In a new interview with Vogue, Serena Williams discusses the scary complication that left her bedridden for six weeks after giving birth in September.
Williams, who has previously suffered from blood clots, told Vogue she realised something was wrong when she suddenly felt short of breath while recovering from her C-section in the hospital the day after she gave birth.
Given her health history, she had a gut instinct that she was suffering a pulmonary embolism, a condition that develops when a blood clot in another part of your body breaks off and travels along the blood stream and into your lungs, blocking the pumping of your heart, and preventing your heart from taking in oxygen. According to the Vascular Society for Surgery, it's the third most common cardiovascular disease after heart attacks and strokes.
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Louis DePalo, MD, a professor of pulmonary medicine at the Icahn School of Medicine at Mount Sinai, says that pregnant women are particularly at risk for blood clots. In addition to hormonal changes that make blood clots more likely, "as the baby grows in the uterus, it can compress the veins in the pelvis, and cause slower [blood] flow," he says, which in turn can contribute to blood clots.
Since it wasn't the first time Williams had suffered a pulmonary embolism, when it happened in this instance, she knew she needed a CT scan right away, and told the hospital staff as such. But, according to Williams, the nurse thought that her pain medication might be making her confused, and a doctor instead performed an ultrasound on her legs. When the ultrasound didn't reveal any findings, doctors did the CT scan that she had asked for, and sure enough found multiple small blood clots in her lungs.
"I was like, listen to Dr. Williams!" she told Vogue.
At the time, Williams says she had also gone off her anticoagulant regimen (blood thinning treatments that prevent clots) in order to prepare for the C-section. According to Dr. DePalo, this is recommended to prevent a patient from bleeding excessively during any surgery, not only a C-section.
Thankfully, doctors were able to treat the embolism, but it still led to severe coughing spells that caused Williams' C-section wound to open up — and upon returning to surgery, doctors found a haematoma, a collection of clotted blood that formed in her abdomen. As it turns out, the blood thinner that doctors used to treat her contributed to more haemorrhaging at the site of her C-section, she says.
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While Dr. DePalo says that blood thinners don't cause haemorrhaging, they can contribute to even more bleeding during surgical procedures — after all, the whole purpose of a blood thinner is to help blood flow more smoothly.
After giving birth, Williams had to come back to the operating room to have a filter inserted into one of her major veins to prevent more clots from entering her lungs. As a result, she spent her first six weeks as a new mom unable to leave her bed.
Though Williams was fortunate enough to be able to treat her condition right away, her experience is just another reason we need better maternal healthcare. Women still die from childbirth — even in the US. In fact, a 2017 report from NPR and ProPublica last year found that more American women are dying from pregnancy-related complications than in any other developed country. Every year in the US, 700 to 900 women die from pregnancy or childbirth-related causes, and some 65,000 nearly die, according to the report.
And those numbers are disproportionately high for Black mothers, who hospitals continue to fail — according to the CDC, Black women are three to four times more likely than white women to die of pregnancy complications.
Hopefully, Williams' story can help raise awareness for the work we still need to do to ensure that moms receive the maternal healthcare they need and deserve.