“If your blood pressure doesn’t come down, we’re going to have to send you to Tampa,” my OBGYN told me as I lay in a hospital bed during the 30th week of pregnancy. I looked at the doctor with a shocked expression on my face and told him, ”It’s too soon.” It wasn’t until that moment I really understood just how dangerous preeclampsia was.
A note from our editor: May is Preeclampsia Awareness Month. Preeclampsia can be deadly for both mother and child. In fact, it kills over 10,500 babies every year by causing the mother’s blood pressure (BP) to rise to dangerous levels and endangering blood supply to the baby. Here is Shannon's story.
Headache, dizziness, belly pain in the upper right side of the torso and extreme fluid retention can all be symptoms, but these can be difficult to distinguish from normal pregnancy discomforts. High blood pressure and protein in the urine are often considered the key clinical markers, but other tests can help in diagnosis. Worse, preeclampsia can become eclampsia and may lead to seizures, organ failure and more. In recognition of this month and our writer's experience and in the interest of helping to raise awareness, here is Shannon's story.
I’d walked into the hospital that day after the other OBGYN who was caring for me was concerned that my diastolic blood pressure (the bottom number) was 110 during a prenatal check-up.
For weeks, I’d struggled to maintain a healthy pressure. At that point I was taking two medications to control it, but it was still incredibly high. This particular hospital visit was my second in three weeks.
After the doctor mentioned Tampa, I started to panic. I knew they would want to transport me either by ambulance or life flight. And I live about 45 minutes away from Tampa General Hospital. All I could think about was how much emergency transport would cost. Fortunately, I didn’t have to go. My blood pressure reduced with medication, and I left the hospital two days later, still pregnant but with a prescription for a third blood pressure med.
I was also given a warning by one of the labor and delivery nurses who cared for me. She told me to make sure I took my medication on time every day because “women lose their babies all the time” as the result of not taking the BP medicine consistently. Those words stayed with me.
Preeclampsia is a condition that causes elevated blood pressure in pregnant women and is usually diagnosed after the 20th week of gestation. The illness can affect a mother’s liver, kidneys, heart, lungs, brain and other organs.
Prior to 2020, doctors also looked for elevated protein in a woman’s urine before they diagnosed her. According to new guidelines from the American College of Obstetricians and Gynecologists, that's no longer necessary because problems in the liver and kidneys sometimes occur without causing an increase in protein.
Women with a history of hypertension, like me, are at a greater risk of developing the illness, but it can impact any pregnancy.
Here are some other risk factors to be aware of, according to Mayo Clinic:
The risk of developing the complication is highest during the first pregnancy. I developed it in my second. My first son had been born 14 years prior, and I'd had no complications other than the fact that he weighed 11 pounds, and I spent the next 3 years awake.
There are some symptoms we can look out for.
I didn't experience any of the physical symptoms of high blood pressure. Even at its highest, I never had headaches, vision changes or any other warning.
Since I had preexisting hypertension, I was already taking medication. The only reason I knew there was a problem was that I monitored my BP an hour after I took my medication. For instance, I took one of the meds at 9 a.m., so I took my BP at 10 a.m. and wrote it down in a book. When I had two readings that were higher than the number my doctors asked me to watch for (it’s different for each woman), I immediately went to the hospital. One of my nurses told me later that my strict adherence to the doctors’ orders probably saved my life.
I also never skipped a prenatal appointment. Those were important because they gave my doctors an opportunity to take my BP, and the doctors were also able to monitor the baby. So, once a week, I went to prenatal appointments and then to the hospital for a biophysical profile of the baby. Those examinations are ultrasounds to check on the baby’s growth and overall health.
Unfortunately, the scary thing about preeclampsia is even when you do everything right, it doesn’t go away.
A week later, after spending a night trying to reduce my BP at home, I knew I had to go to the hospital. When the nurse took my vitals, my BP hovered at 190/100. My doctor was on call, again, and he told me that it looked like I was going to deliver that day. I called my best friend and started sobbing. It was too soon. I was only 31 weeks pregnant, and my baby's lungs weren’t even developed.
My doctor put me on magnesium sulfate (MgSO4), a medication to bring BP down and to protect mother and baby from seizures. It was horrible. My entire body felt like it was on fire. I started to have contractions, and the doctor had to give me pain medication because every time I contracted, my blood pressure spiked. My best friend spent hours brushing my hair, making me laugh and updating my terrified family and friends. I’ve never told her, but there’s no way I’d have made it through the 24 hours of MgSO4 without her and my nurse, Merry.
In addition to the magnesium, I was also given two steroid shots over the course of 24 hours to help the baby’s lungs mature. Eventually, I stabilized. Once again, I was able to go home. However, my doctor told me the goal was to get me to 34 weeks, and then he’d deliver the baby.
I spent the next two and a half weeks in bed at my mother’s house, at the doctor, or in the hospital being checked. On December 18, 2018, 34 weeks and 1 day into my pregnancy, my husband and I welcomed our second boy into the world.
My blood pressure was dangerously high during the c-section. It was the most terrifying 45 minutes of my life. My doctor, who was usually very positive and upbeat, told me later that I scared him. He also made it clear that I could not have another baby because it would almost certainly kill me. I told him that I’d never felt closer to death than I had throughout that pregnancy.
I didn’t get to hold my son after delivery. He was taken to the neonatal intensive care unit (NICU), and I was sent back to my room for more magnesium sulfate. About six hours after his birth, at midnight, my incredible nurses rolled my bed into the NICU so I could hold him for 5 minutes.
My son spent 24 days in the NICU. I could write a novel about that experience, but what I will say here is the nurses who cared for my baby are my heroes. He wasn’t the sickest infant, but he was given just as much love and attention as the sickest among them. I never, not once, worried about him when he was in their care. They all loved him and his perfectly round head.
He’s 17 months old as I write this, and he’s hit all of his milestones. You’d never know he was a preemie. I still have hypertension, but it’s controlled. Overall, things are going well for us.
I’m still sad sometimes when I look at my kids and feel the desire to have another one. I know it wouldn’t be fair to put myself at risk again when I have two incredible children who need their mom. Also, my doctor worked really hard to keep me alive last time. I owe it to him not to take that for granted. He practices in another city now, but my family will forever be grateful to him.
We were lucky; my son and I could have lost our lives. We aren’t 100% safe, however. Preeclampsia often results in long-term damage. Women who have suffered from the condition double their risk of a stroke or heart disease. My son is at a higher risk for cardiac diseases, as well. I will see a cardiologist regularly for the rest of my life, and we won’t know what impact it has had on him until later.
Still, we survived.
The month of May is Preeclampsia Awareness Month. Every year, preeclampsia occurs in 4% of pregnancies and kills 50 mothers and 10,500 infants in the United States and 500,000 infants worldwide. There is no way to know if preeclampsia will develop in any pregnancy and the symptoms are often invisible so developing an awareness of procedures is key. The Preeclampsia Foundation offers reliable information on this condition.