Conditions that threaten women’s lives in childbirth & pregnancy
Pregnancy and symptoms
This website is about severe maternal illnesses, women who are about to, or have just given birth. These illnesses could lead to the mother’s death without urgent medical intervention. These are sometimes known as ‘near misses’. As described in ‘What is a life threatening condition in childbirth’ these illnesses are rare, and can be caused by several different conditions (e.g. placental disorders, blood pressure, thrombosis - the formation of a blood clot inside a blood vessel, septicaemia - blood poisoning). The onset and symptoms of these illnesses will therefore vary greatly.
Here we describe what women told us about their pregnancies and early symptoms, if they had any. Some women had symptoms and a diagnosis before their baby was born, such as pre-eclampsia (high blood pressure) or placenta praevia (the placenta may be partly or completely covering the cervix/birth canal), which meant they realised they were at high risk before the birth. Others developed their illnesses after the birth (see ‘Pulmonary embolism (PE) and deep vein thrombosis’, ‘Hysterectomy’, ‘Haemorrhage’). Few of the women realised their conditions were so life-threatening.
Pregnancy
Experiences of pregnancy vary from woman to woman. While some women had problems from the early weeks, others sailed through their pregnancies with no symptoms or warning signs that anything might go wrong. Many of the women we spoke to described normal pregnancies with no signs of illness until very late in pregnancy. People can develop life-threatening complications even if they have had a normal pregnancy and a healthy lifestyle.
Alison, who had a haemorrhage after giving birth to her son, said that apart from a little blip...
Alison, who had a haemorrhage after giving birth to her son, said that apart from a little blip...
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And, you know, obviously when I got pregnant for the third time, thought, was quite hesitant and not quite sure whether I had, I wanted to be excited, but wasn’t quite sure whether it was going to work out or not. And at about five and a half, six weeks I had some slight spotting and thought here we go again, another one. But that passed and everything seemed okay and had an early scan at eight weeks, and everything was okay.
And so apart from a little blip early on and feeling quite sick for the first three months, I actually had a really lovely pregnancy, really enjoyed being pregnant, you know, I felt, I felt really good actually and felt happy and confident in myself, what my body was doing and yes, had a really nice time actually [laughs]. Which will all probably annoy some people, because they aren’t as fortunate to have such a nice, a nice pregnancy, but yes.
Natalie, who also haemorrhaged (heavy uncontrolled bleeding) after delivering her son, said “It was my first pregnancy, and it went really well”. Helen and Kate both developed HELLP syndrome (a combined liver and blood clotting disorder) and were shocked as they had both had very healthy, active pregnancies. Helen said, “I was having a completely normal pregnancy. I felt well. I was going to yoga, I was going swimming 2km a week, everything was completely normal. I was having a lovely time.” Kate also said she had a “model pregnancy” up until the 34th week.
Other women had more problematic pregnancies. Alison T had pneumonia during her pregnancy and was admitted to hospital. While she was there doctors discovered she had developed blood clots in her lungs (pulmonary embolisms, PEs) in her chest. She was told to drink lots of water, and was given anticoagulant injections to try and prevent clots. The rest of her pregnancy was closely monitored.
When she developed flu like symptoms it was discovered that Alison T had pneumonia. While she was...
When she developed flu like symptoms it was discovered that Alison T had pneumonia. While she was...
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The pregnancy was quite traumatic from when we first found out, because we were older parents and didn’t even know if we wanted another child. She wasn’t expected. But decided to go ahead and we were both really pleased. I had had some complications with other pregnancies such as gestational diabetes, so was checked regularly for that. Had high blood pressure… and I think apart from that wasn’t too bad, wasn’t too… complicated.
And then it was, when I became ill, and then with a bad cold which turned into flu and then went to the doctors and was told it wasn’t on my chest, but it was just flu like symptoms. To go home and to rest but I felt so poorly that had, I went to bed. Which looking back and finding out from medical people was the wrong thing to do, because when you’re quite heavily pregnant you shouldn’t lay down for long periods of time.
