Paternity Leave and Maternal Mortality: A Case Report on Placental Site Vessel Subinvolution

Abstract

Introduction Despite improvement in maternal healthcare in Malaysia, postpartum haemorrahge (PPH) remains a leading cause of maternal death. Common causes include uterine atony and retain products of conception. A rare but grave cause is placental site vessel subinvolution (VSI), often requiring emergency interventions like hysterectomy. Case Presentation A 32-year old woman, Para 6, day five postpartum, was found unconscious by her husband upon returning home from work and pronounced dead at the scene. The autopsy identified secondary postpartum haemorrhage from VSI as the cause of death. This tragedy was deemed preventable by the maternal mortality inquiry, highlighting a missed opportunity for earlier medical intervention in the absence of a postpartum companion. Unfortunately, due to their unregistered marriage, the husband was not entitled paternity leave. Thus, the patient was left unaccompanied with her newborn. No Other family support was available. Discussion Acceptable postpartum support, crucial for maternal well-being, traditionally involves family or local midwives. Some nations have enacted paternity leave policies to improve paternal involvement in early childcare and support However, in Malaysia, paternity leaves benefits are restricted to legally married couples, leaving some mothers without necessary support. Conclusion This case emphasizes the need for comprehensive paternity leave policies that include all parental figures, irrespective of marital status. It also signifies the importance of formal marriage registration to qualify for such benefits. Ensuring that every mother receives support during the critical postpartum is vital in decreasing maternal mortality as it can ease prompt access to medical care and essential assistance.