Still, the number of maternal deaths has ticked up. The CDC reported that in 2003, the number of maternal deaths, while still very rare and down significantly from the turn of the century when the rate was 850 for every 100,000 live births, rose to 12 for every 100,000. In 2004, it again rose to 13. It was the first time the number had passed 10 since 1977.
While researchers attribute some of that to how deaths are calculated, it could also be tied to the high number of C-sections. In 2011, Florida had one of the highest C-section rates in the nation at 36.8 percent of all births, according to a report by ratings company HealthGrades. The national average was 34 percent.
Yasin said scar tissue from C-sections, along with more infections, were causing more bleeding problems because placentas are not properly implanting.
“The placenta has an invasive nature. It will invade through tissues,” he explained.
Normally, a placenta will separate across a thin line of loose tissue attached to the uterus. “The uterus contracts and everybody’s happy thereafter,” he said.
But when it implants on scar tissue, it does not separate easily and can even invade other organs. Recently Yasin cared for a pregnant mother who was 43. She had had multiple C-sections and the placenta had implanted on the scar, gone through the uterus and into the bladder. Her doctor in Palm Beach County, a University of Miami graduate, called Yasin to take the case.
“She came to us and stayed for five weeks,” he said. “We gave her 10 liters of blood to cope with the blood loss. If this would have occurred in a small hospital, she would have died.”
In the past half-dozen years, he said, the hospital would get these cases every two or three years. Now it gets 10 a year or more.
In addition to bleeding issues, Yasin said the hospital has handled more serious cases, including a baby whose heart was outside its body, and pregnant transplant patients. One mother who had a liver transplant at Jackson as a child returned to give birth to her two sons, because medicine she takes to prevent the liver rejection made her pregnancies incredibly risky.
“A simple infection you get in pregnancy, like a urine infection, can kill her,” he said. “We were able to carry her through two pregnancies. We had two healthy babies, her liver is working well and she is happy.”
Unlike smaller hospitals, he said, Jackson staffs the unit with physicians round-the-clock. Altogether, the hospital has 30 obstetrics faculty members, 36 residents and more than 350 nurses, he said.
In recent years, financial problems have caused Jackson Health System to lose nearly $419 million and caused a bitter battle between the health system and the University of Miami, which supplies 90 percent of Jackson Memorial’s doctors. But Yasin argued having a bad business model has not made Jackson a bad hospital.
“When things fail anywhere else, they come to Jackson. We really feel this is a mission we do because we provide the highest level of care. This is not a luxury. Everybody should have the best medical care they need,” he said.
The day before her daughter was born, Donovan was visiting her doctor across the street from Jackson when the baby’s heart rate started fluctuating during an ultrasound.
“He said go to the hospital right away because she’s waving the red flag,” she said.
Nurses started her on medicine to induce labor that evening. At 11:42 a.m., Cailinh Madison Bui was born.
“If you’re a normal delivery, a community hospital is fine,” she said. “But if you’re high risk, you don’t want to be anywhere else.”