Hold on a minute! Did that 56 year old new mother die because of advanced maternal age or because of medical error?

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I admit it.

When I saw headlines like this one from Yahoo Parenting, A Week After Welcoming the Twins She Longed for, Mom, 56, Dies, I assumed that she died as a result of her decision to attempt pregnancy at such an advanced maternal age. I expected that when I read the article, I would learn that she died from a heart attack, or postpartum cardiomyopathy, or a worsening of a long term serious medical condition. In other words, I figured that she was partly responsible for the deadly outcome.

But she didn’t die as a result of advanced maternal age. According to the article, she died as a result of a bowel obstruction, a surgical complication, and one that is very treatable if recognized early.

Nonetheless, the focus seems to be on the age of Dr. Lisa Swinton McLaughlin, mother of premature twins Dylan and Jordan.

… Dr. Vincenzo Berghella, …, a professor of obstetrics and gynecology at Thomas Jefferson University in Philadelphia, says he is all for pregnancy for any woman who wants it. But he’s also careful to go over all the risks involved, he says, and compares opting for IVF pregnancy at an advanced maternal age to that of people who choose to not wear helmets while riding their bikes. “If the risks are not too high for you, then you do it,” he says. “But while the baby might be healthy, it might not be able to enjoy a healthy mom.” The risk of pregnancy-related death for women 40 and over, according to the Guttmacher Institute, is five times higher than that of women 25 to 29.

Medical News Daily weighs in:

Pregnancies in older women are associated with greater risk of miscarriage, stillbirth, cancer, needing a caesarean or assisted delivery, fetal anomalies such as Down syndrome, and even a heart attack in pregnancy, albeit a rare event, Dr Tony Falconer, the president of the Royal College of Obstetricians and Gynecologists (RCOG) in England told The Guardian. These types of pregnancies are also associated with increased risk for gestational diabetes and multiple pregnancy, such as what occurred in McLaughlin’s case. Both these conditions can complicate childbirth and increase the risk of developing injuries.

But McLaughlin did not die of any of those complications.

Due to her condition, doctors decided to deliver her sons via C-section on Dec. 27, 2014. Though their birth was premature, the boys were reportedly born healthy. Unfortunately, the same could not be said for their mother. McLaughlin complained of stomach pain, which she had attributed to her C-section incision. In reality, the new mother was suffering from a severe bowel obstruction. A week after giving birth McLaughlin passed away from her condition, leaving her newborn sons in the care of her husband.

A bowel obstruction, a kink in the intestine that stops all flow through the digestive system, is a well known surgical complication. It is unusual after a C-section since the bowel is not touched during the typical C-section, but it can happen. They symptoms include pain, intermittent and often severe, as well as nausea and vomiting.

A post surgical bowel obstruction is a treatable condition. Sometimes it will resolve on its own if the bowel is allowed to rest and nothing is taken by mouth. If it does not resolve on its own, surgery must be performed to untwist the kink. It’s important to diagnose and treat a bowel obstruction in a timely fashion. That’s because the kink can also cut off the flow of blood to that area of the intestine, leading to gangrene and/or perforation (a hole in the bowel spilling its contents into the abdominal cavity). These are potentially deadly complications.

Let me stress that I don’t know what actually happened. I, like everyone else, know only what I have read in the mainstream media. But if Dr. McLaughlin died of a bowel obstruction, it is unlikely that her age had much to do with it and far more likely that this was a surgical complication, possibly one that was not diagnosed and treated in a timely fashion.

This is a terrible tragedy. A woman who desperately wanted children died shortly after meeting those them, and two premature babies who desperately needed their mother are destined to grow up motherless. There’s not much that could be worse than that, except perhaps for implying that Dr. McLaughlin’s death was the result of a bad choice on her part when the reality is that is may have been the result of a medical error.

  • Sadlady

    I have a concern for a friend with a sudden last minute complication that she says changes everything for her scheduled c section. Shingles with 7 days left! Is the medication ok for breastfeeding? Is cutting her ok? Do they need to try version again instead to turn baby? Do they need a vaginal breech birth expert now? Will the body change its due date due to illness? Will baby get chicken pox? What if baby needs to nurse for immunity but it’s too hard due to the illness? Scary!

    • Daleth

      Your friend needs to ask her doctor. Best of luck to her.

  • nomofear

    I just saw her picture – we know from a few studies that women of color often have pain levels discounted, don’t we? I wonder if that played a part here.

