美国国家公共电台 NPR Many Nurses Lack Knowledge Of Health Risks To Mothers After Childbirth

 

AILSA CHANG, HOST:

On average, two mothers die from complications of pregnancy¹ and childbirth every day in America. That's a rate far higher than in other wealthy countries. NPR's Renee Montagne and ProPublica's Nina Martin are investigating the reasons why. This morning we hear that the most vulnerable time for a mother is after she has her baby.

RENEE MONTAGNE, BYLINE²: It is a fact that can surprise even the experts. Debra Bingham is a perinatal nurse with a doctorate³ in public health and a leader in the movement to bring down maternal⁴ mortality. She remembers sitting in a meeting a few years ago where she was struck by the number of deaths that can happen in the days and weeks after giving birth.

DEBRA BINGHAM: And all of a sudden, a big light went off in my mind. And it's like, oh, my gosh - the bulk of the deaths, 61 percent, are occurring in the postpartum period.

MONTAGNE: Sixty-one percent, a CDC statistic⁵ that floats up and down but has stayed consistently over 50 percent. Most women die within six weeks of birth, many in the very first week.

BINGHAM: No one can predict. The women can't predict; the nurses can't predict nor the doctors predict which women are going to have certain types of complications. Every woman should know about the post-birth warning signs. What are the symptoms? Which ones are emergencies?

MONTAGNE: But most women are not educated about postpartum risks, like Lindsay Averett in Decatur, Ga. When she gave birth to a healthy baby girl, it was more difficult than with her earlier twins. Lindsay's placenta wouldn't come out, so her obstetrician had to remove it in pieces. Here's how she remembers being discharged.

LINDSAY AVERETT: And you get the folder⁶ of aftercare instructions. And the nurse comes in and, like, (laughter) speed-reads this list of things to you. And, you know, you're still in vampire⁷ mode and hiding from sunlight as they're opening the blinds and trying to get you out of the door. And so it's possible that, you know, they mentioned things about how long afterpains should continue. But I don't recall that ever happening.

MONTAGNE: For her, those severe afterpains when she nursed her baby never stopped. And she was clammy and feverish⁸. But...

AVERETT: A lot of what I was feeling, I - you know, I attributed to the hormonal⁹ regulation and sleep deprivation¹⁰.

MONTAGNE: And it wasn't until a lactation consultant¹¹ told her that those pains were not normal two full weeks after birth that Lindsay made an emergency call to her obstetrician. When he discovered her uterus was full of placental tissue and that she had a temperature of 105, her husband rushed her to the hospital.

AVERETT: Yeah, I'm a very left-brained, rational person. But I just had this overwhelming sense that I was going to die. And my response was to just to start telling my husband, you know, what to do for our children and to let them know that I loved them. And, you know, our 2-week-old baby's in the back backseat screaming. And I just kept telling him, I have to tell you this now, I said - because I just had the sense that I didn't have a lot of time. And I wanted him to understand.

MONTAGNE: When they got to the hospital, a nurse told Lindsay it looked like she was going into septic shock and that she needed to give the baby to her husband so they could prep her for surgery.

AVERETT: And I just - for the first time, that day, I just became just wild with grief and sadness and rage. I mean, I just couldn't - I couldn't have her taken for me because I was - in that moment, I just realized this could be the last time I hold my baby. (Sobbing) And I said you can give me the IV in the hallway. You know, I'll sign a release or whatever. You can treat me here. I said, but if this is the last time, I'm not going to let her go before I have to.

MONTAGNE: What should have been a 30-minute operation took two hours. But Lindsay Averett was able to go home that day. If there is a front line for educating mothers like Lindsay about postpartum troubles, it is the nurses. A new survey of what they know is online today; 372 members of the Association of Women's Health, Obstetric and Neonatal Nurses responded. Study author Debra Bingham says the results point to a critical gap in their knowledge.

BINGHAM: Some of the striking findings for us was that 46 percent of the nurses surveyed were not aware that maternal mortality rates had increased in the last decade. In fact, 19 percent thought maternal mortality had decreased.

MONTAGNE: A majority did not know that most maternal deaths occur postpartum. And two thirds of the nurses reported spending less than 10 minutes going over the warning signs. Plus, lead author Trish Suplee says many shied away from talking about the postpartum complications that could prove fatal.

PATRICIA SUPLEE: One of the things that we did hear from nurses was, well, we don't want to scare them.

MONTAGNE: Certainly, some mothers will be frightened. Marie Rose McCausland is not one of them. The week before she gave birth in Cleveland, she came across our NPR/ProPublica story on the forum¹² Baby Bumps on Reddit. Someone had posted it under trigger - scary because it detailed¹³ the sad death of Lauren Bloomstein. So you weren't scared away. But it is scary, I think.

