5 new Rajasthan mothers' euthanasia plea puts spotlight on postpartum kidney injury: Doctor explains symptoms, causes and prevention

For most women, the weeks after childbirth are spent recovering, bonding with their newborn and adjusting to life as a new parent. But for a group of women in Rajasthan, that period turned into a nightmare.

Five women from Kota, who underwent Caesarean deliveries at a private hospital, have alleged that they developed severe kidney failure following childbirth. Facing the prospect of lifelong dialysis or kidney transplantation, they have written to President Droupadi Murmu seeking either financial assistance for treatment or permission for euthanasia. The case has sparked outrage and renewed attention on a little-known but potentially life-threatening condition- postpartum acute kidney injury (AKI).

According to a News18 report, the women delivered their babies between May 5 and May 7 at New Medical College Hospital in Kota. They have since been undergoing dialysis every alternate day after allegedly suffering severe kidney damage following childbirth.

The women have remained hospitalised at Kota's Super Speciality Block for nearly two months and claim their kidneys failed due to medical negligence during treatment. They have sought financial assistance for kidney transplants or, failing that, permission for euthanasia.

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While investigations into the Rajasthan case are underway and the exact cause is yet to be established, nephrologists say postpartum AKI is a recognised medical emergency that requires swift diagnosis and treatment.

What is postpartum acute kidney injury?

Postpartum acute kidney injury refers to a sudden decline in kidney function that develops within days or weeks after childbirth. The kidneys, which filter waste from the blood, regulate fluid balance and help control blood pressure, are already working harder during pregnancy. Serious complications during or after delivery can overwhelm these organs, causing them to fail.

"Although uncommon, postpartum AKI can rapidly become life-threatening if not recognised and treated promptly," says Dr K Kranthi Kumar, Senior Consultant Nephrologist and Transplant Physician at the Asian Institute of Nephrology and Urology, Hyderabad.

What causes it?

According to Dr Kumar, postpartum AKI usually does not occur in isolation. It is often triggered by complications surrounding pregnancy and childbirth.

The most common causes include:

-Severe bleeding after delivery (postpartum haemorrhage)

-Pregnancy-related hypertension, including preeclampsia and eclampsia

-Severe infections or sepsis

-Dehydration

-Rare disorders such as thrombotic microangiopathy

-Inappropriate use of certain painkillers or other kidney-damaging medicines

Women with pre-existing kidney disease, diabetes, hypertension or autoimmune disorders are also at a higher risk of developing the condition.

Why early diagnosis matters

The severity of postpartum AKI varies widely. Some women may experience only temporary kidney dysfunction that resolves with treatment, while others may progress to complete kidney failure requiring dialysis. If diagnosis is delayed, the consequences can be devastating.

Dr Kumar warns that untreated postpartum AKI can lead to chronic kidney disease, prolonged hospitalisation, complications in future pregnancies and, in severe cases, even maternal death.

The encouraging news, however, is that most women recover completely when the condition is identified early and managed appropriately.

Warning signs new mothers should never ignore

Many of the symptoms can easily be mistaken for normal postpartum fatigue, making awareness especially important.

Seek immediate medical attention if a new mother experiences:

-Noticeably reduced urine output

-Swelling in the legs, face or body

-Breathlessness

-Persistent vomiting

-Extreme or unexplained fatigue

-Sudden worsening of overall health after delivery

"Any new mother experiencing reduced urine output, swelling, breathlessness, persistent vomiting or unexplained fatigue after delivery should seek immediate medical attention," Dr Kumar advises.

Can postpartum AKI be prevented?

Dr Kumar says prevention begins well before delivery. Regular antenatal check-ups help identify women who are at higher risk, allowing doctors to closely monitor kidney function and pregnancy-related complications.

Managing high blood pressure promptly, controlling excessive bleeding during childbirth, treating infections without delay, maintaining adequate hydration and avoiding unnecessary kidney-damaging medications all play a crucial role in reducing the risk.

Dr Kumar also stresses that collaboration between obstetricians, intensivists and nephrologists is key to recognising the condition early and starting treatment before irreversible kidney damage occurs.

A reminder that recovery doesn't end with childbirth

While postpartum acute kidney injury remains relatively rare, experts say it serves as a reminder that maternal healthcare should extend well beyond delivery. Monitoring a mother's health in the days and weeks after childbirth can be just as important as ensuring a safe pregnancy.

As Dr Kumar puts it, "Healthy motherhood does not end with childbirth. Protecting kidney health in the postpartum period is an essential step toward ensuring a healthier future for every mother."