Conditions that threaten women’s lives in childbirth & pregnancy

Women's emergency experience

We spoke to women who had experienced different life threatening conditions during childbirth. These are sometimes known as ‘near misses’ and are described in ‘What is a life threatening condition in pregnancy’. These illnesses are rare, affecting less than one woman in every hundred giving birth* and can be caused by several conditions (e.g. placental disorders, blood pressure, heavy bleeding / haemorrhage, thrombosis- the formation of a blood clot inside a blood vessel, septicaemia - blood poisoning). These different conditions mean women’s experiences of their emergencies were very varied. But what they all had in common was a life threatening traumatic birth they had not expected. Reading and hearing some of these experiences can be distressing.
 
Women may need to be in hospital for days or weeks being monitored closely before their baby is born. This may be so doctors and midwives can monitor their high blood pressure (which can be an indication of pre-eclampsia or HELLP syndrome). Sometimes women needed to stay in hospital because of a condition called placenta praevia (where the placenta is in the wrong position and blocking the birth canal), which can have a high risk of haemorrhage.
After being closely monitored, a worsening in their or their baby’s condition can lead to a sudden need for women to have their baby delivered. Sometimes women become seriously ill very quickly. Helen was monitored for a few days before she was admitted to hospital, where doctors diagnosed HELLP syndrome (a combined liver and blood clotting disorder).
Some women develop symptoms quite suddenly at home which mean they have to rush to hospital, sometimes by ambulance. These experiences can often be very frightening, and women may not really understand what is happening until much later. If this happens several weeks before the expected birth date, women may feel emotionally unprepared for birth. At 36 weeks, Kate developed high blood pressure and severe pains in her chest and she went to her local hospital where her baby had to be delivered during the early hours of the morning by emergency caesarean. The suddenness of the birth left her feeling “just completely mind blown.” Often women we spoke to didn’t realise how seriously ill they were.
Sometimes women need to go to hospital days or weeks after the birth of their baby due to a life-threatening illness such as a blood clot in their lungs or in their leg. Cate developed a blood clot three weeks after her daughter was born, while Sophie experienced a haemorrhage several weeks after she had given birth. Sepsis or septicaemia (blood poisoning) is another reason why women may need to go back to hospital as an emergency.
Some women were not really aware of the medical emergency for much of the time, as they were not conscious or had a general anaesthetic. In these cases, the women had to piece together what had happened to them after they woke up (see Understanding what happened). Alison T had amniotic fluid embolism (AFE), a very rare complication of pregnancy in which amniotic fluid, fetal skin or other cells enter the woman’s blood stream and trigger an allergic reaction. She remembers a sudden severe pain in her head and back within minutes of being induced and being rushed to theatre and having a general anaesthetic. She woke up 4 or 5 days later in intensive care. Debbie also had only partial memory of her emergency.
Rachel was concerned when she couldn’t feel her baby moving. She went into hospital and a scan showed her baby had died. This was probably because she had developed a form of temporary diabetes in pregnancy (gestational diabetes) which was not diagnosed but can threaten the life of the baby. When she was induced to give birth to the baby, she started bleeding internally and developed amniotic fluid embolism.
In some cases, women had an emergency caesarean and then their condition worsened.
Although their conditions were life-threatening, several women described a calm, confident atmosphere around them. Even though things were happening quickly, and they were scared, they felt reassured by the professionalism of medical staff.
Some women who had a haemorrhage described doctors and midwives using internal compressions (or pressure) and massage to stop the bleeding. When they were unable to stop the bleeding they had to perform a hysterectomy to save the woman’s life. Women’s experiences of haemorrhage and hysterectomy are described further in ‘Haemorrhage – heavy uncontrolled bleeding’ and ‘Hysterectomy’.
*Waterstone, M., S. Bewley, and C. Wolfe, Incidence and predictors of severe obstetric morbidity' case-control study.BMJ, 2001.322(7294)'p. 1089-93; discussion 1093-4

Last reviewed April 2016.

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