Conditions that threaten women’s lives in childbirth & pregnancy


Age at interview: 35
Age at diagnosis: 28

Brief outline: Mandy was pregnant with her first child. She developed Acute Fatty Liver and her son was delivered at 36 weeks. She started to haemorrhage and it was necessary to perform a hysterectomy to stop the bleeding.

Background: Mandy is a marketing officer, married with one son. White British.

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Mandy was expecting her first baby, and had a very good pregnancy up until 36 weeks. She started to feel unwell just as she was starting her maternity leave. At a routine check up with the consultant on the Thursday she complained of stomach pain, but he thought it was just indigestion and suggested Gaviscon. 
However, over the weekend she felt very poorly and when she noticed that her eye whites were “luminous yellow” on the Sunday night, she decided to take herself to hospital. Once she was in, on the Monday, doctors started running lots of tests but couldn’t work out what was wrong. They finally diagnosed her condition as Acute Fatty Liver. By the Tuesday they decided that she should deliver the baby, although she had already started dilating. She felt pretty well and strong through the delivery, and her son was born healthy at about 9 pm on the Tuesday evening. But at that point, Mandy started to haemorrhage, steadily through the night. She had a midwife monitoring her constantly overnight, but the blood loss was such that by the Wednesday morning two consultants came to explain to her and her husband what the options were – an operation to try and brace the uterus, and if that failed a hysterectomy. 
Both Mandy and her husband felt that the options were explained very clearly, and while they regret having to have a hysterectomy and only one child, they are accepting that it was necessary to save Mandy’s life. The operation was very tricky, and she was unconscious in intensive care (ICU) for 5 days before coming round. She was very happy with her care overall, but found the transfer onto the post-natal ward was very difficult, and she became very distressed. Although doctors were still keen to monitor her liver function, they allowed her to go home after a few days.
Six years on the experience is still very important and upsetting. Mandy felt very well supported by close family and friends, and although offered counseling, did not take it up. She had a follow up with the consultant at six weeks which was very helpful, and got copies of her notes about two years after the event, which she has also found helpful to read through. On her son’s first birthday she and her husband went back to visit the ICU midwives and consultants – a really positive closure for all concerned.


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