During the last three weeks of my first pregnancy, my OB told me that because my blood pressure was somewhat high he wanted me to be on bedrest for five hours a day, resting on my left side. That’s all I was told. No instructions were given about symptoms and danger signs to watch for. I was young, I trusted my doctor and it didn’t even occur to me to ask questions.
I had no idea that I had preeclampsia, a condition that happens only during pregnancy and postpartum. When it occurs during pregnancy it affects both mother and baby. It is characterized by high blood pressure and protein in the urine.
Other symptoms are swelling (especially in the face and hands) sudden weight gain, headaches and changes in vision, vomiting, upper abdominal pain, shortness of breath; however, some women who develop preeclampsia report few symptoms.
Preeclampsia is still not fully understood, which may be one of the reasons that around the world it kills an estimated five women an hour.
In developed countries, it is highly treatable, but the key is to act quickly.
Not every woman will have all the symptoms of preeclampsia, as in the case of a postpartum mom who was diagnosed as having preeclampsia without the primary symptom of high blood pressure. She stated “I want to really stress the swelling and rapid weight gain because my blood pressures were
within normal ranges.”
Research indicates that confusion about how to recognize worrisome symptoms and treat obstetric emergencies make caregivers more prone to error.
“California researchers who studied preeclampsia deaths over several years found one striking theme: “Despite triggers that clearly indicated a serious deterioration in the patient’s condition, health care providers failed to recognize and respond to these signs in a timely manner, leading to delays in diagnosis and treatment.”
There are anecdotes online posted by women who experienced preeclampsia. Some are shocked to learn how serious the condition can be, others are enraged at and severely disappointed by the medical system that failed to educate them about preeclampsia.
One mother who had very high blood pressure at her checkup stated that her doctor wanted her to check into the hospital and “He wouldn’t let me drive because at any moment I could have a stroke. I had no symptoms. I felt like a million bucks.”
When we checked into the hospital I too felt like a million bucks. My contractions were quite bearable and I was excited to meet our baby boy. I wasn’t experiencing any symptoms other than facial swelling. During labor, my blood pressure soared, and I could see that the nurses were becoming alarmed. Immediately after giving birth they checked my urine and found high levels of protein.
I was told that I was at risk for having a seizure, and was given medication and told to rest on my left side. At the time I didn’t entirely grasp the danger I was in, partly because of the staff using “medical speak” (also I wasn’t an RN at that time!)
After 48 hours I was deemed healthy and discharged home, unaware that I was actually still at risk since preeclampsia can also occur as late as 6 weeks postpartum (there is one reported case of an occurrence at 8 weeks postpartum.)
I have no recollection of being instructed to watch for signs and symptoms of postpartum preeclampsia, it may be because giving birth was thought to “cure” preeclampsia.
Ultimately I stayed healthy, and neither my baby nor I sustained any permanent injury.
My experience with preeclampsia occurred 32 years ago. It was very fortunate for me that the staff knew about the signs and symptoms of preeclampsia and were monitoring me closely. I survived and went on to have two more children without experiencing any complications.
Unlike *Lauren Bloomstein, who died 20 hours after giving birth to a healthy baby girl on October 1, 2011. It happened because the hospital, her doctor, her nurses failed her. The hospital did not have preeclampsia treatment protocols in place, the nurses weren’t educated and trained about preeclampsia, she wasn’t adequately monitored, her doctor failed to recognize the signs and symptoms until it was too
The U.S. has the worst rate of maternal deaths in the developed world, due in part to the fact that the medical community worries more about babies, has devoted almost all resources to saving babies and often ignores their mothers.
The consensus seems to be that in many instances the medical system is also failing mothers by not providing instruction about how to tell if they need medical attention.
A new mother may ignore or downplay her symptoms because she assumes they’re a result of sleep deprivation and exhaustion. Even if you’re not sure it is better to report your concerns, insist on answers.
You may be told there wasn’t anything to worry about, but what if there had been?
Women must be empowered to be their own advocate, and this can only be achieved through education.
“It was only when I had my own child that I realized ‘Oh my goodness. That was completely insufficient information. The way we’ve been trained, we do not give women enough information for them to manage their health postpartum. The focus has always been on babies and not on mothers.” ~Elizabeth Howell, Professor of Obstetrics and Gynecology at the Icahn School of Medicine at Mount Sinai Hospital In New York City
Having had personal experience with preeclampsia and other maternal health issues both as a patient and a care provider I have long had an interest in promoting and providing education regarding maternal health.
It is my hope that by sharing information with one another and providing support to each other we may help avert a devastating outcome while honoring those who have so tragically lost their lives.
*You can read about Lauren’s story here: https://www.propublica.org/article/die-in-childbirth-maternaldeath-rate-health-care-system
This is an excellent resource if you are interested in learning more.
The Mother Baby Bond
Liz Ozkan, RN, LCCE, IBCLC, RLC