    • Daleth

      For another perspective, a friend of mine (who happens to be a woman of color) walked around for days with a rupturing and then ruptured appendix because she apparently has a really high pain tolerance and it didn’t bother her much. She spent a while recovering in the hospital, as you can imagine. Meanwhile I all but writhe in agony on the ground every time I get a paper cut–I have pretty much no pain tolerance–so I can’t even imagine walking around with end-stage appendicitis.

      • nomofear

        Ha, I had a friend (white guy) who did the same, till he passed out in an airport bathroom and had to be rushed to the hospital because his had ruptured, too. The difference in both of these is that the person had a high pain tolerance, wasn’t under medical care to begin with, and ignored symptoms. We don’t know if this lady did, too – but it sounds like her case was mishandled in several respects, regardless of how she was handling the pain. Like, releasing her even though she hadn’t had a real movement.

  • Tosca

    Cue NBCers using this as to PROVE!!!1! how dangerous C-sections are…

  • Nathan0127

    Amy,

    You said that: “Let me stress that I don’t know what actually happened. I, like everyone else, know only what I have read in the mainstream media. But if Dr. McLaughlin died of a bowel obstruction, it is unlikely that her age had much to do with it and far more likely that this was a surgical complication, possibly one that was not diagnosed and treated in a timely fashion.”

    You are correct with only one fact and that is :”Let me stress that I don’t know what actually happened.”

    Saying anything else besides that as you did that is way too much for someone not knowing what happened.
    Age *may* have something to do with it.
    Having had twins iatrogenically *may* have had something do do with it.
    She *may* have had adhesions and prior surgery and, and and…
    So all these “mays” require physicians to just not say more and just say: “I don’t know what happened and refuse to speculate.”

    • Amy Tuteur, MD

      Unfortunately, the doctors interviewed by various mainstream media outlets had no problem speculating about the effects of advanced maternal age on this woman’s case. I thought it was only right for another doctor to speculate that her age had nothing to do with it. Doesn’t that seem fair?

      I’m moved that McLaughlin was a physician like myself and I can easily appreciate her desperation to have children. She’s not here to speak for herself, but I suspect that if she were, she would not be pleased with the way that the media is portraying her death.

      • Nathan0127

        “Unfortunately, the doctors interviewed by various mainstream media outlets had no problem speculating about the effects of advanced maternal age on this woman’s case. I thought it was only right for another doctor to speculate that her age had nothing to do with it. Doesn’t that seem fair?”
        No, that is not fair.
        Two wrongs do not make a right.

        • guest

          Really? You don’t think it’s entirely appropriate to counter someone’s speculation of “it almost certainly was X” with a “well, sure, but it also could have been Y.”

          It helps interested people see the full scope of a situation. And not as black and white as you are making it out to be.

      • Lisa from NY

        I suspect it’s the progesterone shots given to women undergoing IVF. They cause constipation.

        • Daleth

          Wrong. The progesterone stops no later than the end of the first trimester. This poor woman had five-six months (depending on the gestational age of her twins) to get it out of her system, so it was gone gone gone.

          What IS possible is that Vicodin or Percocet were given for pain relief after her c-section, and caused peristalsis (constipation due to lack of movement in the intestine).

  • sdsures

    It’s sad. 🙁 You’ve just had major abdominal surgery (i.e. CS), and of course there will be some abdominal pain. Of course she would have attributed it to the surgery – post-operative abdominal pain with a CS is expected.

  • Staceyjw

    I also wonder how much of that bias towards her age and sex contributed to the fatal event. Womens pain is often ignored, even with pregnancy related problems. All it takes is for a few people that should have been paying attention, to chalk ip her pain as CS, or just a whiny older woman.
    That they are focusing on her age is not a surprise. It’s unique enough to make the story sellable, as well as a way to shame other women for having/wanting late babies. So it’s a two-fer: catchy headline, plus woman shaming. Maybe a triple play of you add all the superiority others will feel for not making the same choices.
    Making the public blame her also makes those providers look innocent….

  • Daleth

    That’s so horrible. I had a type of bowel obstruction–an ileus–after my c-section and it wasn’t diagnosed correctly for two days. I kept telling doctors that something wasn’t right and they kept insisting my symptoms were normal. Finally a resident (!!!!) realized what was wrong, sent me for an x-ray (working her ass off to get me to the x-ray room before it closed for the night–I got there with like 10 minutes to spare) and diagnosed it. And this was at a really good university hospital.

