Study: Many nurses lack crucial information about postpartum care

A recent study published in MCN: The American Journal of Maternal/Child Nursing found that many American nurses -- even those with advanced degrees who specialize in maternal and infant care -- lack critical knowledge about postpartum complications. For example, nearly half were unaware that the maternal mortality rate in the U.S. has risen in recent years.

Over the past few months, ProPublica and NPR have been reporting on maternal and infant health. A number of mothers who nearly died reported that their doctors and nurses seemed slow to recognize potentially complications from childbirth. This study substantiated their reports.

The U.S. maternal death rate is the highest among affluent nations. Some 700 to 900 mothers die each year from causes related to pregnancy and childbirth. Another 65,000 come close to dying, according to the Centers for Disease Control and Prevention. The problem is most common among African-Americans and women who live in rural areas, and nearly 60 percent of maternal deaths are preventable.

For the study, researchers surveyed 372 U.S. nurses who specialize in obstetrics and neonatal care. Nearly a third had master's degrees or doctorates. All were members of the leading professional organization of its type, the Association of Women's Health, Obstetric and Neonatal Nurses.

Beyond failing to recognize that maternal mortality is on the rise in the U.S., the nurses had significant gaps in their knowledge. Only 12 percent knew when most maternal deaths occur, which is in the days and weeks after the delivery. Only 24 percent knew that heart-related problems are the leading cause of maternal mortality in the United States.

Without knowledge of common complications and the symptoms to watch out for, these nurses are unable to educate new mothers on the risks they may face. Failure to inform mothers of common risks and their symptoms could be nursing malpractice.

Some symptoms mothers should watch out for because they may indicate serious or even life-threatening complications:

• Profuse or uncontrolled bleeding
• Shortness of breath or chest pain
• Coughing up blood
• Signs of shock
• Fever
• Severe, persistent or increasing pain in the abdomen, pelvis, vagina or perineum
• Any worsening pain or soreness
• Pain or burning while urinating, dark, bloody or scanty urine
• Pain or tenderness in one area of the breast
• Severe or persistent pain, tenderness and warmth in one area in the leg
• One leg more swollen than the other
• Severe of persistent headaches
• Double vision, blurring, dimming vision or flashing spots
• Severe or persistent vomiting
• Inflammation at the IV insertion site
• Extreme sadness or despair, or delusions about harming yourself or the baby

If you experience any of these symptoms or feel that you're getting worse instead of better, contact your doctor or call 911.