The truth about amniotic fluid embolism
The tragic loss of a beloved nurse highlights a serious - but rare - birth complication.
Anytime we lose someone to a complication of pregnancy or childbirth and the media covers it, it can trigger a lot of anxiety in pregnant people — which is completely understandable. In light of that, I want you to know that it’s OK if you want to skip this week’s newsletter. But if you want to understand what an AFE is and learning that it is exceedingly rare may feel helpful to you, then I hope this information brings you peace.
In the News: What You Should Know About Amniotic Fluid Embolism (AFE)
The devastating news that nurse and online influencer Hailey Okula died shortly after giving birth to her baby boy came across my social media feeds last week. While I hadn’t heard of Hailey or her account prior to this, a quick scroll told me she was someone dedicated to her career and educating others. Her loss is a tragedy to her family, and I know it will be felt deeply across the nursing community as well.
It appears that Hailey died from something called an amniotic fluid embolism (AFE). I imagine most people haven’t heard of this rare pregnancy complication. But with a lot of coverage and potential fear upon learning about it, I wanted to give you some information so you can feel informed and, hopefully, not so scared.
1. AFE is extremely rare
Amniotic Fluid Embolism affects only about 1 in 40,000 births. It is one of the rarest complications in pregnancy, and most patients will never experience it.
2. It happens suddenly — and we can’t prevent it
AFE typically occurs without warning during labor, delivery, or immediately postpartum. It’s not caused by anything a pregnant person does or doesn’t do. It’s a spontaneous, unpredictable event that is still being studied. Symptoms may include a feeling of anxiety, that something isn’t right, shortness of breath, sudden loss of consciousness, and cardiac arrest.
3. Think of it as a life-threatening allergic reaction
While we don’t know everything about AFE, we do believe it stems from having a severe allergic reaction (like anaphylaxis) to amniotic fluid that enters the pregnant person’s blood stream. This then wreaks havoc on the function of the heart and lung’s and the blood’s ability to clot normally.
4. It is serious — but survival is increasing
While AFE is life-threatening and carries a mortality rate of 20–30%, outcomes have improved significantly in recent years. Those who survive may still have ongoing issues such as PTSD and residual neurologic and cardiac dysfunction, so it is important that they receive ongoing treatment and support.
5. Treatment requires a team
There is no single cure for AFE. Treatment focuses on stabilizing the patient and may include:
Oxygen or ventilation support
IV fluids and medications to support blood pressure
Blood transfusions if bleeding occurs
ICU-level care
Emergency delivery (often cesarean) if needed for maternal or fetal well-being
Ongoing research and awareness efforts have led to improved outcomes and support for families. The AFE Foundation is a great resource behind a lot of this, and if you want more information I highly recommend checking them out. I’ve got more on them below.
Q&A: How do I know when to go to the hospital?
Q: I'm around 11 weeks pregnant and really struggling with mood swings. I feel angry or overwhelmed for no clear reason, and it's starting to affect my relationship. What can I do to manage these emotional ups and downs?
A: It’s completely understandable that things don’t always feel joyful 100% of the time — especially in 2025 (let’s be real). What you’re experiencing is actually very common. In early pregnancy, hormone levels (particularly estrogen and progesterone) are rapidly rising, and they can significantly impact your mood.
On top of the hormonal changes, you may be dealing with fatigue, nausea, body image shifts, and the stress of so many unknowns. All of these can make emotions feel bigger and harder to manage.
A few things that may help:
Talk openly with your partner. Let them know what you’re going through. Having their support can make a big difference.
Identify your stressors. Try making a list of what’s weighing on you, so you can address each concern more intentionally rather than feeling overwhelmed by all of it at once.
Take breaks from information overload. If you find yourself spiraling after reading too much online, consider taking a break from them.
Prioritize YOU. Whether it’s prenatal yoga, a walk outside, journaling, or simply quiet time to yourself—find small ways to recharge each day.
Consider therapy. I kind of feel like everyone needs a therapist these days, so why not you?! If it feels like having someone to talk to might help (either for you or also your partner) think about giving it a try.
And importantly: talk to your OB/GYN or midwife. Anxiety and depression can start during pregnancy—not just after delivery—so it’s important to keep an open line of communication about your mental health. If your symptoms ever feel severe or unmanageable, especially if you have thoughts of harming yourself or someone else, please seek help immediately.
Want to get your question answered in the BBC newsletter? Shoot me a message and I’ll incorporate them into future newsletters!
*no personalized medical advice*
Spotlight on the AFE Foundation
I can’t talk about Hailey’s story without sharing more about the AFE Foundation.
If you're looking to learn more about amniotic fluid embolism or you want to hear first-hand stories from survivors who have experienced it, the AFE Foundation is an invaluable resource. Founded by families affected by AFE, the organization is dedicated to raising awareness, advancing research, and providing compassionate support to patients and their loved ones. They offer educational materials, survivor stories, and ways to get involved in advocacy and research efforts. You can learn more at afesupport.org.
You can also go here to donate and support their ongoing research.
Until next time,
Dr. Jen