    Once I read the symptoms of an ileus online, I could not understand how so many doctors could have missed it. And I don’t understand it in this poor woman’s case either.

  • Gozi

    I mean no disrespect to this woman and her family, but if I ever say I want kids at 50 plus years of age please come find me and give me several swift kicks in the ass.

    • The Bofa on the Sofa

      I know what you mean. We had our second when I was 42, and my response was, “I’m too old for this shit”

      • mythsayer

        Pshaw…. I had my one kid at 32 and after she was born I was ready to give her back because I felt so old (not really, lol). I only want one kid anyway, but I told my husband that if I ever had baby fever again, I still wouldn’t have another because it’s just so damn hard over 30 (I also manifested an autoimmune disease after she was born… probably had it for years but it was fairly dormant until after my pregnancy, which is pretty common). I always though the young’uns having kids were crazy (two of my cousins started at 21… one an “oops” and the other married but still an “oops”). I can now understand the appeal of having kids young.

        • Julia

          Ha ha, I’m actually glad that I had my one child later (40) – I would not have handled motherhood well in my 20s and early 30s. I just didn’t have the emotional maturity – – but probably a higher tolerance for sleep deprivation. It wasn’t until my late 30s that I felt ready, and it actually hasn’t been hard (granted, I’m only 3.5 yrs into the whole thing).

          • wookie130

            I feel the same way. I had mine at 34 and at 36, and feel like this was absolutely the best window of time for me.

        • Mishimoo

          I had mine at 18, 21, and 25 – all planned, because I was told when I was 13 by an Ob/Gyn that I’d be infertile by 25. Looks like the Ob/Gyn was wrong but I don’t regret doing it this way, and neither does my partner.

          • just me

            That’s so great for you that your potential infertility was discovered so young. Most women with infertlity don’t find out til it’s practically too late. So smugly saying “too bad you weren’t smart like me and had kids young” doesn’t really help anyone.

        • AB

          You may have felt differently if you had dealt with any kind of infertility issues. I was so absolutely sure I wanted to have my first before I was 30, so my ex-husband and I started trying when I was 28. Well, as it turned out, the ex was infertile and we tried for over four years and did three rounds of infertility treatment, all unsuccessful.(And now we’re no longer together, which is a whole other story…) My point is, I turned 36 in September, and if I’m lucky enough to meet someone new at this point, I’ll be the most ecstatic AMA mother ever, no matter how tired I am. I thought I’d be done at this point, but life doesn’t always work out as you plan. In complete honesty I am so jealous of women who can plan how old they are when they have their babies, because if life had worked out as I planned, I’d be helping a second grader with his/her homework right now.

          I don’t think I’d go as far as this woman did (I don’t want to use donor eggs) but I can certainly understand why she did it, and I feel heartbroken for her family. I’m glad someone out there is pointing out that her age may not have been the primary issue.

      • sdsures

        Picasso fathered children well into his 80s, didn’t he? 😉

      • Gozi

        I know guys who are continuing their families in their late sixties.

        • Lisa from NY

          Fertility doctors truly don’t warn older women of the risks. They just want the money.

          • just me

            Have you ever seen a fertility doctor? I highly doubt it. There may be a very few who fail to warn but not most.

          • Mac Sherbert

            My fertility doctor didn’t seem to have any trouble finding patients. Plus, I’ve been told there’s a waiting list for donor eggs. They get plenty of business and have not need to with hold the risks. Women desperate for a child/pregnancy will generally take the risks.

          • Daleth

            Lisa, fertility docs do indeed warn people of the risks, actually. My clinic warned me about preeclampsia and various other risks.

            My clinic, like many if not most, also requires woman 40 and up to get a mammogram before proceeding with IVF (this doesn’t benefit the clinic at all since the mammograms are done elsewhere), and will not do IVF of any kind (own egg, donor egg…) on women 45 and up unless they get an EKG showing that they don’t have cardiac problems. There are probably other requirements for women 45 and up but since I’m not in that group, I didn’t take much note of the requirements.

  • demodocus’ spouse

    Poor family. We’ve dealt with infertility issues, too, though not as long. Luckily, we had our boy on the first round of IVF, since we can’t afford another round. Adoption must not have been an option for them; that’s what my grandparents’ did. I hope the boys and their father do get lucky and he’s one of those who’s as sharp as ever at 90. My best friend’s grandma was like that, had her youngest at 39, lived to 103, and didn’t really get infirm until well into her 90s. Her brain was awesome until 6 months before she died. I wonder what’s the oldest any woman has had a baby and both survived.

