A friend of mine is writing a story, which involves a woman (young, perhaps early to mid twenties) dying in childbirth. Assuming the birth took place outside of a hospital (with a midwife, for example), what complications could result in the mother’s death?
IANAMD,
but I did work in a clinical lab for two years. IIRC, maternal death in childbirth is (usually) caused by one of 4 things:
- Blood loss
- sepsis
- eclampsia (convulsions that lead to coma)
- obstructed labor (not sure how this causes death. It seem s like it would lead to death through blood loss or eclampsia)
There are others, of course. I’m sure Qadgop will be along shortly to clean up my mess, but that is what I was told by several docs.
Aneurysm would be a possibility. That’s the rupture of a vein in the brain.
Given that the midwife is a trained professional and has access to backup, there’s actually not much in a homebirth to put a mother at more risk than in hospital. If the midwife is carrying drugs to control bleeding then it’s unlikely a woman would be more likely to bleed out at home. Sepsis is less likely at home because the woman’s at home with all her own familiar pathogens.
Anyone with serious pre-eclampsia or with eclampsia, is not going to be birthing at home unless they’re insane and their attendant is a loon. Obstructed labour should lead to transfer to the hospital.
What’s the slant of the story? Is the woman supposed to die as a result of the choice to homebirth? Then you need an incompetent midwife (but in general, that’s more likely to lead to the death of the baby than the mother). But an aneurysm or a stroke’s probably your best bet because the major risk factors logically lead to a transfer to hospital for most midwives and labouring women.
I’m not an MD but I was a consumer advocate with NZ College of Midwifery. After reviewing hundreds of cases over the years, I saw one maternal death and that was in hospital and it was not a result of pregnancy and labour but rather an aneurysm.
Retained placental parts could cause persistant hemorrhaging severe enough to cause quick death.
Eclampsia would also be a good candidate.
QtM, MD
DIC= disseminated intravascular coagulation whereby elements utilized in blood clotting may be consumed rapily and the patient may bleed to death
Ruptured Uterus with massive bleeding can lead to death and
Amniotic fluid embolism may cause “sudden death”
just to name a few.
Also add to the list placental abruption (or a previously undiagnosed placentia previa, but that would be rare in these days of routine prenatal ultrasounds) - another cause of severe hemorrhage.
Not necessarily. There is a bacterium called Group B Strep that can be found in the normal vaginal flora. During labor, it can cause a condition called chorioamnionitis, which can lead to maternal sepsis. Other pathogens can cause the same disease.
In the US, it’s fairly routine to be screened for GBS, and those women who test positive do receive antibiotics during labor to prevent infection. However, in the past, the only women treated for it were women known to have had GBS in the past (e.g. fetal death).
Robin, whose OB was an infectious disease and who has had chorio in the past.
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Robin, whose OB was an infectious disease and who has had chorio in the past.[\quote]
wow, MsRobyn, I guess you and your OB really didn’t hit it off well?
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*Originally posted by Qadgop the Mercotan *
**
Hahahahaha. He’s an infectious disease specialist. That’s what I get for posting before caffeination.
Robin