It Happens in the United States

No one thinks that this is something that could happen to them. No nurse thinks this is going to be her patient. But it can happen, it does happen, and it is happening every day in the United States.
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No one expects a mother to die from childbirth. But it happens, and it happens far too often, even here in the United States. Every day, nurses put on their scrubs and go to work not knowing what their day is going to be like, what assignment they might get or who will walk through the door. As labor nurses, we hope for the Holy Grail -- a woman in active labor who we could almost bet every dollar in our bank account will deliver easily and quickly and will present us with a pink and screaming baby. There is a reason we love people who come to us in active labor. Their labor is usually quick and uncomplicated, and the process usually ends with everything we work so hard for -- a mom and baby who are both happy and healthy. But that isn't this story.

I was sitting at the nurse's station when I heard a bunch of noise at the end of the hall. On a labor unit, we frequently hear people screaming, and it doesn't even make us blink. But when it's an emergency, somehow, everyone just knows. I ran towards the sound. When I walked into the room, a mother was lying there, her legs still in stirrups. Her head was turned towards the side, so I could see her face as soon as I walked through the door. I had only been a nurse for about a year, but I knew immediately we were in trouble. The patient's eyes were rolling into the back of her head and I could literally hear the blood hitting the floor beneath her. Her baby was crying in the radiant warmer next to the bedside. There were a lot of family members scattered throughout the room. Someone was still taking pictures of the baby, oblivious to the fact that their wife/daughter/sister/best friend was hemorrhaging less than a foot away. A scrub tech ran out of the room to open up the OR. The doctor sat in front of the patient's open legs, fervently trying to find the source of the bleed. With shaking hands, I managed to place another IV. Someone ushered her family members out of the room. Someone took the baby to the nursery. And before I knew it, the patient had been transferred in the bed to the OR, and I was left alone in an empty room.

Looking around, cables and monitor parts had been haphazardly thrown about in an effort to get the patient to the OR as quickly as possible. The floor was covered in puddles and puddles of bright red blood, glossy under the glare of fluorescent lighting. I heard someone call a code over the intercom. In shock, I turned around quickly and slipped in the blood. Lying on the floor, I could feel it seep through my scrubs. I bounced up, went to the break room and grabbed an extra pair of scrubs I kept in my locker. I went to the bathroom and changed, crying silently as I scrubbed the patient's blood off of my hands and body. My insides were shaking. Had that just happened? I then stopped crying, splashed water on my face and walked out of the bathroom so that I could go back and check on my own patient, the patient who was still pregnant and laughing and making bets with her family on when her baby would be born.

To this day, I think about that mother and I pray that she at least heard her baby cry. Her face will forever be frozen in my memory, her head turned towards her crying baby. I think about her newborn daughter, who left the hospital without her mother, and how inherently wrong that is. I think about a father raising a family on his own, and how their other small children must have wondered why their mother never came home. I think about her parents, who left the hospital and went straight to a funeral home, as someone had to make decisions that inevitably had to be made. As nurses, the only reason we come to work day after day after day is because we love what we do, and we want a healthy mother to go home with a healthy baby. That is the only thing we are working towards, the only thing we work for.

That was not my last experience with a maternal death. And I've witnessed countless close calls, as we all have. If you are a nurse, know that we have to help these mothers, because they are coming in more and more sick, with more and more problems, and this is just not going away. We don't talk about all of those close calls, the mothers who go into DIC or the ones who end up with a hysterectomy. We don't talk about all of the Hemabate, Methergine and rectal Cytotec we're giving. We don't talk about the increase in the number of blood transfusions we are having to give. We have to share our stories, because no one knows what we do.

If you are a mother, know that this is not something that your physician or your nurse can fix alone. We all have to start working together to make sure that you and your baby leave happy, and healthy, and together. No one thinks that this is something that could happen to them. No nurse thinks this is going to be her patient. But it can happen, it does happen, and it is happening every day in the United States. Talk to your doctor about being healthy during your pregnancy. Unless there is a medical reason to be induced, wait for labor to start on its own. And if you're the family that took a baby home without its mother, the nurse that took care of your mother/sister/daughter/best friend is not the only nurse thinking about you. You are on all of our minds. Every single unexpected and crushingly sad delivery we see, you are the reason we work as hard as we do. All of us remember all of you. We do not ever want our patient or our baby to be the one with a bad outcome. Every nurse, every physician, every scrub tech and nurse's aide and unit secretary all want a heathy mom and baby. You are not forgotten, and you are why we will continue to fight for moms and babies.

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