A new dad called me the other night. His wife gave birth six months ago after a perfectly healthy pregnancy and an uncomplicated labor and birth. Six months later, completely out of the blue, she can't catch her breath. On a whim, he thought he might as well rule out something with postpartum, though neither really thought it could have anything to do with that.
Like most new parents, he had no idea that in the United States heart failure is the leading cause of death for women in postpartum. And so he didn't know shortness of breath is a serious warning sign, constituting an immediate visit to the ER.
It ends badly way too often. The maternal mortality rate in the US is one of the highest in the developed world- 900 mommas die every year, and another 65,000 almost die*. 65,900 mommas. That’s our neighbors, friends, sisters.
Most maternal deaths happen in the weeks and months following childbirth rather than in labor and delivery, and 60% of these deaths are preventable. Preventable. That means mommas aren’t receiving the care they need just to keep them alive. Maybe because they didn’t recognize the symptoms as life threatening. Maybe because they couldn't get a quick enough appointment with their doctor. Maybe because they felt terrible but thought it was normal and didn't want to be high maintenance. Anyone can have life-threatening postpartum complications. No matter if you’re healthy and had the most uneventful pregnancy and easy birth -complications are no respecter of your awesome birth abilities.
Here are the warning signs that need to be taken super seriously, and what to do if you experience them.
Keep an eye out for a full year following birth for any of the following complications.
Call 911 Immediately:
Pain in your chest
Obstructed breathing or shortness of breath
You should making an appointment you’ve got 100.4 F or higher. But if we’re looking at something a couple of degrees above 100.4- get yourself to the hospital ASAP. It's a big deal.
Thoughts of hurting yourself or your baby
Seriously - this is a 911 call. And if you won’t call 911, please at least call 1-800-PPD-MOMS (1-800-773-6667). Do not be ashamed. Do not be scared. You are not alone. Do this for you and for your family.
Make an appointment with your healthcare provider:
Bleeding that is soaking through one pad/hour, or blood clots the size of an egg or bigger
Take pictures of these things. And if you are continuously, heavily bleeding (be it during pregnancy or during postpartum)- call 911, and don't clean up the blood. Collect your pads, unders, and anything else that's getting soaked and bring them with you. Not only that, but don't sit on the toilet and let all that blood flush- soak whatever you can and bring it along. When you're hemorrhaging, it's important for your care providers to be able to measure blood loss as closely as possible- so all the bloody things help, as gross as it sounds.
Incision that is not healing.
What exactly does that look like? If there’s puss, if it’s red, swollen and tender, if it’s becoming MORE painful and not less, or if it just isn’t actually healing- it’s staying more or less the same as it was on day one- problems. You should see daily improvement to any incision, be it a cesarean incision or a vaginal tear. If you've got any of the above and a fever, you've got yourself an infection- get to the hospital ASAP.
Red or swollen leg that is painful or warm to touch.
This isn’t necessarily your entire leg, but might be a section or large spot on your leg. (On that note- don't get leg massages during either pregnancy or postpartum. The risk of moving blood clots is legit. And blood clot movement is pretty much the worst thing ever. Most massage therapists- including ones trained in prenatal/maternity massage- don't seem to know this, so don't be afraid to tell them to back off the legs.)
Temperature of 100.4° F or higher
Headache that does not improve, even after taking medicine, or bad headache with vision changes.
Please do not write this one off. It’s easy to do, especially if you’re someone who gets frequent headaches anyway. Get checked out.
Two or more of any of the above symptoms simultaneously
And by appointment, we mean....
Be seen in the next 24 hours. In our current state of abysmal postpartum care, mommas are often written off if they're well enough to call in and aren't insistent. Here’s how to make sure you get the care you need. Remember, most deaths happen in the weeks and months after birth....do not let them schedule you next week. Seriously, do not.
In all of these situations:
Be sure to to let whomever you speak with know that you’ve had a baby, and give them the exact date of birth. Taken alone, some of these symptoms may be treated as benign when postpartum makes them really dangerous.
I created a handy little printable to share with those you love and those you live with, just in case in your exhausted new-mom delirium you’re not recognizing the symptoms (or you’re trying to write them off)- someone else can encourage you to take the action needed. Print this out and put it on the fridge, on your bathroom mirror, at your bedside, and hand out copies to your people.
Nine- hundred mommas. But not you. And not your friends. Share this with everyone you know, and protect yourself.
Have you had any of these symptoms? How did you know to get help?
Tell us your story in the comments below!