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Pregnancy and Childbirth Can Cause Lingering Health Issues
From postpartum depression to increased risk of heart attack and stroke, complications can be severe and long-term. The health issues from having a child can linger for years after the child is born, and some are so severe that they can prevent women from being able to care for their children in the way they would like to.
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Those complications can be mental and emotional. Pregnancy and childbirth can have extraordinary mental and emotional effects on the mother, many of which go undiagnosed. From the "baby blues" all the way up to post-partum depression, the mental effects of childbirth can be severe. And they are very common: hundreds of thousands of women are estimated to suffer annually from post-partum depression.
Having a baby can be one of the most exciting and fulfilling new challenges. Alongside the late-night feedings and diaper changes, however, many women have to deal with mental health problems that their husbands do not.
The "baby blues," where women experience bouts of crying and sadness in the week following childbirth, affects at least half of all mothers. The Cleveland Clinic estimates that 50–75% of women experience these symptoms.
Up to 15% of those women will develop full-blown postpartum depression, with symptoms such as frequent crying, anxiety, irritability, and fatigue. Those symptoms can last from a few weeks up to a full year.
Part of what can be challenging about treating PPD is that it presents differently in different women. For some new mothers, it’s an intense anxiety about failing their new child, while for others it has more of the hallmarks of traditional, clinical depression (such as a lack of interest in usual activities and feelings of sadness).
About 400,000 to 800,000 mothers in the U.S. suffer annually from PPD, though that number may be an underestimation. One study found that up to 50% of cases of PPD will go undiagnosed. Undiagnosed PPD affects women of color disproportionately.
Only a single drug has been developed and approved to treat PPD in the U.S. Women are often treated with anti-depressants or talk therapy. Left untreated, PPD can greatly reduce a woman’s quality of life—and sometimes even end in suicide.
And a new study found that women who experienced postpartum depression for several months were at a heightened risk of developing long-term, clinical depression that lingered for years. The researchers also found that a mother's depression could have negative effects on her kids: the children of women who suffered from this kind of prolonged depression were twice as likely to have behavioral problems as the children of women who did not.
They can also be physical and even life-threatening. This can temporarily affect a mother’s lifestyle or responsibilities or permanently impact her physical health and well-being. Some of these complications can even result in the death of the mother. Bed rest, infected wounds, and lingering issues with major organs are all potential post-partum consequences.
Mothers can be placed on bed rest This reduces a woman's ability to work, care for other children, or even complete basic tasks. While some people might imagine bed rest to be a casual diagnosis, wherein a woman is simply "taking it easy" for a while, that is often not the case. Some women put on bed rest are so debilitated that they can barely get up from bed to get a drink of water.
Being placed on bed rest is a relatively common occurrence during pregnancy and can result from a variety of conditions. High blood pressure, cervical changes, vaginal bleeding, premature labor, poor fetal development, gestational diabetes, and placenta complications are just a few of the conditions that may lead to a woman being placed on bed rest for as long as several months.
Bed rest is prescribed to thousands of women each year. Its severity can range from simply taking it easy to literally limiting women to their beds for months on end. This is done in the goal of reducing the risk of a premature birth or a miscarriage. It is often prescribed to women with hypertension or who have a history of preeclampsia.
The consequences on women and their families can be severe, however. One woman, for instance, was put on bed rest for several months when she already had a 3-year-old daughter. Her husband was forced to quit his full-time job in order to take care of them both, drastically reducing their income just as they needed it more than ever.
Confined to the couch or the bed, the woman told NPR: "I wouldn't even get my own glasses of water. So I like to say that 'I was on bed rest, and he was on house arrest,' because he really couldn't leave either."
The effectiveness of bed rest continues to be debated, all while the practice itself carries its own risks. Some recent studies have claimed to find that bed rest can be riskier for some women than simply continuing on with normal activities. Doctors claim it can even be fatal in certain cases.
"One of the most dangerous things that can happen when a woman is on bed rest is having a blood clot," said Anne Drapkin Lyerly, an OB-GYN and professor of bioethics at the University of North Carolina at Chapel Hill. "You can have blood clots in your legs or in your pelvis. And if those clots travel to your lungs, it's life threatening."