Went to the hospital a few days later for the gestational diabetes test, was too poorly to have that, and was discovered that I had PE’s, pulmonary embolisms and pneumonia. So, was taken to the labour ward into a room, because, just in case labour started, even though it was early, and also it was more specialist care in there, than just going to the to the ward.
So how many weeks pregnant were you when that happened?
Well that was the Christmas, so it was two months, probably about eight weeks before, so yes.
And when you ill with the pneumonia…?
Yes.
Describe to me how you felt with that?
Don’t remember that much about it, just remember struggling to breathe, coughing constantly, wheezing, all the usual flu like symptoms. Ached everywhere, just felt really, really poorly and unwell, unable to do anything, just wanted to sleep really. And obviously worried about the health of the baby, because I had all sorts of pains from coughing and but didn’t realised it was PE’s as well.
So they took you to the labour ward?
Yes.
And what happened once you got there?
I was monitored. I was on observations every fifteen minutes. Was given antibiotics, oxygen, a drip for fluids. Blood tests in my wrist, which is that’s where they determined, it was, it was, they were PE’s because they were multiple in both lungs. Had to drink lots because that helps to absorb the clots, and was on a nebuliser for quite a long time, and if not on a nebuliser then just on oxygen.
How did they describe to you what PE’s were? Did you, had you heard of them before you went in hospital?
I hadn’t heard of them. I wasn’t aware of what they were. The most upsetting thing was one of the consultants sat me on the end of the bed and said, did I know that PE’s were one of the biggest killers in pregnant women? And then that’s how I was told how I had them. So didn’t like his bedside manner.
My husband was more upset. I think I was so poorly I wasn’t taking everything in, but to hear it like that wasn’t, wasn’t nice.
Looking back, Jo said that she never really felt that well during her pregnancy. She went on to...
Looking back, Jo said that she never really felt that well during her pregnancy. She went on to...
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Six weeks into the pregnancy I started a new job which was just when the morning sickness kicked in and I was a teacher at the time, in a special, a new special needs school which had brand new carpets throughout which smelt vile and my sense of smell was just, well I’d never experienced anything like it. So I spent the whole of the first few weeks in my new very stressful job dealing with this vile smell of carpet and various other things.
The job, my job, was very demanding I was teaching post-16 students with profound and multiple learning difficulties. Which was often very physical. Emotionally challenging, you know, there was a lot of battling. There was issues with the people I was working with as well. So it was an unhappy, working time really.
Which consequently I was often finding myself very stressed very upset, just generally not very happy and ended up taking quite a bit of time off work, through sort of stress and anxiety really. Which obviously when you’re pregnant is not, is not ideal.
In hindsight, looking, you know, having had a subsequent pregnancy where I felt fine throughout, I realised actually that with my first pregnancy I really wasn’t feeling well. But I couldn’t have pin pointed what it was. It was a general kind of malaise, just really not feeling right. And, so, actually for the first six months of my pregnancy, there was nothing, there was no, there was no problem. My blood pressure was fine. Everything was fine. There was a bit of a glitch with my glucose tolerance test. I went and re-did that but then that was fine.
Hannah was pregnant with her second child. She felt a lot of pain and discomfort and found her...
Hannah was pregnant with her second child. She felt a lot of pain and discomfort and found her...
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Very painful. Couldn’t sleep on one side. Couldn’t sleep on my back at all. Whenever I slept on my back it was excruciatingly painful, because things were being squished. A lot of pain, sort of bladder region, because obviously that was in the wrong place and getting completely squished. A lot of hip pain headaches as well. Just lots of things, that were sort of, you know, this isn’t really right, because I had a really easy pregnancy before, and this was very strange. And then when, going into the midwife’s and saying, “Well you know I think this is, there’s something not quite right here.” And they would write down ‘Hannah feels uncomfortable’ [laughs]. Yes, because they don’t… you’ve got no way of telling them look I’m normally quite good at coping with this sort of thing because they don’t actually know you.