MARIE ROSE MCCAUSLAND: Yeah, I mean - I almost wanted to read most of the ones that said trigger warning because I wanted to know the scary things that might happen.

MONTAGNE: And five days after her son's birth, Marie did recognize something scary, the symptoms of pre-eclampsia she'd been reading about, swelling¹⁴ and high blood pressure. When an ER doctor did not recognize those symptoms and tried to send her home, she pushed back until she was admitted to the hospital and spent the next 24 hours on a magnesium¹⁵ sulfate drip, a key treatment for the complication.

MCCAUSLAND: I hate feeling like I'm, you know, complaining or being dramatic or something. And I - you know, we had just come home. And I probably would have just wrote it off just so that I could be home with the baby.

MONTAGNE: Kind of toughed it out.

MCCAUSLAND: Yeah. And thank God I didn't because it was pretty bad. I really don't - I don't know if I'd be here. (Laughter) I really don't.

MONTAGNE: Since NPR and ProPublica posted a call-out for childbirth stories, more than 3,000 women have clicked on the category, I Almost Died. And that dramatic number fits a grim reality. According to the CDC, about 65,000 American women do nearly die every year from complications of giving birth. Renee Montagne, NPR News.

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1 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 doctorate   

n.(大学授予的)博士学位

参考例句：

• He hasn't enough credits to get his doctorate.他的学分不够取得博士学位。
• Where did she do her doctorate?她在哪里攻读博士？

4 maternal   

adj.母亲的，母亲般的，母系的，母方的

参考例句：

• He is my maternal uncle.他是我舅舅。
• The sight of the hopeless little boy aroused her maternal instincts.那个绝望的小男孩的模样唤起了她的母性。

5 statistic   

n.统计量；adj.统计的，统计学的

参考例句：

• Official statistics show real wages declining by 24%.官方统计数字表明实际工资下降了24%。
• There are no reliable statistics for the number of deaths in the battle.关于阵亡人数没有可靠的统计数字。

6 folder   

n.纸夹，文件夹

参考例句：

• Peter returned the plan and charts to their folder.彼得把这份计划和表格放回文件夹中。
• He draws the document from its folder.他把文件从硬纸夹里抽出来。

7 vampire   

n.吸血鬼

参考例句：

• It wasn't a wife waiting there for him but a blood sucking vampire!家里的不是个老婆，而是个吸人血的妖精！
• Children were afraid to go to sleep at night because of the many legends of vampire.由于听过许多有关吸血鬼的传说，孩子们晚上不敢去睡觉。

8 feverish   

adj.发烧的，狂热的，兴奋的

参考例句：

• He is too feverish to rest.他兴奋得安静不下来。
• They worked with feverish haste to finish the job.为了完成此事他们以狂热的速度工作着。

9 hormonal   

adj.激素的

参考例句：

• Some viral diseases are more severe during pregnancy, probably tecause of hormonal changes. 有些病毒病在妊娠期间比较严重，可能是由于激素变化引起的。
• She underwent surgical intervention and a subsequent short period of hormonal therapy. 他接受外科手术及随后短暂荷尔蒙治疗。

10 deprivation   

n.匮乏；丧失；夺去，贫困

参考例句：

• Many studies make it clear that sleep deprivation is dangerous.多实验都证实了睡眠被剥夺是危险的。
• Missing the holiday was a great deprivation.错过假日是极大的损失。

11 consultant   

n.顾问；会诊医师，专科医生

参考例句：

• He is a consultant on law affairs to the mayor.他是市长的一个法律顾问。
• Originally,Gar had agreed to come up as a consultant.原来，加尔只答应来充当我们的顾问。

12 forum   

n.论坛，讨论会

参考例句：

• They're holding a forum on new ways of teaching history.他们正在举行历史教学讨论会。
• The organisation would provide a forum where problems could be discussed.这个组织将提供一个可以讨论问题的平台。

13 detailed   

adj.详细的，详尽的，极注意细节的，完全的

参考例句：

• He had made a detailed study of the terrain.他对地形作了缜密的研究。
• A detailed list of our publications is available on request.我们的出版物有一份详细的目录备索。

14 swelling   

n.肿胀

参考例句：

• Use ice to reduce the swelling. 用冰敷消肿。
• There is a marked swelling of the lymph nodes. 淋巴结处有明显的肿块。

15 magnesium   

n.镁

参考例句：

• Magnesium is the nutrient element in plant growth.镁是植物生长的营养要素。
• The water contains high amounts of magnesium.这水含有大量的镁。