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