Pre-eclampsia and high blood pressure in pregnancy

Angela

Female
Age at interview: 36
Age at diagnosis: 34

Brief outline: I had high blood pressure at the end of the third trimester of my pregnancy. I went into labour and vaginally delivered my baby at 9 months (40 weeks). My pre-eclampsia was labour-induced and started when I was 7cm dilated.

Background: My name is Angela, I am 36 and a nurse. I am married and have one daughter. I identify as White British.

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The start of a high blood pressure problem

Most of my first pregnancy went well, despite some morning sickness and feeling quite tired. However, about a month before my due date, I had a GP check-up and it was found that I had high blood pressure. My GP said I should contact the hospital. However, when I phoned them, they said that my blood pressure was not that high and so there was no need for me to come in. At a later antenatal appointment, my blood pressure was taken again and the results caused concern. I was sent to the labour ward to have a series of blood pressure measurements taken, all of which came back as fairly normal. I was discharged home and asked to return in a few days for more testing. I was also told about a research study for self-monitoring blood pressure during pregnancy, which I decided to take part in. For the next few weeks, my blood pressure stayed mostly the same. I had some swelling on my hands but not my ankles.

Labour and giving birth

The night before I was going to be induced on my due date, my waters broke. I went to my local hospital who have a policy to see a pregnant women once her waters have broken. I was examined and my cervix was 2cm dilated, so I was sent home and told to come back the next day. However, my contractions were so strong and frequent that they made me be physically sick. I went back to the hospital where they examined me again and found I was now 7cm dilated. I was relieved to get an epidural to help with the pain. However, my pre-eclampsia then kicked in. As my labour progressed, the midwife and my husband noticed that my face had become more swollen. A sample of my urine was tested and this showed a high level of protein. I was given medicine to lower my blood pressure, which helped, and I vaginally delivered my baby girl. 

After the birth

A few hours after giving birth to Amelia, I noticed some unexpected bleeding. It wasn’t pleasant but a doctor had to manually remove a clot from my uterus, which at least meant I didn’t have to go into theatre for surgery.

The next day, my blood pressure shot up and I felt breathless. I stayed in hospital for an extra five days so my blood pressure could be checked and I was given more medicines. It was a very worrying time and it was difficult to balance getting better myself with looking after my newborn. Once I had been discharged from hospital, I kept taking my blood pressure tablets. This was mostly fine, until one day when I had a severe headache and a high blood pressure reading. The results didn’t settle after taking my tablets and so I had to go back to hospital. I started on a different high blood pressure tablet (ramipril) which meant I couldn’t breastfeed my baby anymore. I didn’t like having to take medicines for my high blood pressure and I stopped them as soon as I got the all-clear from my doctor that my blood pressure was back to a ‘normal’ level.

The emotional effects

My experience had a big emotional impact on me. It left me feeling constantly worried and I had panic attacks, sometimes about other health issues. For example, I had a pain in my thigh which I thought could be a blood clot, though this was ruled out with tests by my doctors. I think my anxiety and high blood pressure became a cycle, reinforcing one another. My GP prescribed me with anxiety medicine and this helped me to feel calmer over time. I also paid privately for counselling and had some good support from friends as well as through an online ‘traumatic birth’ group. My husband and I are unsure if we want to try for another baby. For me, there’s the fear factor that I might have high blood pressure problems again. I know that a subsequent pregnancy would be closely monitored but I would want a guarantee of a booked-in caesarean to avoid the birth getting out of control again.

Areas for improvement

I feel I have been left with many unanswered questions. For example, why did I start to develop high blood pressure and why was I able to have a vaginal delivery when other women with pre-eclampsia need emergency c-sections? I met with a midwife at my hospital at a later date to go through my medical notes, but this added little insight into why it happened. I think the immensity of pregnancy and having a baby is often under-estimated, but this is probably because the reality of pregnancy and birth might scare and put off some women. I feel strongly that consistent care from doctors, midwives and nurses is important – it would be good for each pregnant woman to have a named midwife throughout. I think everybody should receive good quality and free pre-natal information, especially given that many people can’t afford to pay for classes if their local free ones are fully booked.

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