Hailey Okula — a nursing influencer known as “Nurse Hailey” — died late last month of complications from giving birth to her first child, her husband Matthew Okula, announced in a heartbreaking Instagram post Tuesday.
He subsequently revealed to Fox 11 Los Angeles that the cause of death was amniotic fluid embolism (AFE), a rare and often fatal complication that is one of the leading causes of death during and just after childbirth.
Her death was made all the more tragic by the fact that she and her husband had been struggling to get pregnant for two years — a journey that she chronicled to her 425,000 Instagram followers.
Matthew Okula told Fox that he and his wife shared a “quick little laugh” over how big their newborn son, Crew, was before going into cardiac arrest.
“A minute later, the doctor lets me know that they’re doing CPR on her. I’m making the decision, ‘Am I going to the ICU to be with my wife or am I staying with my newborn little baby?’” he said in tears.
“She wanted to be a mom so incredibly bad.”
What is amniotic fluid embolism?
AFE is an unpredictable and life-threatening labor-related emergency that occurs when amniotic fluid — the protective liquid surrounding a baby during pregnancy — enters the mother’s bloodstream.
This intrusion can trigger a severe allergic-like reaction, leading to sudden cardiac and respiratory collapse, as well as excessive bleeding.
How does an amniotic fluid embolism happen?
While the exact cause remains unknown, it’s believed that during labor or delivery, amniotic fluid or fetal material may inadvertently mix with the mother’s blood.
In some cases, this leads to an overwhelming immune response, causing the mother’s body to react violently.
Risk factors and frequency
AFE is exceedingly rare, with estimates suggesting it occurs in approximately 1 in 40,000 pregnancies. However, with a mortality rate of 11% to 44%, it is one of the leading causes of maternal death.
A 2014 analysis noted that “AFE has become more common in recent years, for unclear reasons.”
A 2023 handout from the Amniotic Fluid Embolism Foundation states that, “Since it is not understood what causes an AFE, it is impossible to know who may be at risk. The words unpreventable and unpredictable are often used to describe AFE.”
Other research suggests certain factors may increase the risk, including advanced maternal age, pre-eclampsia, and rapid labor.
Symptoms of an amniotic fluid embolism
The hallmark signs of AFE often appear abruptly and can include:
- Sudden shortness of breath
- Rapid drop in blood pressure
- Cardiac arrest
- Severe bleeding
- Seizures
Diagnosis and treatment
There is no diagnostic test for amniotic fluid embolism. Urgent medical intervention must be taken at the onset of symptoms, and can include medications, breathing tubes, chest compressions, blood transfusions, and/or surgeries.
