By the second day of her wife Hillary B.'s induction at the hospital, Emily J. could tell that something was wrong. Hillary had a pounding headache, was unable to urinate and felt severely dehydrated. After undergoing an emergency C-section on day three, the urine that Hillary was able to pass was brown.
Emily suspected that Hillary was experiencing preeclampsia and warned her care team about her wife's symptoms. At first, "they didn't listen or do any labs to check other than her blood pressure, which was asymptomatic," Emily says. Adding to the intense fear and stress was the fact that their newborn had been rushed to the NICU after breathing in meconium during labor, making it impossible for the couple to focus solely on Hillary's intensifying symptoms.
Hillary’s doctors and nurses finally confirmed she had preeclampsia and began treatment. "As first-time parents, advocating for ourselves was hard because I didn't know what to expect," Emily recalls.
In the end, it was Emily's willingness to speak up about her wife's symptoms that led to Hillary getting the help she needed. But when the family of three finally left the hospital a week later, Emily and Hillary were "really traumatized."
Although Hillary and their newborn made it home safely, not every family is so lucky. Pregnancy-related complications kill 750 to 860 women each year in the United States, according to the Centers for Disease Control and Prevention (CDC). But many of these deaths are preventable. And non-birthing partners can play an important role, experts say.
"Being a good support system may help the patient remain as healthy as possible during and after pregnancy," says Marquita Anderson, M.D., an OB/GYN on the medical staff at Texas Health Harris Methodist Hospital Hurst-Euless-Bedford and a Texas Health Physicians Group physician at Texas Health Women's Care in Bedford, Texas.
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As one example, "If a pregnant woman has a medical condition like hypertension that requires monitoring at home or medication, their partner can encourage and remind her to check her blood pressure and help make sure she makes it to appointments recommended for monitoring,” Dr. Anderson says.
Partners can also familiarize themselves with the symptoms of pregnancy-related complications and advocate for their partners during pregnancy, in the delivery room and postpartum, as Emily did for Hillary.
Although it can be scary to think about, familiarizing yourself with symptoms of pregnancy and postpartum complications and knowing how to advocate for your partner can help ensure a safe outcome. That's why the CDC's Division of Reproductive Health launched Hear Her, a campaign to raise awareness of maternal warning signs and improve communication between patients, their partners and their health care providers.
Here are some red flags every non-birthing partner can be on the lookout for.
Pregnancy and postpartum warning signs to watch for
Symptoms like fatigue or achiness are par for the course during pregnancy and in the postpartum period. Heavy postpartum discharge and bleeding, called lochia, is also normal, whether a new mom has given birth vaginally or via C-section.
However, other symptoms that crop up in pregnancy and postpartum could be signs of life-threatening complications such as postpartum hemorrhage, deep vein thrombosis, preeclampsia or heart problems. Many of these complications can occur both during pregnancy and after giving birth.
Symptoms that warrant a call to the doctor include:
- A bad headache that won't go away or keeps getting worse. Throbbing pain that doesn't ease up with medicine or fluid intake could mean a mother is developing preeclampsia, especially if she has a history of high blood pressure.
- Feeling dizzy or fainting. Lightheadedness or passing out can signal problems including preeclampsia, stroke, heart or lung problems, excessive bleeding or blood sugar issues. This symptom is especially serious if it's accompanied by a headache, blurred vision, slurred speech, rapid heartbeat, chest pain, shortness of breath or heavy vaginal bleeding.
- Vision changes. Blurry vision, blind spots, seeing double or vision loss are all red flags. They could indicate preeclampsia or a stroke.
- Fever of 100.4 F or higher. Fever may be a sign of an infection, especially if it's accompanied by diarrhea, nausea, vomiting, chills, severe abdominal or back pain, trouble urinating or foul-smelling vaginal discharge.
- Trouble breathing. A mom might feel short of breath, complain of chest tightness or need to prop herself up with pillows to breathe easier when lying down. These could be symptoms of preeclampsia, pulmonary embolism, a lung infection or a heart problem.
- Chest pain or a racing heart. Chest tightness or pressure and fast or irregular heartbeats could be signs of a heart attack, blood clot in the lungs or other heart problems, especially when accompanied by arm or leg swelling, trouble breathing, headache or dizziness.
- Nausea or vomiting. These are concerning when they go beyond the usual morning sickness symptoms — think not being able to drink for more than eight hours, not being able to eat for more than 24 hours or not being able to keep fluids down. Severe nausea or vomiting could indicate a viral infection, liver or pancreas problems or severe food poisoning.
