The postpartum period is a precarious one, with limited medical attention and a largely unaddressed risk for complications. Of all maternal deaths, close to half occur within the first two months after childbirth.
A Wall Street Journal journalist and first-time mother gave birth to a healthy baby, an outcome that every mother hopes for. Then, all went downhill when she lost her appetite and ran a low-grade fever. Two weeks after giving birth, she was back in the hospital fighting for her life. Within those two weeks, she had lost twenty pounds and her energy. She could not even care for her baby. Her postpartum checkup had not been scheduled to occur for another four weeks from then. She is not alone in her experience.
The writer reported her experience in a recent Wall Street Journal article, which highlights a vast chasm in maternal care in America. The six-week period between childbirth and the first checkup holds hidden dangers for women unaware of what to look for among the many bodily changes they experience after childbirth.
And yet, infection is common after delivering a baby. Other life-endangering conditions include excessive maternal bleeding and preeclampsia, a condition typically experienced during pregnancy but which can also occur postpartum. This dangerous condition may have no other signs than high blood pressure and possibly protein in the urine. Despite the limited number of signs, it can cause severe kidney and liver damage, even death if left undetected.
Lack of Training and Care in the Postpartum Period
Still, most doctors have no specific training in the best methods and diagnostic triggers for the postpartum period. It seems particularly long when one considers the physical trauma of giving birth and the numerous physical symptoms that may occur thereafter, but the six-week postpartum checkup is the standard. Despite the American College of Obstetricians and Gynecologists (ACOG) recommendation that women see their doctors sooner or have postpartum nurse home visits, most health insurance companies only pay for the currently accepted checkups at six weeks.
Insurance companies often deny funding for early and additional checkups, even though the United States has one of the highest maternal mortality rates among developed nations, and early detection of complications is the best remedy for preventable deaths. The CDC reports that many preventable maternal deaths result from delay when diagnoses come too late, in addition to inadequate health care access. With so little research conducted about postpartum care, health insurance companies find insufficient support for the increased costs of earlier and more frequent post-delivery office visits. More importantly, the strain on the already delicate healthcare system makes the obvious solution to situations like the aforementioned writer’s unattainable. More office visits mean more doctors dragging exhausted mothers in office just to tell them they are fine. For some physicians, this does not seem justifiable. And habitual practices are hard to change among long-time practicing obstetricians and gynecologists.
Failure to Recognize Warning Signs after Delivering a Baby
However, as is evidenced by this mother’s story and so many others, things can and do go disastrously wrong. For this woman, her infection resulted from postpartum bleeding, a common occurrence. Blood had accumulated in her abdomen and become infected, causing her a dangerous sepsis that could have cost her life. She was sent home and told to head home repeatedly, by emergency room doctors and medical professionals at a walk-in clinic. Despite the severity of her condition and the potential to quickly progress, her symptoms and high white cell blood count did not raise alarm bells. With further testing, doctors found an extreme infection as her fever spiked.
After delivery, women do experience bleeding, fever, and high white blood cell counts. New breastfeeding mothers likewise develop breast infections. Knowing that 12% of U.S. mothers die from hemorrhaging postpartum and 20% of those are not at high risk for the condition, places the burden on obstetricians and all healthcare professionals caring for pregnant women to treat every pregnancy as a potential postpartum emergency. At the very least, the postpartum period should be viewed as a time of physical fragility and vulnerability to complications, necessitating additional awareness and vigilance by healthcare providers caring for women during this time.
Setting a New Standard with Preventive Medicine after Mothers give Birth
From ensuring that high-risk women are birthing children in facilities equipped to treat postpartum hemorrhaging promptly, to active management of labor and delivery, including placenta delivery, doctors can proactively treat and prevent common conditions. Among bleeding prevention and treatment options are a Pitocin injection at delivery, massaging the uterus, and proper umbilical cord handling. Other preventative measures include reducing routine episiotomy, cutting the perineum to widen the baby’s exit, and early diagnosis of hemorrhaging. Early postpartum checkups are also crucial preventive medicine. Even if vaginal births were treated like cesarean births, with a two-week checkup after delivery, fewer maternal deaths might occur due to excessive blood loss, organ failure, stroke, and sepsis. Doctors could arguably detect the warning signs in the early stages with a change in methods and attitudes.
To better care for mothers delivering newborns across the United States, long-held physician attitudes must change, as well as impracticalities in the healthcare system. Despite ACOG recommendations and research findings of best practices to protect maternal health, obstetricians who follow old routines may cause unnecessary pain and suffering to women when they are most fragile. They may doubt their instincts about their bodies and ignore the signs when their doctors tell them their symptoms are the usual. With a more cautious approach, careful doctors can order the tests to ensure that the symptoms are typical body changes and schedule checkups to verify that postpartum bleeding absorbs into the body with time, among other important life-saving actions.
Educating patients about postpartum signs and symptoms is equally vital to late pregnancy and delivery preventative practices. If hospitals must send mothers home soon after giving birth, they should remain highly attuned to patient complaints that may be common but suggest a larger problem. For instance, an obstetrician who assumes a postpartum fever is due to normal childbirth effects without further testing may cause a patient prolonged illness and risk the mother’s life.
Mothers who Experienced Undiagnosed Complications are a Startling Call to Action
The WSJ journalist spent weeks recovering in the hospital largely away from her weeks-old baby. In addition to nearly causing her death, her early bonding and childrearing choices narrowed because doctors failed to recognize a common postpartum complication. Her article details another patient’s post-delivery trauma as well. A medical doctor, who suffered from hemorrhaging that turned into a severe infection, was also sent home from the hospital after complaints of dizziness. She went home with her baby, only to later find that a significant amount of pooled blood in her abdomen likely caused an infection. Her doctors assumed she was experiencing typical postpartum symptoms. One specialist avoided weighing in on her dizziness, as postpartum conditions were not his specialty. Overall, the connection between the two cases is the delayed diagnosis from incorrect assumptions about postpartum symptoms. This dangerous delay occurs despite postpartum hemorrhaging’s third-place ranking for maternal death causes.
Perhaps this is evidence of a broader trend. In fact, studies show that healthcare professionals regard women’s pain less seriously than men’s in a phenomenon called pain bias. This bias may or may not contribute to the two cases detailed in the article or the statistics on maternal mortality rates, but indeed the wait-and-see approach that doctors rely on for post-delivery complications such as bleeding, needs revising. If your doctor is one who took such an approach and caused you harm, you might consider consulting a legal professional about a possible claim against your providers. Postpartum malpractice may be due to ignorance, bad habits, prejudicial attitudes, or other negligence. Still, doctors owe their patients quality care, free of callous or hurried disregard and outdated attitudes that endanger their patients.
Contact an Attorney to Discuss Your Postpartum Injuries in NJ
If you developed a postnatal infection, bleeding, or another complication due to substandard medical care after delivering a child, a medical malpractice attorney can explain and explore your legal options for obtaining what you need – accountability, financial compensation for your monetary losses, and damages for the emotional and physical trauma that you suffered due to critical gaps in postpartum care. You might be surprised to learn that you can seek restitution to repair the damages you suffered. Call (866)-708-8617 or contact us online to speak to a medical malpractice attorney regarding your specific case. Our renowned, highly knowledgeable team is particularly concentrated on maternal and birth injuries caused by medical negligence in New Jersey and nationwide. We encourage you to reach out for your free consultation.