Wounds can become infected, and other complications can be severe. Occurrences of serious complications during childbirth are rising in many countries and can threaten the lives of both the pregnant person and the child. Emergency hysterectomies alone have risen by over 50 percent in some nations. What's more, the public perception of serious complications is that they are rare, meaning that patients and doctors alike might not take symptoms seriously until it is too late.
Complications from pregnancy are common and can cause a variety of problems, ranging from temporary discomfort to chronic illness—and even death.
For example, bacteria that are typically active in the vagina before pregnancy can cause an infection in open wounds after a mother delivers her baby. This bacteria can affect the uterus and areas around the uterus.
There is typically a low chance of developing these infections unless the woman is young and there is an unscheduled cesarean, or a long delivery with excessive bleeding.
Nearly one-third of pregnant people worldwide are expected to deliver their babies via C-section by 2030. Chronic pain from the scar tissue resulting from that surgery is very common, affecting as many as 18 percent of pregnant people, according to one study.
For example, a young mother lost nearly half her body's blood during her C-section. After a week in the hospital, she thought the worst was over, but she went on to develop chronic pain around the scar tissue where the incision was made.
Common complications during childbirth include perineal tears (when the area between the vagina and the anus tears or is surgically cut), excessive bleeding, perinatal asphyxia (when the child does not get enough oxygen), and abnormal heart rate of the baby.
Many of these conditions also go unmonitored after childbirth because parents are so focused on their child's health that they neglect their own. One study found that as many as 40 percent of new parents don't go to their own doctor's appointment check-up after giving birth.
Kristen Terlizzi, who cofounded the National Accreta Foundation, had her uterus, appendix, and part of her bladder removed in 2014 because of a life-threatening placenta condition. “There’s this misconception that these complications are rare,” she told ProPublica. “And we [women] get brushed off — ‘The risk is not a big deal.’ But it is.”
For instance in the U.S., a 2017 investigation from ProPublica found that serious complications during childbirth were "skyrocketing." More than 50,000 women suffer severe complications each year—a number that has doubled since the 1990s, according to the report. And the investigation found that women who survive severe complications often deal with long-term consequences such as severe pain, the inability to give birth again, and intense trauma.
Emergency hysterectomies, for instance, have risen 60 percent. Not only is a hysterectomy an invasive surgery with a potentially long recovery time, but it renders the patient unable to get pregnant again. In 2014 alone, doctors in the U.S. had to carry out 4,000 emergency hysterectomies.
In the worst case scenarios, they can die. The U.S. has the highest maternal mortality rate of any industrialized country. In the modern era, many Americans forget just how common it is for women to die in childbirth. Blood clots and infections can advance quickly. And Black women and women of color are vastly more likely to die in childbirth than their white counterparts in the U.S.
Kameleon007, iStock by Getty
In the United States, approximately 700 women die each year as a result of complications from child birth. The maternal mortality rate in this country has been increasing since 2000, despite the fact that most of these deaths are preventable.
The rate of maternal mortality in the U.S. is higher than that of any other industrialized country by some measures. Especially when compared to other developed nations, the U.S. has a staggering number of maternal deaths. In 2018, for instance 17 women died for every 100,000 live births—more than double the rate for countries with similar healthcare and economic systems.
The differences in maternal mortality are stark when it comes to race and ethnicity as well. The maternal mortality rate for 100,000 live births more than doubles when the mother is Black (coming in at a rate of 37.1 deaths per 100,000 live births).
Women are advised to monitor themselves post-childbirth for warning signs of blood clots, infections, and hemorrhage, which can be potentially life-threatening. Severe complications—such as kidney, heart, or liver failure; bleeding in the brain or long-term comas—can also be fatal for mothers.
Some of the complications during pregnancy and childbirth—such as pre-eclampsia and gestational diabetes—put women at higher risk of heart disease, diabetes, and stroke throughout the rest of their lives. Even if they don't die in childbirth, therefore, they might die from complications that arose during childbirth.
"Both of these conditions are associated with basically a doubling in their lifelong risk for cardiovascular disease," Dr. Lisa Hollier, president of the American College of Obstetricians and Gynecologists, told NPR.
CLOSURE
The health risks, both emotional and physical, of pregnancy can last long after a woman gives birth. These can last months or even years and are sometimes life-threatening.
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