- Severe abdominal pain. Sharp or stabbing pain that doesn't ease up or gets worse over time is a serious warning sign, especially if a mom-to-be is also experiencing back pain, bad heartburn, pain in the upper belly or vaginal bleeding. It's possible that these could indicate preeclampsia, HELLP syndrome or placental abruption.
- Vaginal bleeding or fluid leaking during pregnancy. Period-like bleeding, fluid leaking or foul-smelling discharge in pregnancy may be signs of an infection or placental abruption. Leaking fluid could also mean a mom-to-be's water is breaking.
- Very heavy vaginal bleeding postpartum. Postpartum bleeding is normal and can last for up to six weeks. But soaking through one or more pads in an hour, passing very large clots (the size of a lemon or larger) or foul-smelling vaginal discharge are serious. They could mean a new mom is experiencing postpartum hemorrhage, has an infection, has a vaginal tear that isn't healing properly or still has some of the placental tissue in their uterus.
- Legs or arms that are very swollen, red or tender. It's not uncommon to experience mild swelling during pregnancy. But severe swelling (during pregnancy or within six weeks postpartum) that's accompanied by redness or tenderness, especially in the calves, or swelling in just one leg, could be a sign of a blood clot.
- Face or hand swelling. Swelling is serious if it makes it harder for a person to bend their fingers or open their eyes, especially if it happens quickly. It could mean a mom-to-be has preeclampsia.
- Intense exhaustion. Feeling tired during pregnancy or postpartum is normal. But sudden exhaustion or feeling so tired that she can't get up to care for the baby is not — it could signal anemia, heart disease, diabetes or postpartum depression.
- Less or no movement from the baby during pregnancy. A significant change in movement could mean a mom-to-be has a uterine infection, her amniotic fluid is low or the baby is experiencing distress.
- Thoughts of self-harm or harming the baby postpartum. These thoughts may be accompanied by extreme sadness or hopelessness, intense worry or anxiety, or appearing to be out of touch with reality. They could mean a mom is experiencing postpartum depression, postpartum anxiety or postpartum psychosis. If you're worried that your partner is in danger of hurting herself or others, call 911 right away.
How partners can support new moms and moms-to-be
You should call your partner's health care provider or seek emergency medical attention to get treatment for the possible pregnancy or postpartum warning signs listed above. But getting help for severe symptoms isn't the only way you can help protect your partner's health and give her the support she needs.
Know her risk factors
Pregnancy or postpartum complications can happen to anyone, but some conditions may be more likely to strike in certain people. Preeclampsia, deep vein thrombosis and heart problems such as cardiomyopathy are more common in pregnant women who are older, overweight or have high blood pressure, for instance. Other complications, such as gestational diabetes or hypertension, disproportionately affect Black moms-to-be.
Go to prenatal appointments together when you can
Attending visits means you get a chance to listen to her health care provider and voice your own concerns (as well as ones that your partner may have trouble speaking up about).
"I recommend non-birthing parents attend appointments with their pregnant partners whenever possible, encourage their partner to speak up and doctor appointments and ask their own questions as well," Dr. Anderson says. As an added bonus? You'll feel more involved in the pregnancy and closer to the baby, too.
Be the dedicated note-taker
Take on the task of keeping a running list of questions and/or symptoms that your partner wants to discuss with the doctor at her next visit. Be the one to write down important information at appointments, too, so you have detailed records of what the doctor says.
Pay attention to your partner
Listen when she speaks up about a symptom, especially if she brings it up more than once. Take note of your partner's appearance, too, Dr. Anderson recommends. For instance, does she look puffier or more swollen than usual? Does she report a headache that's getting worse even after taking medication?
State the facts without being scary
Speak up if you suspect that a symptom could signal something dangerous, but try not to be alarming. You might say something like, "Remember when the doctor said to watch out for X, Y and Z? It looks as if that may be happening," Dr. Anderson suggests.
Take charge with follow-up care
Be the one to get information on instructions for moving forward with care at home, and find out which new symptoms warrant medical attention.
Pregnancy and postpartum complications can be scary to think about. The good news is that non-birthing partners can play a big role in keeping moms-to-be healthy and safe. Working together with your partner can help ensure her safety, plus it's great practice for functioning as a team once your sweet bundle arrives.
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