    • D/

      Maria del Carmen Bousada de Lara’s delivery in 2006 of twin boys at the age of 66 (and 358 days) is evidently the oldest verified birth. She died at age 69.

      Although there are unverified “70-year-old” mothers in India reportedly giving birth as well. http://www.bbc.com/news/world-asia-india-27775003

      In 2008:
      Rajo Devi Lohan gave birth to a daughter at the age of 69-70
      Omkari Panwar delivered twins, a boy and a girl, at age 70-72

  • Amy M

    Ok, I read the article. She thinks people don’t understand the risks associated with ART? If a couple undergoing ART doesn’t understand the risks, then their RE did a shitty job in the informed consent area. I might say that most people don’t fully appreciate the risks of carrying multiples unless they have experience with it, but most people are aware the multiples ARE a risk of ART, and that multiples themselves are higher risk.

    • Guestll

      A couple of observations from my experience as an ART patient and a veteran of online infertility groups.

      I don’t think many ART patients fully understand the risks of ART, even with good counsel from their RE. And sometimes, they understand, but the goal and the dream supersede common sense.

      I think many patients underestimate the risks and overestimate the probability of success. Most people are aware that multiples are a risk of ART, but don’t fully grasp the risks involved in carrying multiples.

      Patients become more willing to accept risk the more treatment fails and with increasing ART cycles. This is one why there are also quacks and snake oil sellers in the realm of reproductive endocrinology.

      As a 39 year old woman, I developed mild OHSS on my first IUI cycle, on low dose injectable FSH. Yes, really. Unusual, to say the least, especially given my age, but I was, as we discovered, a high responder with higher than average ovarian reserve.

      A year later, with no baby, and having failed at everything (IUIs, IVFs, FETs) I insisted on doing the same protocol I’d done the first time, only with a higher dose of FSH. Why? Because the first time I did it, it worked, despite the OHSS. I conceived, though I miscarried. So I was convinced, let’s do it again! I did, with the addition of a well-timed antagonist, and STILL developed OHSS. Only this time, not as mild. I triggered with 3 mature follicles and 2 nearing maturity, after verbally agreeing to selectively reduce should I conceive HOM. And now I have a daughter. Would I do that again? I don’t know.

      • Amy M

        I had to do IVF too. I was lucky though, and only dealt with treatments, leading ultimately to the IVF, for a year. That IVF was successful–with a SET that led to ID twins. So maybe I’m a little more aware of the risks than some, having lived it.

        You are right–its been a long time since I’ve thought of those awful days of anxious waiting, and then a treatment failing, and feeling willing to try almost anything to conceive.

        I remember seeing a lot of people in the online groups saying they wanted twins, so they wouldn’t have to go through treatments again. I totally understood/stand that, but anytime someone says (directly to me) that they would love to have twins, I find myself cautioning her–telling her she has no idea what that really means and how dangerous and scary a multiples pregnancy really is. And of course, even with IVF and transferring multiple embryos, we don’t have a choice to conceive multiples, we can only increase or decrease the risk.

        • Ainsley Nicholson

          Absolutely agree about the twins thing…people always tell me “twins! I want to have twins!” to which I reply “no you don’t…you only think you do”.

          • Deborah

            I HOPE it was single embryo transfer with identical twinning . . . even though the twinniness is not what killed her (vaginal birth even with a singleton at age 56? Not too likely either!) it’s still almost malpractice to put in more than one embryo in someone that age.
            We just had a maternal death here in Phoenix of a mother of quadruplets who conceived by IVF. The decision to put in more than one embryo is basically what killed her (I’m assuming it wasn’t single embryo transfer that split into 4 . . . when that happens it’s always news in and of itself.) IVF doctors need to really stick to their guns with single embryo transfer.

          • Amazed

            Patients are not clients. Patients are not clients. Patients are not clients. Like in, Patients are not buyers.

            Looks like it should be applied so some IVF doctors, not only homebirth midwives!

          • Courtney84

            I am unaware that it is always a negligent, awful RE who transfers more than one embryo. I thought that depending on age, sometimes two or even three can be transferred as long as the patient is aware of how many are being transferred, statistics on how many will “take” and understand potential complications of a multiples pregnancy. A twins pregnancy is undeniably more risky than a singleton pregnancy, but I don’t think it’s so risky as to be unreasonable.

