THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: SUNDAY, June 5, 1994 TAG: 9406030058
SECTION: HAMPTON ROADS WOMAN PAGE: 06 EDITION: FINAL
SOURCE: BY DENISE WATSON, STAFF WRITER
DATELINE: 940605 LENGTH: Long
Those who saw him the morning of March 31, slumped in one of the hallways at DePaul Medical Center, knew he wasn't overflowing with joy. He was scared to death.
{REST} As his son lay at one end of the hallway breathing his first hours of life, his wife lay in an operating room down the hall on the brink of death.
``I was sitting there, alone, at 1:30 in the morning and the best they could tell me was that she was dying and they didn't know why,'' Blasdell said recently, sitting across from his wife, Nancy, who has recovered.
``All I could think of was this wasn't supposed to happen.''
And usually it doesn't. A century ago, a woman had as high a chance of dying while giving birth as she did of living. While medical advacements have pushed the U.S. maternal mortality rates to some of the lowest in the world, childbirth is still a danger for many women.
In one in every 12,500 births, a woman dies in the United States due to childbirth complications, according to the U.S. Department of Health and Human Services. For African-American women, the numbers triple, with the chances increasing to one in about 5,470.
``Maternal mortality is certainly very low compared to infant mortality, but yes women still die,'' said Dr. Alice Linyear, director of Women and Infants Health of the Virginia Department of Health and Vital Statistics.
``Certainly some things can be prevented but other times you do the best you can do and they still die.''
Being 37, Nancy Blasdell knew the risks were higher with her pregnancy but, like many women, she worried about the baby's health - not her own.
``I had an amniocentesis done to make sure everything was OK with the baby . . . we went through Lamaze. Everything was perfect,'' said Blasdell, a nursing instructor.
``I went into labor, that progressed just fine. Delivery was fine. I put the baby on my chest and my husband was elated. Then he took the baby to the nursery.'
``I don't remember anything after that.''
Within minutes of delivery, Blasdell's uterus inverted, producing massive bleeding.
Her husband returned to his wife's room where nurses were swarming with monitors and gadgets. His wife was slipping into unconsciousness as they tried to keep her awake. All he could do was hold the oxygen mask on her face while her obstetrician, Dr. James Stanley, manually corrected the uterus.
Then her blood pressure began to drop.
Blasdell was rushed to the operating room while nurses tried to track her pressure. At one point, it dropped to 40 over 0.
Throughout the evening, Blasdell received countless units of packed red blood cells, platelets, albumin and plasma. At one point, Blasdell remembers waking up and seeing dopamine and debutamine drips pumping into her veins.
``I remember thinking, I must be in trouble.''
It wasn't until the next day, swollen and stabilized, that Blasdell realized how much ``in trouble'' she had been.
``I told her, `I thought I was going to have to go home with Alan and not you,' '' Alan Blasdell, recalls telling his wife.
Nancy smiles only slightly.
``I heard about it in nursing school and they mentioned it briefly in Lamaze, but I never even thought about about the possibility of dying. You only think about the joyful, nice things,'' she said.
``But shortly after that I heard of similar incidents at other hospitals.''
Her obstetrician agrees such complications occur more often than people realize.
``I would say at least once a month,'' Stanley said. ``Most people think it can never happen, like car accidents; it can happen to the other guy and not to me.''
While maternal mortality has declined, medical officials are still concerned about the high rates among minority women.
``There are the obvious causes - lack of prenatal care. Less access to it, these women go to their doctors less often,'' said Dr. Peter Van Dyke, senior medical adviser of the Maternal and Child Health Bureau for the Health Resources and Services Administration in Washington.
``The clinics might not be culturally conducive for them, especially in the case of Hispanic and Asian women.''
Linyear says the cultural barriers are a problem in a transcient state like Virginia.
``We have a lot of immigrants who don't speak the same language . . . . other things might prevent them from seeking help or cause them to be offended early in their care,'' Linyear said. ``And I think we try to be sensitive to people of other cultures but it's hard to say that in each case that we are.''
On average, 11 women die in Virginia each year due to complications of childbirth. No telling how many, like Blasdell, come close but are saved.
The leading causes of death are pulmonary embulus when ``a blood clot breaks from the leg and locks into the lung or from the pelvis region and lodges in the lung,'' Linyear said.
Infection, hemorrhage and heart disease follow respectively as leading causes.
Complications can sometimes be prevented.
Doctors stress the importance of prenatal care to determine women who might be at-risk and their need to be monitored more carefully. Women who become pregnant before age 18 or after 35 are at a higher risk for complications.
Having more than four children increases the health risks of pregnancy and childbirth, especially if previous births have not been spaced more than two years apart.
Other warning signs include previous difficulty, premature or Caesarean births, other children born weighing less than 4.4 pounds or moms-to-be who weigh less than 84 pounds or under 4 feet 8 inches tall.
And despite the growing popularity of home births, professionals suggest that women be taken to a medical faciliity for delivery.
``No doctor would suggest that a woman deliver at home,'' Stanley said.
Blasdell believes that even with the quickest ambulance, she would not have survived a home birth.
``And she's probably correct,'' Stanley said.
The Blasdells have been married for two years and once had plans for a bigger family.
After Nancy's complications, however, they've decided to put those plans on hold.
``My husband often says, he'd rather have one son and a wife,'' Nancy repeats, ``than to have two children and no wife.'' by CNB