Standing outside the hospital elevator doors, Matthew Okula faced an unimaginable choice. Just moments after the birth of their son, Crew, via cesarean section at Orange Coast Medical Center in Fountain Valley, California, the medical team was wheeling his wife, Hailey Okula, to the intensive care unit. As the elevator doors began to close, a doctor posed a critical question: Should Matthew stay with his newborn son in the delivery room or follow his wife to the ICU? It only took a split second for him to decide. Clad in the blue scrubs he wore during the operation, Matthew hurried up the stairs toward the ICU, only to witness through the glass window as doctors performed chest compressions on Hailey.
Tragically, Hailey, affectionately known as “Nurse Hailey” on Instagram and TikTok, passed away on March 29 due to a rare complication called amniotic fluid embolism (AFE). This devastating loss came after a two-year fertility journey that included in vitro fertilization (IVF). “I stood at the foot of the bed the entire time until it was all done,” Matthew recalled. He repeatedly asked himself, “How is this even possible?” This question resonates with countless families across the United States, where hundreds of women die each year during or shortly after childbirth.
Despite advancements in technology that assist women in growing their families, the U.S. healthcare system has struggled to keep pace in safeguarding maternal health during pregnancy. In 2023, maternal mortality rates finally showed improvement, decreasing from 22.3 deaths per 100,000 live births in 2022 to 18.6, according to provisional data from the Centers for Disease Control and Prevention (CDC). However, this progress is not universally experienced; the mortality rate for Black women is still 3.5 times higher than that of their white counterparts. The U.S. continues to lag behind other wealthy nations, such as the United Kingdom (5.5 deaths per 100,000 live births) and Canada (8.4 deaths per 100,000 live births), per a Commonwealth Fund study based on 2022 data.
Dr. Kisha Davis, chief health officer for Montgomery County, Maryland, and board director of the American Academy of Family Physicians, expressed concern, stating, “Childbirth is not a fear that we should have.” She emphasized the anxiety many Black women experience regarding pregnancy, urging that society should not still be confronting health challenges that have persisted for over a century.
While certain rare conditions like AFE cannot be avoided, the CDC asserts that approximately 80% of maternal deaths are preventable. Experts, including obstetricians and fertility specialists, highlight the importance of adequate prenatal care, insurance coverage, and access to nutritious foods during pregnancy in shaping maternal outcomes. Chronic diseases such as heart disease and diabetes, along with advanced maternal age (considered to be 35 and older), significantly increase the risk of complications, according to Dr. Davis.
Research indicates that rates of chronic diseases have surged in the U.S. in recent years. According to CDC statistics, 6 in 10 Americans suffer from at least one chronic condition, while 4 in 10 have two or more. The likelihood of developing chronic conditions also rises with age, which may partially explain the increasing maternal mortality rates as more women opt to have children later in life. A CDC report from March revealed a staggering 90% increase in births to women aged 30 to 35 from 1990 to 2023, and a 193% increase for those aged 40 and older.
The risks associated with advanced maternal age extend beyond chronic conditions. Older mothers face higher chances of miscarriage, stillbirth, gestational diabetes, high blood pressure, and chromosomal conditions during pregnancy. Furthermore, they are more likely to undergo cesarean deliveries, which can lead to complications from scarring in subsequent pregnancies, according to Dr. Jeffrey Ecker, department chair emeritus of obstetrics and gynecology at Massachusetts General Hospital.
After marrying in September 2022, Hailey and Matthew were eager to start their family but sought assistance after eight months. Their journey through IVF was complex, involving genetic testing and requiring double the time and financial resources compared to the average family. In September 2024, Hailey excitedly announced their pregnancy to her hundreds of thousands of followers, marking a significant milestone in their long-awaited journey. “It was a pretty special moment,” Matthew recalled, reflecting on the joy of finally starting the family they had always envisioned.
As more women turn to IVF and other assisted reproductive technologies, the number of babies born from such methods increased from approximately 91,700 in 2022 to over 95,800 in 2023, according to new data from the American Society of Reproductive Medicine (ASRM). While IVF can increase the likelihood of multiple births and placental abnormalities linked to frozen embryos, experts like ASRM president Dr. Elizabeth Ginsburg stress that fertility clinics should limit the number of embryos transferred to mitigate these risks. However, the risks associated with IVF largely depend on the patients' pre-existing medical conditions.
Despite having access to quality care and being healthy, Hailey's tragic death from AFE underscores the unpredictability of certain pregnancy complications. Matthew is determined to share his wife's story to raise awareness about maternal health. He finds solace in speaking about Hailey, ensuring her memory lives on through their son. On April 9, he took Crew to the park for the first time, reminiscing about the many joyful times spent there with Hailey and their dog, Brodie. “Every quiet moment with my son is an opportunity to talk about Hailey,” Matthew reflected. “I don't want to forget the little details of what she used to say.”
In sharing his journey, Matthew hopes to inspire others to prioritize maternal health and advocate for improvements in the healthcare system, ensuring that no family has to endure the heartache he has faced.
For more information on maternal health and to support advocacy efforts, please reach out to Adrianna Rodriguez at adrodriguez@usatoday.com.