            I took ovulation induction medication when we hadn’t conceived a viable pregnancy after 12+ cycles and 2 early miscarriages. I chose a drug that’s used off label instead of Clomid becuase Clomid is more likely to result in a twins pregnancy. I wanted to avoid the risks of a multiples pregnancy, but I took different risks in using the other drug. I don’t think there’s anything wrong with choosing Clomid.

          • Daleth

            It depends on the age of the egg more than the age of the patient. At 56 this doctor was obviously using donor eggs (or perhaps donor embryos, in which case the age of the woman whose egg was used is still what counts).

            The good donor-egg clinics never put back more than two blastocysts, and only rarely (or at mediocre clinics) do they put back day 3 embryos (vs. blastocysts, which are 5-6 days past fertilization and more likely to result in a baby). In those rare cases in which they put back day 3’s, MAYBE they MIGHT put back three, tops. But everyone I know who has done DE has only had the option of one or two (most people pick two, and of those who do get pregnant at least 30% end up with twins).

        • demodocus’ spouse

          My husband keeps hoping for twin girls (provided we scrape the money together for IVF or have a miracle). He’s insane.

        • Daleth

          Amy, I had identical twins from an eSET too! We should form a club. 🙂

      • SisterMorphine

        I got massive OHSS on my first IVF go-round too–I looked about 8 mos along. However, after switching doctors I never had another issue. I was fairly young at the time though (28)–might have had something to do with it. This is such a sad story–if my life had been different, it could have been me, I certainly understand the child-at-any-cost feeling. My stepsister, who adopted, once told me that when she was childless she felt as if she was always being judged, that “women who have children always think they’re better than those who don’t.”

    • Lisa from NY

      I have a friend who did IVF. Her fertility doctor DID NOT inform her of the risks of IVF or advanced maternal age. The booklet they gave her was very lacking.

      • just me

        I think that’s the exception not the rule.

  • Amy M

    I guess some homebirth advocate will see this story and say “SEE! C-sections KILL women!” But the obvious rebuttal is: would this woman and/or her babies survived a homebirth? Of course, we don’t know for sure, and yes, its unlikely she would have died of that particular cause, but a 56yr old first time mom carrying multiples is NOT a good candidate for homebirth.

    I’m sorry for this woman’s husband and children who are now growing up motherless. She probably had planned to have a Csection no matter what, and its unfortunate that this error happened. It wasn’t “being the hospital” or “having a Csection” that killed her, it was human error. And I bet the doctor/s that missed her condition and sent her home are pretty remorseful, unlike some homebirth midwives, who say things like “at least she had a lovely homebirth.”

    • mythsayer

      And the sad thing is that Dr. Amy doesn’t defend doctors when they do something wrong. In this case it doesn’t sound like anything in particular went wrong… it’s just a complication that can happen. And she acknowledges that as well. The NCB’ers just grab onto things like this as proof that homebirth is better. The reality is that risks exist anywhere. Bad things can happen during surgery, too. But you’re generally going to be far safer at the hospital. Just because both places carry risks doesn’t mean you should pick the higher risk one.

      This is a sad example, but after 9/11 people started driving everywhere. They were afraid of flying despite the fact that flying has always been far safer statistically than driving. You have an extremely greater risk of dying in a car accident than of even BEING in a plane crash.

      But people were scared, so they drove. The next year, they found that around 3,000 EXTRA people died in car accidents. Not 3,000 people. 3,000 MORE than usually die that way. So in one year, we lost as many people as we lost on 9/11 because they drove. Now of course there is more that goes into this, but in general, this makes sense. Put more cars on the road, where accidents happen daily, and you’re going to have more accidents, partially because of over-crowding and partially just because more people are around to get hurt.

      It’s basically the same idea. People read stories like this and say “oh wow… CS are dangerous! Maybe I should just stay home, because I trust myself and my home more than the hospital.” The hospital is by far a safer choice, but fear makes them stay home.

      There are risks to flying and risks to driving. Why drive if statistically you are in more danger? Because of fear. It’s true you can’t eliminate risk entirely, but you can certainly choose the lower risk. That’s what NCB’ers don’t understand.

      And really, if you think about it, the same holds true for vaccines. You are far more likely to be permanently damaged, or even die, from measles than you are to have a bad reaction to a vaccine. And yet, they are scared of vaccines and would rather their child catch measles and possibly die or become blind.

