Life-threatening complications overlooked in weeks after childbirth, researchers say
CBC
Paige Eaton wanted to stay open-minded about the birth plan for her first baby, so when she ended up needing an emergency C-section, the Kitchener, Ont., resident felt somewhat prepared.
Still, she never imagined the terrifying rollercoaster to come.
A few days after her son Archie's birth in June 2023, Eaton developed severe pain, chills, and a fever. She was readmitted to hospital and treated for cellulitis, a serious bacterial skin infection at the site of her C-section wound, which progressed to a pelvic abscess, inflammation in her abdomen and uterus, and eventually life-threatening sepsis.
The first-time mother was stunned, but she could barely process what was happening due to the pain radiating from her infection. Wound cleanings felt torturous, and Eaton recalled screaming when one health-care worker gave her an injection to try numbing the area.
"Anytime they touched it slightly, I was in excruciating pain," she said.
Eaton spent two weeks in the hospital, breastfeeding her newborn baby around the clock while undergoing a host of treatments and constant IV antibiotics. At one point, she even went into early septic shock, leading to abdominal surgery, a blood transfusion and a months-long recovery.
"It's really hard to describe the pain of sepsis unless you've been through it. Basically all you can say is: it's just the worst pain you could ever imagine," she told CBC News. "And the main thing is, you feel like you’re going to die."
Despite the severity of her infection — and how close she might've been to death — Eaton's experience in the weeks after her son's birth wouldn't necessarily be captured in typical data on severe maternal morbidity, a term covering a range of potentially-deadly complications linked to pregnancy and childbirth.
In Canada, it's thought those serious cases happen at a rate of less than 18 out of every 1,000 deliveries. But that estimate is based specifically on labour and delivery, the relatively short period of time spanning from the onset of regular contractions to the moment the placenta is expelled after childbirth.
New Canadian research suggests close to a third of life-threatening complications also happen to women after that period, during the early weeks following the delivery — a time when mothers typically experience far less medical tracking and support than they did during pregnancy.
From sepsis to severe hemorrhage, nearly 30 per cent of cases of severe maternal morbidity happened within the first six weeks postpartum, according to findings based on a cohort of more than a million births in Ontario between 2012 and 2021.
More than half of those serious cases were during labour and delivery itself, while another 16 per cent occurred earlier during pregnancy.
Overall, expanding the time period showed roughly four in 10 cases of severe pregnancy and childbirth-related complications in Ontario were previously missed, wrote the authors of the paper published on Monday in the Canadian Medical Association Journal (CMAJ).
Senior author Dr. Giulia Muraca told CBC News that maternity care in Canada remains "very strong," with 97 per cent of pregnancies not affected by these kinds of severe health issues. Still, she stressed that every case counts.
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