Onset of symptoms
Some women developed symptoms of their illnesses during their pregnancy and so were aware they had complications. Sometimes this led to the baby being delivered very quickly, in other cases it meant that they were monitored closely for the rest of their pregnancy.
Pre-eclampsia and HELLP syndrome
Doctors or midwives may pick up early signs of pre-eclampsia or HELLP syndrome through monitoring women’s blood pressure and measuring protein in their urine. Women who develop these conditions may need to have their babies delivered by emergency caesarean. Sometimes women will be monitored for a while, because the longer the pregnancy can be continued the better it is for the baby, but if symptoms become severe the baby needs to be delivered quickly for the sake of the mother’s health.
Julie's baby was overdue. She had high blood pressure which was being monitored by the midwives....
Julie's baby was overdue. She had high blood pressure which was being monitored by the midwives....
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Yes, and obviously with me being with me being overdue the midwives came quite frequently just to see if anything was happening. And they booked me in for a standard induction on a certain date, saying, “Right if you’ve not had your baby by then, we’ll book you in, and you’ll go in on that day and, and things’ll proceed.
I think they must have come in about day five and they did the manual sweep to see if they could start things off, and they did all the routine tests of my blood pressure which had started to go up, just ever so slightly, but nothing significant. And at that point, I just felt heavily pregnant, didn’t feel anything wrong.
And then, one afternoon I was sat on a birthing ball in the living room and I just got all these horrendous lights coming in front of me and my head and I thought someone had hit me over the head, this severe pain, so I thought ooh I don’t feel very well and felt very sick. And I thought ooh I’ve gone into labour, because obviously I’ve never had a baby before. I had no idea other than physical pain. I didn’t know if these were just quite normal.
So I got my books out and rang the hospital and spoke to the midwives and they asked me to ring my community midwife and I rang her and she came out, took some bloods, did a urine test and just examined me and everything and took the bloods, ranging me later with the bloods from the hospital saying I was borderline having the starts of pre eclampsia. So she said, “You rest. And when I say rest, you rest. You know, you’ve got to be really careful.” And came in every day.
Then so, that started on the Thursday. On the Saturday I started with really severe headaches again and the, the visual disturbances were there pretty much all the time. So I felt very, very unwell. By then I couldn’t put shoes on my feet, because my feet were so swollen and I started to get pitting oedema on the legs. I mean I didn’t think my face looked swollen, but when they saw me, they were like, “Yes, you are, you are very swollen.” But I think that was then I felt that poorly I didn’t really, I wasn’t bothered by then.
So we got the pleasure of going to [hospital] Maternity Unit for the day where they could monitor [daughter] and make sure she was okay, monitor my blood pressure. They did, I had to do a twenty four hour urine collection over the weekend, for looking at the protein and my blood pressure all the time and it was just going up and up and up and they were like, “For now, you’re okay. You can go home.”
So we went home on the Saturday after being there for about nine hours, since my (or I) came home with the 24 hour collection and I was told to ring if I felt anything had changed overnight, and I had to go back in at 4 o’clock on the Sunday just for them just to see how I was again.
Sunday morning I got up, well I mean I can barely remember sort of the Sunday, Monday because it all just… I felt that ill. So I got up on the Sunday morning and I had to take all my jewellery off because my hands had really swollen. I mean I could see it at that point. And every time I moved I felt very dizzy and very, very unwell.
And I got a little bit of tummy ache. Not like labour pains, because we never got to that point. But I just felt, I didn’t feel right. So I rang the ward and they said, “You need to come in.”
So we got there, they did my blood pressure and I think it was something like 220/130 something. So they said at that point I was definitely not going to be going home [laughs].
The women we spoke to who developed HELLP syndrome had high blood pressure and doctors also measured their liver functions. All these women had their babies early.
Helen had a normal pregnancy but her GP was concerned when she started to develop high blood...
Helen had a normal pregnancy but her GP was concerned when she started to develop high blood...
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I was having a completely normal pregnancy. I felt well. I was going to yoga, I was going swimming 2km a week, everything was completely normal. I was having a lovely time. And all the rest of it.