      It’s just fear. They should just admit it.

      • Daleth

        Failure to diagnose a common complication of abdominal surgery, in a woman who just had abdominal surgery, IS “something going wrong.”

    • Elaine

      Right. If she hadn’t had a c/s, she wouldn’t have died of THIS particular cause… but who knows what would have happened? It seems pretty darn unlikely that she would have had an easy breezy vaginal birth and everything would have been hunky dory.

  • It is a tragedy – as the loss of any new mother is.

  • Rachel

    Wow, she was an extremely accomplished person!
    “Lisa Swinton McLaughlin, the medical director for the American Red Cross in Baltimore…was licensed to practice medicine in 11 states and law in two”

    Also, this article gives some insight into why the doctors didn’t catch the obstruction: http://www.nydailynews.com/life-style/health/baltimore-woman-56-dies-delivering-twins-article-1.2094085

    “The new mom stayed in the hospital for four days after the procedure
    because the doctors wanted her to have a bowel movement before she went
    home. She produced a liquid bowel movement that the hospital deemed
    enough to discharge her.”

    • Amy Tuteur, MD

      Actually, that makes it sound like they should have caught it. She had severe pain, bloating, couldn’t eat and wasn’t getting better.

      • sdsures

        I’m assuming that trouble eating and bloating is abnormal after a CS?

        • momofone

          Not Dr. Amy, and this is only my experience, but I had no trouble eating or bloating after my c-section. I also wouldn’t describe my pain as “severe,” though I know that’s subjective. Tylenol was sufficient.

        • Daleth

          I had trouble eating and severe bloating after my CS… because I had an ileus (functional bowel obstruction). I refused to leave the hospital until they could tell me what was causing it and I was clearly on the mend. My babies were in the NICU anyway so it was not a hard decision to flat-out refuse to let them discharge me until they figured it out and I was clearly getting better.

          • sdsures

            Argh! I’ve been in a similar c**k-up myself. It happens. 🙁

        • Mac Sherbert

          It wasn’t normal for me. I ate like a pig and no bloating.

          • sdsures

            OK. Can someone, perhaps Dr T, point me to a list of possible CS complications post-op? Thank you.

      • Nathan0127

        Sorry, but much what is being said here about her unfortunate death is pure speculation. “..they should have caught it.” is pure speculation.

        • Bombshellrisa

          Not really, it’s standard to be watching out for this after any surgery.

    • S

      Encopresis?

      • Medwife

        Partial obstruction rather than complete. It’s hard to understand why anyone thought that some diarrhea after 4 days, with those symptoms continuing, meant that she was good to go. I wonder if they did any workup for SBO.

        • Samantha06

          I was wondering about that too. The last time I saw a post C/S bowel obstruction, years ago, the patient had diarrhea then no stool at all. She was treated with gut rest and an NG tube. She recovered fine but it took a few days.

          • Medwife

            I had the same situation recently. She had some diarrhea. It’s not rare as far as I know.

          • Samantha06

            I haven’t seen it for a while here. I wonder if it’s in part due to patients’ post-op pain being so well controlled, they are able to get up quickly and they are mobilizing within 6 hours after surgery.

  • Guest
    • just me

      Yeah. But gotta agree with her on the maternity leave/work thing. Although I hate when people refer to Calif paid leave without noting the important caveat that not everyone gets it. All private sector workers do but for some reason the legislature didn’t require it for public sector employees resulting in a lot of us getting zero paid maternity leave other than our own vacation we’ve saved up.

      • Liz Leyden

        Paid family leave would be an asset for people without kids. My short-tewrm disability insurance paid for 8 weeks off after a C-section, and 6 weeks after a vaginal birth. It wouldn’t have helped 2 years earlier, when my parents died 6 weeks apart. Between travel expenses and 3-1/2 weeks off work, I was flat broke.

        • just me

          California has that too…6 wks pd fam leave. But again, many public employees including me don’t get it. I get nothing.

      • Samantha06

        In Canada, women get up to one year maternity leave. I’m not sure, but I think they get paid a percentage of their salary.

        • Carolyn the Red

          In Canada: About 16 weeks are maternity leave (related to giving birth, some can be taken before birth). The rest of the year is parental leave, all new parents (adopting a 12 year old, say, counts) are eligible, if there are two parents, they must split it up (I think it can be overlapping). Some provinces (Quebec, ?) have more, and at least Quebec has some that must be taken by the father (written out more neutrally, there’s a maximum one parent can take). It’s paid from EI, the same system you get unemployment benefits from, the maximum payout is the same as the maximum unemployment benefit.

