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When Rarity Becomes Reality

By Doula Jen

emergency_roomMany of you caught our short blurb on Facebook about my decision to send a new mama to the ER a few weeks ago due to leg swelling and severe shortness of breath. She also complained of a pain in one calf. As doulas are not physicians, it is not our position to provide medical diagnosis. However, we are familiar with both typical and not-so-typical conditions that tend to creep up in the postpartum period and are extensively trained in “not normal.” Additionally, doulas are by nature intuitive and quite skilled at tuning in to gut feelings in a possible emergency.

The symptoms of this mother in particular pointed to numerous possibilities—blood clot, elevated blood pressure, C-section infection, and heart failure—none of which could wait for a morning appointment with her general practitioner.

Turns out she had developed postpartum cardiomyopathy. All of us at Welcome Baby Care, and of course the family in question, are very glad that we could be there to help and advise.

From Johns Hopkins School of Medicine: Postpartum cardiomyopathy is a weakness of the heart muscle that by definition begins sometime during the final month of pregnancy through about five months after delivery, without any other known cause. Most commonly, it occurs right after delivery. It is a rare condition that can carry mild or severe symptoms.

We are pleased to report that this mama was treated with blood pressure meds (as well as diuretics for the swelling) and is doing well. In fact, when she returned from that initial hospital visit the next day she already seemed like a different person.

One thing I want to highlight in discussing this situation is that intuitive side of decision making.

This was my first time meeting this family. They called us at the last minute, quite worried that something was wrong with one of their twins. He had been spitting up. Upon our initial check-in, the father mentioned his wife’s labored breathing as a side note. “If you could check that out as well…” 

Immediately I could see that the babies were healthy and thriving. The description of the spit up scenario was nothing out of the ordinary.

Mom, on the other hand, just felt off. A little out of it, anxious, and “full.” The fullness had nothing to do with her actual size—she seemed abnormally puffy. And this impression was made before I actually saw her legs.

I waited with the babies while Mom went to the bathroom and when she came out she was listing off concern after concern:  her incision hurt, she was a bit dizzy, that pain in the leg. I had her lie down on the bed so that I could take a look at her incision and it was then that I noticed the swelling of the legs. At this point she also became so short of breath that she could barely speak. Her eyes were distant and fluttery. All of this, of course, inspired me to make the recommendation for urgent care, but there was more too it than that. From the moment I set foot in that house, the message I received from this couple’s words and actions was, “Something is wrong but we don’t know what. Please help.” There was just a general sense of unease and an undeniable feeling that something was off.

The lesson? Trust that feeling.

Worry is a part of the experience for all new parents, but this was another level. Something was wrong and they knew it.

Another important detail to emphasize is how Mom’s breathing was mentioned—by both parents—as a sort of side note. In fact, even after I recommended immediate care Mom tried to assure me that “it was nothing.” She didn’t want to go. She didn’t want to leave the babies. She was still concerned about the spit up. She was still—first and foremost—the mother.

This is so common. Mom is so concerned about her child(ren) that she forgets to take care of herself. Doulas, grandmas, partners, friends…help her remember! 

Well wishes to this loving family for a full recovery and a happy, healthy life.

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