Moms: Make Your Voice Heard for a Safe Labor and Delivery

Last month in this space I wrote about the many things New Jersey hospitals are doing to ensure healthy births. Today’s column is all about the moms.

Moms, there’s nobody more important than you and your babies as you go through our healthcare system. My goal as a nurse is to make sure you feel prepared to be a full partner with your medical team when it comes to your care. I want you to have the information you need in the event that you have an unexpected complication during your pregnancy. Such complications are rare, and you shouldn’t be afraid. In fact, I hope you’ll feel more prepared and confident knowing this information.

For every 100,000 deliveries in the United States, about 20 result in the death of the mother. Two complications account for the majority of these deaths – pregnancy-related high blood pressure (also called preeclampsia) and excessive bleeding (also called maternal hemorrhage.) Here’s what you should know about these two conditions. And if you have questions or concerns, please raise them with your doctor, nurse or midwife.

Preeclampsia: Preeclampsia affects 5 to 8 percent of pregnancies. Those who may be more likely to develop preeclampsia include first-time mothers, those who have previous cases of pregnancy-related high blood pressure, women whose moms or sisters had preeclampsia, women carrying multiple babies, women with high blood pressure prior to becoming pregnant and women who are obese.

It’s important to have routine checkups so your healthcare team can watch for signs of preeclampsia during your pregnancy. They’ll check your blood pressure, urine and maybe other functions like your liver. Signs of preeclampsia include high blood pressure, water retention and protein in the urine. Other symptoms for you to watch for include headaches, blurry vision, stomach pain, nausea, vomiting and gaining weight rapidly (for example, more than five pounds in one week.)

If you experience these symptoms during your pregnancy, call your doctor, nurse or midwife right away. It’s very important for your health, as well as your baby’s. With you and your medical team working together to catch it early, preeclampsia can be managed and you can have a healthy delivery.

Maternal hemorrhage: Some bleeding is normal after delivering a baby, both vaginally or via C-section. However, excessive bleeding is abnormal and potentially dangerous. There are some women who may be more likely to experience maternal hemorrhage, including Asian and Hispanic women. Certain conditions of the uterus or placenta may also make you more prone to maternal hemorrhage. If your doctor, nurse or midwife tell you that you have a condition affecting your uterus or placenta, ask if it increases your risk for maternal hemorrhage.

During labor and birth, certain conditions could also increase the chances of hemorrhage. They include receiving general anesthesia (which puts you to sleep during birth); taking a drug to induce labor; or having a tear or laceration in your uterus during delivery.

Either in the hospital or once you return home, contact your doctor, nurse or midwife or call 911 if you have heavy bleeding that won’t stop, along with feeling lightheaded or feeling like your heart is beating fast.

For more information, visit the N.J. Perinatal Quality Collaborative website at or the My Birth Matters site at But most importantly, make your voice be heard with your healthcare team if you have concerns about these serious conditions.

Aline Holmes, DNP, RN, is the senior vice president of clinical affairs for the New Jersey Hospital Association, as well as the program co-leader of the New Jersey Nursing Initiative.

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Aline Holmes, DNP, RN, is the senior vice president of clinical affairs for NJHA, as well as the program co-leader of the New Jersey Nursing Initiative. She leads the New Jersey Hospital Improvement Innovation Network under the national Partnership for Patients initiative. A U.S. Navy Nurse Corps veteran, Holmes completed her doctorate in nursing leadership at Rutgers University. 

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