          (Edited to add that I make a point of correcting everyone who says they or their spouse are taking a year maternity leave. It’s parental leave after a few months)

          • Samantha06

            Oh, I didn’t realize it was parental leave. Lots of the ladies I work with take their year off, but everyone refers to it as “Maternity” leave.

    • Amy M

      Bladdy-bladdy-interventions cause complications and maternal death-blah-blah–I’m so sick of that line. It doesn’t even make any sense, and most people, if they stop to consider it, could probably figure that out.

      • Samantha06

        What bothers me is how they perceive all interventions as being “harmful.” If someone is in excruciating pain, why shouldn’t they have an epidural and get some relief? Because the idiot NCBers think it’s “better” for someone to be screaming and out of their minds with pain than to get a supposedly “dangerous” epidural.

  • just me

    Thanks. As AMA (not that A but still) I hate when people blame the older woman for having kids.

    • Amazed

      I am totally comfortable with questioning a woman this old having kids. I don’t know just how old her husband is but it’s possible than he’s in his 60s! And I’m saying this as someone who, if she ever has kids, will probably be AMA. Helping a woman this age to have kids – and a twin pregnancy! – is unethical in my book.

      Doesn’t translate into “she got what she deserved”, of course. But let’s differentiate between AMA and someone years PAST AMA. As my grandmother said when little me asked her why she didn’t have babies on her own, “If grandmothers could raise kids, they would have given birth to them.” And let’s not start with grandmothers who took care of the kids a few months at a time or are forced to replace the mother. That isn’t what I’m talking about and it’s clear.

      For the record: my grandmother was great at functioning as a second mom to me. To the Intruder? Not so much. Just a few years turned out to matter.

      • Stacy48918

        The father is 67. That means he’ll be 85 when the kids graduate high school.

        • Amy M

          Oog. I hope they have other family nearby to help out–now and if the father needs it when the children are older. Of course it would be best if he doesn’t become incapacitated (or die), but realistically, his odds of developing some health problem before those kids grow up is high.

          I had a great uncle who was 70 when his wife had their child, but SHE was 30, so it was a little different.

          • Stacy48918

            My grandfather was 70 when my dad was born. He died when my dad was 13. 🙁 Thankfully my grandmother was much younger….

          • Amazed

            To be fair, my grandfather is in great shape for a 85 year old. He even made an additional step for my grandmother, so she could negotiate the high threshold of their door more easily (I immediately tripped over it because there never used to be a step!) These kids’ father might get lucky. I hope so.

            A part of my concerns with both parents being well past the upper margin of AMA is the gap between different generations. It’s hard enough when mom and dad are 20-45 years older than you! They’re so old, old-fashioned and not understanding… What happens when those who are two generations your seniors are not grandma and granddad but actually mom and dad?

          • sdsures

            My grandpa (1921-2010) took up cross-country skiing when he was 80! Tough old bird was an MD, too.

          • My parents are old enough to be my grandparents, and most people we knew had their kids by 25. Generationally, it was weird. More so since my mom went gray very young and stopped dyeing her hair when I was born. She was mistaken for my grandmother a lot, but so happy to have a child that she gave zero fucks.

            Fortunately, I pretty much went straight from age 7 to age 40 in terms of personality and tastes. I was forbidden from playing CDs of “that rock’n’rollin’ music” from my favorite band on the family stereo. That favorite band? The Beatles.

          • Amazed

            My teen years were such that my mom almost went gray! What peeks her most in that the worst of it was concentrated in about 6 to 9 months… during which my dad was absent! So not only did she have to deal with a changeling (and a tween) but my dad not exactly disbelieved but… OK, to this day he disbelieves the existence of the teen monster rearing its ugly head in me then. Like, saying, “It can’t have been this bad.” At which she promptly bristles.

            I was forbidden from reading and buying chief romance novels. I am sure everyone can foresee the result. Recently, I sold out a huge pile of this trash. Looks like I really had the knack for choosing the worst of the genre!

          • The Bofa on the Sofa

            My parents are old enough to be my grandparents,

            My wife and I have both been asked (on separate occasions) if our kids are our grandkids.

            Especially when they were babies.

