just has to go to the GP and she will be given  free Methadone for the rest of her pregnancy. It is safer for the baby as in reduces stilbirths

[Frances]

7 hours ago, Ktgrok said:

And they are purposely avoiding care to avoid being locked up. Also, even if they try to get care, many/most OBs won't take them as patients. And many rehab/treatment centers won't take them while pregnant. And going off the drugs cold turkey is actually NOT advised in the case of opiates, it can kill the baby in utero to go through withdrawals. What they need is specialized care, involving continued but controlled opiate doses, until they give birth. There was a series on it on public radio locally last year...the OB discussing it was one of the only ones in the state who would see these women. 

I’m surprised to hear they would be locked up where you live, that is certainly not happening in my state on any regular basis. Just last week there was an article in The NY Times about some places that specialize in helping pregnant women addicted to opiates, both during and after the pregnancy.

One of the things that discourages me the most when reading all different kinds of articles about these issues is that there is almost never mention of programs to prevent these pregnancies in the first place. I can hardly imagine a better use of government funds.

[Katy]

5 hours ago, Frances said:

I’m surprised to hear they would be locked up where you live, that is certainly not happening in my state on any regular basis. Just last week there was an article in The NY Times about some places that specialize in helping pregnant women addicted to opiates, both during and after the pregnancy.

One of the things that discourages me the most when reading all different kinds of articles about these issues is that there is almost never mention of programs to prevent these pregnancies in the first place. I can hardly imagine a better use of government funds.

 

Yes, you can't lock up someone simply for using drugs while pregnant.  That's not the standard of proof.  Legally it's not child abuse until drugs are found in the cord blood. Even then, in most cases the family just gets checked on for several months to make sure the child isn't at risk for future abuse.  This might include drug testing, checking the residence for safety issues, and parenting classes.  Basically, wraparound services.  A child isn't going to be put into foster care unless its abandoned or the mother refuses to do what's needed to make her baby safe.

Asking for help gets women referred to a methadone clinic here too, and they are treated with compassion because they are making the best choice for their child. The baby will still have NAS, but it's treated like what it is: a woman on a legally prescribed medication who was responsible enough to make the right choice for her baby, not a safety risk.

At the same time, if a police officer sees a pregnant woman who is clearly using and clearly last-trimester pregnant, will he make more of an effort to find a reason to put her in jail than he would with some random user on the street?  Probably. But law enforcement response is different than a physician response.  Physicians are much more likely to treat addiction like a medical issue than a moral or legal one.

Sometimes all it takes is getting arrested and going through the forced detox for a woman to sober up enough to decide that she loves her baby, and even if she chooses to give up her baby to continue the addiction she might go on methadone until she delivers.

[ktgrok]

7 hours ago, Melissa in Australia said:

Here a pregnant heroin user just has to go to the GP and she will be given  free Methadone for the rest of her pregnancy. It is safer for the baby as in reduces stilbirths

An infinitely more humane solution. 

Like I said, here the regular Ob's won't touch them, the GP's won't touch them, and the methadone clinics won't treat them if they are pregnant. They have nearly zero options in many parts of the country. 

[ktgrok]

6 hours ago, Frances said:

I’m surprised to hear they would be locked up where you live, that is certainly not happening in my state on any regular basis. Just last week there was an article in The NY Times about some places that specialize in helping pregnant women addicted to opiates, both during and after the pregnancy.

One of the things that discourages me the most when reading all different kinds of articles about these issues is that there is almost never mention of programs to prevent these pregnancies in the first place. I can hardly imagine a better use of government funds.

They are afraid they MIGHT be locked up, and given that drug use is illegal, that makes sense. It's a reasonable fear. Our jails are full of people arrested for drug crimes, so given that they aren't exactly getting legal advice or well versed in the nuances of the law, it makes sense they'd be afraid. 

But yeah, in this state at least, there are very very very few options for pregnant women addicted to Opiates. I'll try to find the info about it if I can. 

[ktgrok]

10 hours ago, TravelingChris said:

NO, The Opioid epidemic is not predominatly prescribed medicine.  The problem is heroin and fentanyl and other much more addictive opioids.  Check your statistics.

I suppose it depends on your perspective. Are they using legally prescribed medication now? No, most are not. Some are, that they get from the lovely pain clinics Florida became famous for (airlines started creating special flights to capitalize on the people flying down to get their pills). But a large number of the people using heroin (and most are trying to avoid fentanyl) started with a regular prescription for oxycontin from a doctor. They had a chronic back problem or an injury, got hooked, and then when they couldn't get more oxycontin legally started buying it illegally. and then when they couldn't afford that switch to heroin (easier and cheaper to get).

The stories are heartbreaking. And opiate addiction isn't something you can quit cold turkey from in many cases, not on your own. These people are no longer trying to get high, they are just trying to avoid the sickness that comes with withdrawal.