even when it’s different, it’s always the same

It’s funny how reading news stories bring back memories.

It’s always awful when a new mum dies. It’s usually such an awful death, too.

I remember the first time I ever was at a birth like that. An emergency section, an abrupted placenta. Baby’s heart rate frighteningly low, respiratory came for baby, and ended up with front row seats at the show. Enough bleeding for a horror movie. More bags of PRBCs and FFP than I had ever seen before. Fluids, fluids, fluids. I’d been at many c-sections before and they were all elective, scheduled, methodical things. The most tension in the room was an obstetrician demanding a student justify their presence or an anaesthetist calling someone out for making a mess of the OR with gloves covered in baby cheese. None of this wide-eyed adrenaline, the obstetrician and his assistant scrambling to get the baby out as fast as possible, the air thick with the sense of urgency. The jokes about us making him feel like a “real obstetrician” lighten the mood only the tiniest of margins. There’s a little person in there, and it’s not exactly scheduled to come out.

This story, however, is about the mum. When mum gets sick, or something horrifyingly bad happens. These scenes stick in my mind forever, not only because of the family, the husband, the tiny baby. The father and tiny baby aren’t there to see those last five, ten, thirty-five minutes. Just me, and the code team, there to witness what will later be described in one sentence.

Pick your pathology, really; there’s no shortage of pathologies that can cause this type of thing. The one that crosses my mind when thinking about these events is the amniotic fluid embolus. A seemingly normal birth, a happy fresh baby, an elated family. The endings of birth didn’t stop the bleeding. It continued and continued, and what began as a mild worry quickly escalated into a high-strung fear. The bleeding wasn’t stopping.

The infusions of blood products are really only a stopgap measure. By the time her heart stops, it’s already too late. We can only infuse so much. I have, arguably, the easiest job: stand at the head of the bed and watch, while I make her limp body breathe. Everyone else is scrambling and using their brain. I, I am standing there with one hand on the bagger and one hand on the yankauer, suctioning blood that flows freely from her lips, nose, eyes. It seems wrong, these young people coding in our ICU. As if the codes should all involve 90 year olds who were ready to let go. All I can think of, while watching this person die of DIC, is their husband, their family members, their brand new baby.

It’s been a long time since women routinely died in childbirth. These events are admittedly quite rare. But they happen. And when they happen, everything inside me twigs about how abnormal it is for a new mother to die in this place of western medicine and modern cures, of nothing other than having a baby.

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One thought on “even when it’s different, it’s always the same

  1. Dr. Skeptic says:

    I am in India and Maternal mortality is a real worry here. I identify deeply with your sense of distress here… just recently came across a pretty horrifying, similar experience myself. Must say it sucks…

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