And I went for a routine 32 week GP appointment one morning, 8.30 in the morning and said, “Your blood pressure’s too high.” And I said, “Oh well, whatever.” Because I’ve had, I’ve never been regular at having my blood pressure taken because of something that happened back when I was at uni and so I always hate having my blood pressure taken. And so, I sort of brushed it off a bit, and said, to him, “You know, I’m sure it’s okay.” Or whatever. He was like, “I really want you to go into hospital.” And I was kind of like, “Oh that’s a bit extreme.” And he said, “Look, we’ll agree because you’re a physio, and I trust you. You can go to work, but I want you to take your blood pressure once an hour for the next three hours. I’m calling you at 12. If it’s still too high, we’re having this discussion again.” And I said, “Okay, that’s fine. Fair enough.”
So I went off to work and I took it for the next three hours and it was still very, very high, so we agreed that I’d go to the hospital. Which I did, and went to just the day assessment unit, where they did more monitoring of it. It was basically, it was still high, but borderline as to whether they’d medicate or not. So I think they said, if it was over a 150 on a 100 they’d definitely put me on medication. If it was well below that they wouldn’t bother. Mine was sitting pretty well bang on that. So they didn’t know quite what to do. So they took some bloods as well and basically said to me, “Look, we don’t know quite what to do with you. Come back on Monday, and we’ll see how things are then. Unless we call you and tell you that your bloods are off, and then we might ask you to come back in.” So that was fine.
So I came home and then I got a call the next morning, Friday morning, now saying, “Your liver function’s a bit funny. Can you come in?” And I said, “Fine.” So I went in and we pretty much had a repeat of what happened on the Thursday. Essentially, the same things all happened again, except they talked about admitting me, but then decided not to, because they said, “It’s the weekend; nothing’s going to happen over a weekend. Why bother putting you in hospital when we can’t do any tests and things. So you may as well go home.”
And the only thing they did that was different, was they did an ultra sound of Caleb just to make sure that his growth was okay, because they were suspecting pre eclampsia by then and so, apparently, their grown can be affected to they wanted to check that. But that was all completely normal, which was great. So I went home for the weekend. And had a pretty horrible weekend. I felt really, really uncomfortable. I just remember this tight pain kind of here, right under my boobs and trying to work out, you know, what that was, whether that was my liver being quite up high and that was the pain, and that’s what I thought it was, but God I was uncomfortable, and I couldn’t sleep and I just wanted it to be Monday, because I just wanted some kind of resolution. You know, this hanging around was terrible, because no one could decide what to do and it was horrible.
So I was quite relieved when Monday morning came and I went in again, and they said. I mean the blood pressure was still the same. They still didn’t know whether to medicate or not, because it was still borderline and I had no other symptoms of pre ecl
After a 'model pregnancy', Kate developed a pain in her ribs which she thought was indigestion. Her blood pressure went up and she felt swollen, so she went into hospital.
After a 'model pregnancy', Kate developed a pain in her ribs which she thought was indigestion. Her blood pressure went up and she felt swollen, so she went into hospital.
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Well I had a model pregnancy. Barely even registered it [laughs]. No morning sickness, no nausea. No reactions to smells like I believe some women experience. I was exercising. I was going to the gym up until about 22 weeks I think it was. And it was quite straight forward and I was still working fulltime. And you know, I had the regular checks, and everything was all right. Really happy about everything, going very smoothly.
And, let me see. I got to, well, about 34 weeks and I had what I thought was indigestion. I woke up at night with pains between my ribs. And I thought, well this must be indigestion. There’s nothing else for it. But it was quite hard to breathe, and I had that twice in a week, but I didn’t even mention it to the midwife, because I assumed it was indigestion. I actually told her it [laughs] it was indigestion.
I had one episode of slightly high blood pressure, but the rest of it had been fine, and then I was told by the midwife that I was so low risk that she wouldn’t need to see me for another three weeks. So I thought oh wonderful. And then ten days later it all went horribly wrong.
