Melody Lynch-Kimery had a fairly routine pregnancy. But when she got to the hospital for delivery, she says things quickly turned dangerous.
After an emergency cesarean section, Lynch-Kimery hemorrhaged, and lost about half of the blood in her body.
鈥淚 just kept thinking 鈥業鈥檓 not going to die. I'm not going to die. I'm not going to let you let me die,鈥欌�� she says.
After her traumatic delivery, Lynch-Kimery spent a week in the hospital. She went home with her newborn daughter, Sawyer, thinking her delivery complications were resolved.
About three months later, she started to feel pain in her lower abdomen.
鈥淛ust randomly one day I started to have a lot of burning, just a lot of cramping, a lot of pain around my scar area,鈥� Lynch-Kimery says.
She spent months seeing doctors and researching her symptoms online. The pain, she eventually learned, was most likely caused by scar tissue surrounding her C-section scar.
About according to the Centers for Disease Control and Prevention.
鈥淎nywhere from 6 to 18 percent of those will end up with chronic pain in their scar,鈥� says Jennifer Wasserman, a physical therapist who .
Chronic pain is one of many health concerns that women can struggle with after giving birth. Women like Lynch-Kimery who have complicated pregnancies or deliveries can see long-lasting effects to their physical and mental health.
Dangerous pregnancies
Among developed countries, the United States has the highest rate of . And for every woman who dies, .
Rates of maternal mortality are like Lynch-Kimery, who is half black.
Many women who become pregnant already have chronic conditions like and that can negatively impact their pregnancy and future health. Others develop health problems during pregnancy.
The two major pregnancy and delivery complications women face are preeclampsia, or high blood pressure, and gestational diabetes, or diabetes that develops during pregnancy.
鈥淏oth of these conditions are associated with basically a doubling in their lifelong risk for cardiovascular disease,鈥� says Dr. Lisa Hollier, president of the American College of Obstetricians and Gynecologists. 鈥淲hat we鈥檙e seeing is that pregnancy can act as sort of a natural stress test.鈥�
Hollier says most dangerous pregnancy complications clear up after delivery. But some women see a long-lasting impact.
A found that women with gestational diabetes, preeclampsia and preterm delivery had higher risks of heart disease, diabetes and stroke.
鈥淭he fact that [a woman] has these complications during pregnancy, it can be used as a warning sign to her and to her physician that she is at future risk for long-term problems,鈥� Hollier says.
Mental health problems can also develop.
鈥淪ome situations, like having a pre-term birth of a baby that goes to the neonatal intensive care unit, are also associated with a mom developing postpartum depression,鈥� Hollier says. 鈥淚t鈥檚 really important to be sure that a woman is receiving integrated care so that her mental health is not seen as completely separate from her physical health.鈥�
https://youtu.be/57cG8R2X9TE?t=205
Lack of postpartum care
One problem is that many women don鈥檛 seek medical care after delivery. Women are told to see their doctor between six and 12 weeks after giving birth. But 20 to 40 percent of women . Those rates are even worse for mothers on Medicaid; they account for more than half of all births.
And 15 percent of women don鈥檛 have a primary care doctor after delivery.
鈥淲omen who are young don鈥檛 go to the doctor every year unless they鈥檝e got a problem, so they鈥檙e not being monitored,鈥� says Susan Groth, a nurse and associate professor in the school of nursing at the University of Rochester in New York.
With a grant from the National Institutes of Health, how pregnancy affects healthy women three years following delivery.
She says this study will fill gaps in research, which in the past has focused on a mother鈥檚 health only a few months following delivery.
鈥淭he studies have not looked at women long enough to see really what changes over time,鈥� Groth says. 鈥淒oes pregnancy make a difference in their health, or is that really just this incident that happens and then everybody goes back to normal?鈥�
The "fourth trimester鈥�
The College of Obstetricians and Gynecologists also now recommends that women see their doctor three weeks after delivery 鈥� or sooner, if there are complications.
鈥淲omen with high blood pressure, for example, are often seen within the first five to seven days after the delivery,鈥� Hollier says. 鈥淲e really believe that to best optimize the health of women, the postpartum care should really be process, not a visit.鈥�
And experts say care should continue long after one postpartum visit. They call it the 鈥渇ourth trimester.鈥�
During this period, doctors transition women into routine care and connect them to follow up services, like physical therapy.
Lynch-Kimery travels an hour from her home in Bloomington to Indianapolis every few weeks to see physical therapist Camille Fenwick.
鈥淪o tell me how you been feeling since I鈥檝e seen you last,鈥� Fenwick asks to start the appointment.
Lynch-Kimery says her pain has been 鈥渙n and off.鈥� It鈥檚 better after stretching, which Fenwick has shown her how to do safely in previous sessions. The pain is worse when she exercises too long.
Fenwick then massages along the six-inch C-section scar on Lynch-Kimery's lower abdomen.
鈥淚鈥檓 kind of going across that scar and getting those little muscles around it to help it to loosen up a little bit,鈥� Fenwick explains. "I'm kind of feeling for any stuck kind of places or check and see as far as pain that she may have while I鈥檓 doing it.鈥�
Then, Lynch-Kimery stretches on an exercise ball and with a Pilates reformer machine, working to strengthen her core and pelvic floor.
Lynch-Kimery isn鈥檛 sure how long she鈥檒l need therapy for her scar tissue pain. She says the cost of the sessions adds up. Those bills keep her from seeking other needed postpartum care, like therapy to address the trauma of her near-deadly delivery.
鈥淚鈥檇 love to be free of it,鈥� she says. 鈥淚鈥檇 love to not have to worry about it.鈥�
For now, she鈥檚 focused on her daughter, and making the best of a health problem she never anticipated.
This story was produced by , a news collaborative covering public health.
Editor's note: A previous version of the story mischaracterized Susan Groth's position.
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