No one thinks on the day they go into labor that this could be the day they might die. Certainly not obstetrician gynecologist Andrea Campaigne.
And yet, that was what she and her care team faced when she delivered daughter Nina on Oct. 5.
We’ve written about Texas having the highest maternal mortality rate in the country. That’s the rate of mothers who die within 42 days of a pregnancy ending. Texas has 35.8 deaths per 100,000 births, according to a report in the Obstetrics and Gynecology. The national average is 23.8 deaths per 100,000 births.
What we mothers of the first world sometimes forget is that birth isn’t a little thing and it’s not something you can outsmart or outplan all the complications that can happen, says Campaigne, who practices at Austin Regional Clinic and St. David’s Women’s Center of Texas. “The work that I do takes healthy woman to the brink on a really difficult day,” she says. “You can recover from it, but it’s a big day.”
For Campaigne, Nina was her second child. Her first, son Crosby, was a big baby and born after a long labor in 2014. She began to hemorrhage, but her bleeding was controlled quickly. A postpartum hemorrhage after one birth doesn’t put you at risk for a hemorrhage at the next birth.
“We, myself and all my partners, were reassured that a postpartum hemorrhage wouldn’t be part of the day,” she says about the birth of her daughter.
She had “a sweet and easy labor” with Nina, but then began to hemorrhage, much worse than with her son.
She remembers feeling bad very quickly. She felt the blood pouring out of her. She was light-headed and mumbling incoherently. She couldn’t grip her husband’s hand. And then she remembers letting go and putting trust in her care team. “I was afraid and I did not know what would happen, but I absolutely knew I was in the right place and everyone around me would help me.”
This time, instead of being able to control her bleeding with just medication, she was rushed to an operating room. Doctors used a balloon inside her uterus to stop the bleeding and gave her three transfusions.
A colleague, who was an anesthesiologist, Farid Jahangiri was there and asked her if he could call her Andrea on that day as his patient, not Dr. Campaigne, the doctor. She remembers telling him, “I can’t do it anymore.” And he told her, “We’ll take care of you.”
“A peer let me be a scared little girl,” she says. “It meant a lot at a really dark moment.”
She doesn’t tell her story to her patients. “There are 100 different bad outcomes that are not their reality,” Campaigne says. “The level of that anxiety is too hard to bear.”
“I don’t want them to be afraid of it,” she says. “We know how to take care of women. If we could have predicted or prevented the outcome, we would have.”
When patients hand her a birthing plan, though, she counsels them to let go of being in control on this one day because you can’t be, she says. “Birth is unplanned.”
Campaigne’s advice: really know your medical care team, really trust in them.
“We drill to always be prepared to handle every thing, but I don’t go into any birth thinking the worst,” she says.
Her own story reminds her why it’s important to have access to medical support for every delivery. While she used a certified nurse midwife and works in a practice with a certified nurse midwives, she had a doctor on-call and was in a hospital setting if something happened.
“We want to make sure all the layers of support are there,” she says.