I’d been out for a meal the day before. I’d been swimming that evening. I’d been tutoring as well. And on the way home, I was thinking about dinner, as pregnant women always think about their next meal, and I thought, I don’t feel hungry. And I thought, oh this is a bit odd. Didn’t think much of it, got home and didn’t feel right. Something I couldn’t put my finger on. You know your own body don’t you? You know when something’s not quite right. And, I went on the NHS Direct website and I’d felt a bit swollen, my ankles were larger than normal, slightly uncomfortable. My fingers were slightly tingly as well. And I went down the check list of pre eclampsia and I thought well, general feeling of being unwell, swelling, and I thought well that’s a couple of things ticked off.
So I texted the midwife, and I said, “I don’t feel very well. Feeling slightly swollen. Possible pre eclampsia?” And she didn’t reply for four days [laughs]. Which is a bit late by then. So I text the other midwife that I had a number for and she texted me back the next day. I didn’t want to call them because it was about 8 o’clock at night and I thought well, I’ll just sleep it off you know.
So I called my partner. At the time we weren’t living together and I said, “I don’t feel very well.” And he asked me if I wanted him to come round, and I thought oh no, I don’t want to bother you. But something said, yes. Just you know, get him round. And then I have a blood pressure monitor, just as well and I took it and it was extremely high. It was 191/113. Which is high, and I thought oh gosh this is bad.
And I took [partner], I took my partner’s blood pressure and that was fine. So I took mine again and it was still the same high reading and on the NHS Direct site it had also said high blood pressure.
So I called NHS Direct and I said, “I’ve got this, this, and this.” And they said, “You should call the hospital.” So I was due to go to have the baby at a maternity ward. I was going to have drug free [laughs] water birth, you know, how it goes. And they put me in contact with the, with another hospital, and I told the midwife exactly how I was feeling and I told her the reading on my blood pressure monitor and she said, “Well it must be faulty.” So I said, “I’m really sorry. I feel really stupid. Sorry to have bothered you.” And I thought right I’ll just go and sleep it off.
&
Placental disorders
One of the causes of severe maternal illnesses is haemorrhage (heavy uncontrolled bleeding) that can be caused by disorders of the placenta (the organ responsible for providing nutrients to the fetus). For some women, haemorrhage developed unexpectedly during or after childbirth (see ‘Haemorrhage – heavy uncontrolled bleeding’ summary). Some women we spoke to had warning of problems with their placenta from scan results. Cate’s scans during her third pregnancy showed she had developed placenta praevia (the placenta may be partly or completely covering the cervix/birth canal). Doctors scheduled her for an elective caesarean. She was disappointed that she couldn’t have a home birth but it was quite a relief to have the decision taken away from her.
Kerry started bleeding at 11 weeks during her third pregnancy. She was diagnosed with placenta...
Kerry started bleeding at 11 weeks during her third pregnancy. She was diagnosed with placenta...
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The third pregnancy. It was perfectly fine, but there was like eleven weeks I noticed a show of bleeding. I went to the hospital. They just said the baby’s heartbeat was fine. The scan was fine. They never thought anything of it. Sent me home. I went to the hospital for my 20 week scan when they noticed the placenta was covering my birthing canal. They asked me to come back three weeks later to see if it had moved off, subsided anywhere else.
In between the time I was due to go back I started bleeding again. It was just a little bit to start off with. I went into the hospital, they kept me in for 24 hours after I stopped bleeding. Then let me home. Went back for the scan and this time they noticed it was firmly fixed, right across the birthing canal, which they call complete placenta previa.
They never really said anything about it, just told me that if you have any bleeds, or any shows of anything, come straight to the hospital. And that was that. And then I was about 24 weeks into the pregnancy, and I just remember waking up and I just felt really wet down below. I pulled the quilt back and it was just a big flood of blood all over the bed.
