The following quote is written by Dubravko Habek & Ingrid Marton from the University Department of Obstetrics and Gynaecology Clinical Hospital in Zagreb, Croatia. It originally appeared in a letter to the editor published in the medical journal Psychiatric Danubina in 2022.

Original letter including references here

Obstetric shock (OS) is the leading cause of maternal mortality in the world through centuries of obstetrics, and the survival of severe forms of OS carries a significant risk of severe somatic and psychological chronic morbidity due to the consequences of multiorgan failure (Habek 2018). We cite a case of a mother’s knowledge of her near-death experience (NDE) with out-of-body experiences, during severe OS and resuscitation as a clinical observation.

The 28 – year – old healthy primiparas developed peracute severe postpartum haemorrhage after spontaneous singleton delivery due to atony of the uterus with disseminated intra- vascular coagulopathy and severe obstetric hypovolemic shock IV. degree with loss of consciousness.

Just before losing consciousness, she said she would die. All resuscitation measures were promptly taken: endotracheal intubation with assisted breathing and oxygenation, intravascular volume replacement with crystalloids, colloids and blood derivatives with inotropic drugs, atropine, adrenaline, dopamine, dobutamine, and manual exploration and compression of the uterus by an anesthesiologist and two gynecologists and three midwifes. Another senior consultant was called in who performed hemostatic sutures and uterine thamponade after which the bleeding stopped and the blood loss was estimated at more than 3500 mL which was consistent with a state of severe OS.

Treatment was continued at the intensive care unit with respiratory support, intensive therapy and monitoring. Throughout the resuscitation procedure in the delivery room, the mother was unconscious and was not sedated or anesthetized. Her personal and family history was without psychiatric or religious fanatic data. After two days of treatment in the intensive care unit, in contact with the doctors, she told in detail what happened to her in the delivery room:

“I saw a bright light and from above i watched all the events that were very dramatic, but i was not embarrassed. I saw my pale body lying with a tube in its mouth and a doctor blowing an artificial respiration balloon; I had bloody legs spread and the floor was covered in blood. Another doctor came, put on an apron, sat between her legs, vigorously pushed large pieces of gauze into her uterus, and said that a hysterectomy on a dying woman should be avoided as much as possible. He asked what the findings were, and the doctor who inflated the balloon said that she was not coagulating and that she was bleeding, that there was no blood pressure or pulse. Nurses and doctors pumped blood and infusions from plastic bags that hung on a stand. After the bleeding stopped and I was transferred from the delivery room to the ICU transport cart, the whole room was covered with my blood and sheets soaked in blood, and the knowledge of out-of-body experiences disappeared. You are the doctor who saved my life, thank you”, telling the doctors, turning to a senior consultant whom she could not see because she had already lost consciousness and was intubated.

Scientific interpretations of the NDE phenomenon have been presented and explained in the literature from various scientific groups, mostly neuroscientists, but theologians, christologists, parapsychologists. Thus, the PubMed database today contains more than 538,500 different papers commenting on and researching the NDE phenomenon.

Theological, spiritual theories assume that consciousness can be separated from the neural substrate of the brain, psychological theories interpret that NDE is a dissociative defense mechanism that occurs in times of extreme danger or to reflect memories of birth, and organic NDE theories based on cerebral hypoxia, anoxia and hypercarbia and biochemical alterations of neurotransmitters in the brain.

NDEs occur according in 17% of those who were in the dying stages from pediatric to geriatric age, people with comorbidities to healthy people, from believers to infidels, various professions and levels of education. Timmerman et al. discuss the bioche- mistry of NDE and its association with psychedelic phenomenology conditioned by the release of dimethyltryptamine during the dying process, citing Strassman (Timmermann et al 2018, Strassman 2001). There are scale of NDE experiences with 80 variables used to assess the organic or psychological background of NDE (Greyson 1983), and recently the authors demonstrated the development of psychometric validation in the NDE assessment (Martial et al. 2020).

Certainly there have been NDEs in obstetric cases of cardiac arrest, obstetric embolisms, severe forms of obstetric shock, or sudden clinical deaths, but we have not found a similar description in the literature, and we have not personally had contact with such experiences in clinical practice.

Our review is a contribution to the obvious existence of this non-delusional phenomenon in the specific case of the association of severe obstetric shock IV. degree with insufficient multiorgans and brain perfusion and NDE.

Thus, in fact, the original translation of the word resuscitation, re + anima (repeated return of the soul or spiritual spirit according to the ancient medicine of Hippocrates, especially Galen) will have a realistic interprettation of the described phenomenon in this case.

Photo by Stephen Andrews