Meet Dr. Brittney Johnson, a badass birth warrior who discusses her labor and facing the most common delivery complication- postpartum hemorrhage

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**Episode Notes**

Articles

NYT: https://www.nytimes.com/interactive/2023/02/12/upshot/child-maternal-mortality-rich-poor.html

MATERNAL AND INFANT HEALTH INEQUALITY: NEW EVIDENCE FROM LINKED ADMINISTRATIVE DATA

https://www.nber.org/system/files/working_papers/w30693/w30693.pdf

Breast Feeding Resource: KellyMom.com

Terms:

IUD: a hormonal or non-hormonal form of birth control. 

Skyla - hormonal lasts up to 3 years

Kyleena - hormonal lasts up to 5 years 

Liletta - hormonal last up to 7 years (very similar to Mirena)

Mirena - hormonal lasts up to 8 years (increased from 5 years)

Paragard - non-hormonal/copper lasts up to 12 years (increased from 10 years)

Ovulation sticks vs LH kits: a hormone that is detected in your urine that lets you know when you are ovulating 

Ectopic:  a pregnancy that occurs outside of the uterus. 

Miscarriage:  pregnancy loss in the first 12 weeks of gestation or first trimester

80% occur in the first trimester 

50% due to chromosome abnormalities 

Full term:  37 weeks of pregnancy to 40 weeks, your due date

Postpartum hemorrhage:  1000+ blood loss in first 24hrs after delivery

Management for postpartum hemorrhage 

Medical interventions - Uterotonics:  Medications to help stop bleeding

Pitocin given intravenously (IV) 

Methergine given as an injection

Cannot give if you have high blood pressure 

Side effect is high blood pressure

Hemabate given as an injection

Cannot give if you have bad asthma 

Side effect is diarrhea (sorry!)

Cytotec, pills given orally or rectally 

Side effect is fever 

Tranexamic acid (TXA) given in the IV

Mechanical interventions:

Bakri:  Balloon placed in the uterus to apply pressure and drain the uterus

Vaginal pack:  gauze placed in the vaginal to apply pressure 

Surgical interventions for PPH:

Dilation and Curettage (D&C):  removal of contents of the uterus 

Uterine Artery Embolization (UAE):  Procedure performed by Interventional Radiology (IR) to place medicine in the artery that supplies blood flow to the uterus.

Hysterectomy:  Removal of the uterus completely

Anemia in Pregnancy 

First trimester – Hemoglobin <11 g/dL (approximately equivalent to a hematocrit <33 percent)

Second trimester – Hemoglobin <10.5 g/dL (approximate hematocrit <31 or 32 percent)

Third trimester – Hemoglobin level <10.5 to 11 g/dL (approximate hematocrit <33 percent)

Symptoms:  fatigue, shortness of breath, dizziness, and headache 

Lactation consultant:  people trained to help with breastfeeding