My partner dialled 999. I was taken into hospital again. They never really made a big deal of it. It was just, you’ve got to stay in hospital. Keep monitoring the baby. Once you stop bleeding for 24 hours after, you can go home again. But I never got home. I just bled for the full, the remaining two weeks. And then the bleeding stopped on its own.
Alex was diagnosed with the most serious type of placenta praevia grade 4 (the placenta completely covers the cervix/birth canal) and was kept in hospital for 8 weeks as doctors feared that she would haemorrhage before her baby was born. Her baby was born at 34 weeks.
Thrombosis
Some women developed blood clots during pregnancy or after giving birth. (See summary on ‘Pulmonary Embolism (PE) and deep vein thrombosis (DVT)’).
Sepsis
We interviewed a few women who had developed sepsis (an infection) or septicaemia (where the infection spreads to the blood stream) after giving birth. Again, this can develop very quickly or can take a while to build up.
Anna had flu-like symptoms and abdominal pain soon after going home with her second baby. She...
Anna had flu-like symptoms and abdominal pain soon after going home with her second baby. She...
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So then that was on the 21st of December. Because I felt all right and I just wanted to go home. You know, it was near Christmas, I wanted to be home with my family and stuff. They checked me over, everything was fine. He was breastfeeding fab. He just did it, you know, it was really good. And so then I was allowed to take him home at 4 o’clock that afternoon.
With my first pregnancy when my milk came through, my milk didn’t come through for a couple of days because obviously he was early and my body had to sort of kick into the fact that I’d actually had him. So when my milk actually come through with [older son], I felt like, like really ill. I felt like flu like symptoms. I felt dizzy. I didn’t really feel right. So then that evening, I thought I’d feel, after I’d had [younger son] and I was going to leave hospital, I felt dizzy and I felt, I didn’t feel right, but I just put it down to the fact that I’d had a big baby. Because he was, he was eight thirteen and a half and I’m not very big. So that was quite, hard. So you know, I thought my body had been through the mill, you know. So when I was on my way home I didn’t think anything of it. I just could explain everything that I was feeling.
So we went to my Mother-in-law’s, introduced you know, my oldest son to, to [younger son] and I just felt tired and just not, I just, I could explain it, I’d been awake all night, but I didn’t really want to, I just wanted to go to bed, and didn’t want to do anything. So when I came back here I just went straight to bed. And like I got visitors and stuff, but I couldn’t even get out of bed. I was like, “Oh just let them come upstairs, I don’t even care it’s a mess. Just do it.”
So that night when I wanted to breastfeed him, my partner would have to pick him up, put him on, while I had to have a pillow over my stomach and then when he was done put him back, because I just couldn’t do it, I was in so much pain. But I put it down to the fact that after birth, you know, like after pain sorry. After your second baby it’s supposed to be worse than your first anyway. So it was like I could explain all the pains and stuff I was getting. So… like 2 o’clock in the morning I got in the bath to try and ease the pain. It didn’t work, but I was, I kept on top of my pain relief as well. I was on like ibuprofen and paracetamol. I just kept on top of it, hoping that, you know, it would be all right.
So by the time morning came, I thought, right get up, go downstairs, make yourself feel a bit better. Got downstairs and oh I was just like dizzy, and I really didn’t, I just felt like really bad, and luckily my Mother-in-law was coming over. My boyfriend had to pick her up, and I said to him, “While you’re out, just get powdered milk.” It was literally at the point where if [younger son] had have cried, I couldn’t have done anything about it. I was in so much pain. But still at this point, still everyone was explaining it as after-pains. We’re all explaining it off, I was tired, it was a big baby. So many reasons why I’d feel like that.
While they were out, my midwife came. And you know, she was like, “Wow, you look rubbish.” I was like, they weren’t her words, but yes. And I was like, “Yes, I really feel it.” And I felt dizzy walking back to the sofa and that and she just basically said to me, “Look just write today off.” You know, “Go back to bed. Let everyone else take care of your baby and then tomorrow you should be feeling great. You should be feeling better.” And I was thinking, “oh thank God”.
An
Last reviewed April 2016.
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