        • I get really upset when I hear about Elton John’s kids, or other male celebrities who have children into their 60s. Yes, the family will always have plenty of money, and his husband is younger (in his 50s), but he is now 67 and they have sons who are 5 and 3.

      • Julia

        I’m very conflicted about this. Having dealt with infertility issues, although “only” for 2-3 years, I know how all-consuming the desire to become a mother/parent can be and how you become willing to try more and more treatment options. Yet I do agree that from a medical point of view a (twin) pregnancy at that age is ethically questionable. Since the woman almost certainly used donor eggs from a young woman, why didn’t they at least do a single embryo transfer? And most reputable fertility clinics have age limits even for donor egg IVF somewhere around age 50.
        It seems like such a fundamental unfairness of life that men can remain fertile until forever and for women it’s over sometime in their 40s.

        • fiftyfifty1

          “why didn’t they at least do a single embryo transfer?”
          They might have. We don’t know the facts of this case. Spontaneous twinning (identical twins) can occur with IVF.

          • Julia

            You’re right. It’s a possibility. We don’t know anything beyond the press release anyway, so I shouldn’t have speculated. It’s just a very sad case.

          • Amy M

            I can attest to that…

          • Daleth

            I can attest to it too. My identical twins from an eSET (elective single embryo transfer) are sleeping, or kind of sleeping, in the next room.

      • just me

        Yeah well I used to think that way too. I’m not saying having kids in your 50s is great but you know I was 42 and 44 and I’m sure there are many people (who easily conceived of course) who’d be disgusted at my age. And I am probably healthier than many people in their 30s. Which is when I started trying. So yeah until you’ve walked in someone’s shoes….

  • Amazed

    Poor woman. Terrible.

    I remember when I was visiting friends in the postpartum wing. Two of the three C-section moms had nurses coming to ask them if I’d passed wind multiple times in my presence (I know, I know I went there and forot to leave but we both enjoyed it!) The third mom told me that she was hoping for the blasted wind because if it didn’t happen, she’d be taken in for a surgery next day, no other options.

    It does sound like a common enough complication. I hope there are answers.

  • KarenJJ

    So that might explain the obsession the nurses had with asking me if I’d “passed wind” in the early days post c-section. Poor woman, I hope her family get some answers.

    • Montserrat Blanco

      After my CS I was asked that several times too.

  • Ellen Mary

    Thx for this. I love how you rebuke mother blame.

  • PrimaryCareDoc

    At least we can rest assured that this case will be investigated, unlike in home birth disasters.

  • Ronald Hirsch, MD

    Why must it be one or the other? Perhaps it was not a medical error either; maybe she had a perforation and died of septic shock. Perhaps ischemic bowel developed leading to shock. Maybe the doctors were heroic in their attempts to save her. Try not pointing any fingers…bad things sometimes happen to good people when it’s no one’s fault at all.

    • Amy Tuteur, MD

      As you know, the simplest answer is generally the correct answer. It could be both AMA and a bowel obstruction, but it sounds like her age didn’t have much to do with it.

      I wrote about this story for three reasons. First, I never hesitate to write about homebirths gone wrong, so it’s only fair for me to write about hospital births that could possibly have gone wrong. My credibility depends on being fair and impartial.

      Second, the mainstream media has told the story in a way that suggests that Dr. McLaughlin was reponsible in part for her own demise. But the fact that she died of a post surgical complication suggests that her age and her decision to get pregnant had little or nothing to do with it.

      Finally, I’ve seen the results of medical errors up close and personal, including the error involved in my father’s death (cancer seen on a routine pre-op CXR, but no doctor told him). He presented 7 months later with hemoptysis and when he asked then about the chest X-ray, his doctors told him it had showed nothing. I was an attending at that hospital and pulled the film. They lied; it had been seen and noted, and they knew that.

    • Alannah

      With the surgical complications you mentioned (ischemic bowel, perforated bowel, postoperative ileus) she should never have been discharged from the hospital. Pain out of proportion to the surgery and postop day should raise a red flag and prompt additional testing. Especially in a diabetic.

      I agree with you that the cause of death is most likely peritonitis and sepsis but her discharge is a medical error by defnintion. If she had had a relook laparotomy and broad-spectrum ABX in time she would most likely have survived.

      Mommy-shaming her over her advanced maternal age and fertility treatments is completely irrelevant to the matter at hand, as Dr Tuteur is trying to point out.

  • Kq

    Oh god what a tragedy. I hope to hear about the investigation into her death.