The third trimester of pregnancy with my twins was anything but ordinary. I was commuting 30 minutes to and from the office daily, spending most of the workday just trying to get comfortable. I had a standing desk that I used whenever a little leg was snuggled too close to my rib cage. I napped in my car during lunchtime. I had to excuse myself from most meetings for a bathroom break (or two). There was a cushioned bench outside my office that I sometimes laid down on with my laptop when my colleagues weren’t around.
I’ve made it obvious at this point that my office was no place for a pregnant woman. Not to mention it was an “ass in seat” type of culture.
Toward the end of my pregnancy, I finally got a doctor’s note that recommended I work from bed twice a week, but the side-eye I received from my boss when I showed him the note gave me anxiety. I followed my doctor’s orders, but as someone who’s highly career-driven, it took mental and emotional work to stay at home those two days per week, knowing I might be disappointing my boss.
I felt swollen and uncomfortable, but it wasn’t until my baby shower at 30 weeks pregnant that I was aware of how swollen and uncomfortable I appeared to everyone else, too. My friends took one look at my ankles and carefully asked me, “when was the last time you saw your OB?”. Remembering my friend Kelsey’s experience with preeclampsia, I started Googling.
During the next few appointments with my OB/GYN, preeclampsia was all I talked about. But thankfully, I didn’t have it. My blood pressure was way elevated, sure, but I didn’t have protein in my urine, which is the primary way we diagnosed preeclampsia in 2019 (and still do in 2023). Again and again, I left appointments knowing there was something wrong; dis satisfied with my medical care.
During my very last baby appointment before I met Max and Annie, they took my blood pressure, which was high, and had me pee in a cup. They told me they’d call that afternoon with my protein-in-urine results — that if they found it, they wanted me to come straight to the hospital.
The afternoon came and went, so I assumed I was in the clear — thank goodness. But just to double-check, I called my nurse the next morning and she said to me frantically, “No one called you yesterday? Get to the hospital as soon as you can.”
My husband Sean and I flew to the hospital where they ran a few tests, but then discharged me. I’ll never forget that delicious hamburger Sean made me (Emeril’s recipe!) before I fell asleep on the couch for a short evening nap.
I woke up to a droopy left side of my face, as though I was having a stroke. We rushed back to the hospital and stayed overnight. In the first few hours of the morning, we saw a maternal fetal medicine doctor, I was put on a magnesium drip, and we were told it was go-time. Max and Annie were born at 34 weeks and four days, on April 25, 2019.
It's obvious that so many things went wrong during my last couple of months of pregnancy. When I look at the increasingly bleak maternal mortality statistics in this country (which somehow doubled between 2018 and 2021) I feel lucky, privileged, and like a survivor. When it comes to maternal health, these are the things I would change:
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No pregnant woman should ever be given the side-eye. Acknowledge that, even though she might need accommodations to stay healthy, she can still be productive and bring vibrancy to her workplace during those 10 months. Thankfully, in 2024, we have the Pregnant Workers Fairness Act, something we didn’t have in 2019. Moreover, representation matters – we need more women in the c-suite and boardroom, advocating for one another.
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We need OB/GYN practices to rely on wearables. A wearable could have helped my care team more closely monitor my blood pressure, and we all could have taken things more seriously, sooner. Hypertensive disorders account for nearly 32% of prenatal and postpartum deaths, and their incidence is only increasing.
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We need to fund research on and startups building businesses around early identification of pregnancy complications like preeclampsia, risk for preterm birth, and gestational diabetes. When not in a state of crisis, care teams can much better treat these complications. Mirvie, which uses RNA to predict pregnancy complications months before they occur using a simple blood test, is a company doing great work in this space.
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Client communications. Why didn’t my care team call me when they finally found protein in my urine? I’ll never know the real reason, but I can guess: 1) Doctors and nurses are overworked, with too many patients. The system incentivizes them to take as many patients as possible instead of striving for well care vs. sick care. 2) My OB office’s technology failed them. Pop open some of the most popular electronic medical records in the space, and what you’ll find can be likened to signing onto AOL in 2004.
At the end of the day, I realized through this experience something too many women learn the hard way: we must always, always, always advocate for ourselves if something doesn’t feel right.
Similar to other areas of women’s health, maternal health is also a disaster zone. Moms are dying, and it doesn’t have to be this way. Rescripted is a business, but we’re mission-driven at our core, which is why we’re proud to dive into maternal health this month. The world doesn’t need another “top 10 strollers of 2024” list; women need free, readily available, and easily accessible information during the most profound change to their bodies that they’ll experience in their lifetime. Rescripted is here to fill that void. Babies are cute and all, but we’re here for Mom.
Abby Mercado is the Co-Founder and CEO Rescripted.