Dual Burden Birth: Tanisha's story

Tanisha with her son, who was born prematurely. Photo credit: Tanisha Fuller

When Tanisha Fuller, then 26, woke up in the middle of the night with a sharp pain between her shoulder blades, she thought it was just gas. Being six months pregnant with her third child, she was hoping the pain was something that a little more sleep could fix. However, later, when she woke up not being able to breathe, she knew something was wrong.

Once Tanisha’s partner took her to the emergency room, it was discovered that Tanisha’s lung had collapsed and was putting pressure on her heart. Doctors rushed her into the operating room where they installed a chest tube to relieve the pressure. The doctors told Tanisha that she would have to wear the tube throughout her pregnancy. “I was in constant pain because I had a tube hanging out of my chest,” said Tanisha. “I had a one-year-old and an eight-year-old, so I couldn’t just be in the bed like they wanted me to.”

Juggling her pain, her pregnancy, and her two young children, Tanisha was required to visit three specialists each week to monitor her condition. “They gave me all of these appointments on different days.” said Tanisha. When she asked for the appointments to be streamlined into one day she noted a doctor responded that, “If I was concerned with my child and my health I would make it to my appointment.” “It made me think,” said Tanisha. “Am I wrong for asking for these appointments on the same day?”

Tanisha’s doctors eventually decided to induce her, delivering her baby four weeks premature. Tanisha recalled being sent home with a “teeny tiny baby,” and feeling completely lost. All of her other children were full term. “I also didn’t get any information on how to take home a preemie baby,” she said. “No one in my family knew either and everyone was scared to touch him because he was so little.”

Though Tanisha’s lung condition, Spontaneous Pneumothorax, was very rare, she is not alone. Nearly a quarter of women who have serious maternal complications during childbirth also have premature births, posing a “dual burden” on families, according to a study published The Journal of Maternal-Fetal & Neonatal Medicine in July 2019.

Conducted by UCSF Preterm Birth Initiative, in collaboration with NYU Rory Meyers College of Nursing, and Stanford University, this is the first study to quantify the occurrence of dual burden births. The study’s senior author and Director of PTBi’s Discovery Aim, Laura Jelliffe-Pawlowski, explained, “Imagine the deep trauma a family experiences when both the mother and newborn child are simultaneously fighting for their lives. This is the reality for 1,900 families in California, and it can have rippling effects across generations, particularly for Black families who are more likely to have a dual burden birth.”

Through research like this, PTBI is adding to the national conversation on maternal and infant health, specifically through system-wide recommendations. The study notes, “The stress dual burden births place on affected families may not yet be fully recognized by providers, especially when maternal and newborn care are delivered by different providers in different specialties. Family-centered care and parent involvement have beneficial effects on preterm infant and family outcomes and this care model may need to be adapted for families affected by severe maternal morbidity, particularly regarding coordination of infant and maternal health care teams and support to other family members.”