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Many Nurses Fail to Inform New Mothers About Postpartum Health Risks
In the United States, which holds the unfortunate distinction of having the highest maternal mortality rate among developed nations, a recent survey of postpartum nurses may shed light on this alarming issue. According to a study published in MCN: The American Journal of Maternal/Child Nursing, many of the 372 surveyed nurses lacked awareness of the significant health risks that new mothers face shortly after childbirth. Alarmingly, only 12 percent recognized that most maternal deaths occur within days or weeks post-delivery.
The findings from this study highlighted a glaring gap in knowledge regarding critical symptoms that could indicate serious health complications, such as swelling, intense headaches, excessive bleeding, and respiratory issues. This lack of awareness among nursing professionals could contribute to the high rates of maternal mortality, with an estimated 700 to 900 women succumbing to pregnancy-related complications annually in the U.S., alongside an additional 65,000 who experience near-fatal events, as reported by the Centers for Disease Control and Prevention (CDC). The CDC further indicated that nearly 60 percent of these fatalities are preventable.
The study also revealed that close to half of the nurses surveyed were unaware that the maternal mortality rate has increased in recent years, with 19 percent mistakenly believing it had declined. Debra Harrison, a co-author of the study and a leading figure at the Institute for Perinatal Quality Improvement, emphasized the severity of this educational gap among nurses. “If [nurses] lack awareness of the rising maternal mortality rate, it diminishes the urgency of conveying warning signs to mothers,” she explained.
An NPR and ProPublica investigation involving interviews with women who faced life-threatening complications during or after childbirth found a common theme: many believed that healthcare providers were slow to recognize the warning signs of impending crises. Given that nurses typically spend more time with new mothers, it is imperative that they are trained to identify potential postpartum health complications and effectively educate mothers on recognizing these signs themselves after discharge.
A significant issue arises from the limited time nurses allocate to educating new mothers about self-monitoring their health, especially since postpartum complications can manifest weeks after delivery. While 95 percent of nurses acknowledged a direct correlation between postpartum education and maternal mortality, over two-thirds reported spending less than 10 minutes discussing potential warning signs during discharge conversations. Reflecting on her own experience, Sara Greene noted that her discharge instructions primarily focused on her baby’s well-being rather than her own health risks. “I was only given the standard advice about calling if I filled more than one pad per hour,” she said, “but nothing on cardiovascular risks or blood clots.”
Harrison pointed out that some nurses might intentionally avoid discussing postpartum risks due to concerns about dampening the celebratory mood. “Some nurses have expressed, ‘I don’t want to scare the new mom. This is meant to be a joyful time, and I do not want to come across as fixated on death,’” she remarked.
In positive developments, the study is initiating efforts to bridge the gap between nurses and postpartum mothers by providing clear, easy-to-understand educational tools. This includes a one-page handout that new mothers can take home, serving as a quick reference for recognizing concerning symptoms and knowing when to seek medical attention, including the appropriate moments to dial 911. Testing conducted at four hospitals in 2015 yielded promising results, with nurses reporting that women returned to the hospital with the handout, stating, “I have this symptom.”
While numerous factors contribute to the distressing maternal mortality rate in the U.S., adequately educated nurses—who are often the last healthcare professionals new mothers interact with before leaving the hospital—could significantly improve outcomes. We must do better.
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