Pre-eclampsia and high blood pressure in pregnancy

Dominie

Female
Age at interview: 25
Age at diagnosis: 24

Brief outline: I developed pre-eclampsia 6 months (28/29 weeks) into my first pregnancy. I was induced at 7 months (32 weeks) and vaginally delivered my baby. My son, Beau, stayed in SCBU (Special Care Baby Unit) and he was discharged after three weeks.

Background: My name is Dominie; I am 25 years old and a midwife. I am married and have one son. I identify as White British.

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Early signs of a problem

I developed pre-eclampsia 6 months (28/29 weeks) into my first pregnancy. As a midwife, I talked to some of my colleagues to get more information about the condition. I remember a time when I felt funny on a nightshift at work and my blood pressure was high. I felt tired and a bit ill, but I wasn’t sure at first if this was just a ‘normal’ part of pregnancy. I was sent home and signed off for a couple of weeks. During this time, I had an overnight stay in hospital where I was monitored and told that I was okay for now but might develop pre-eclampsia later on. I had weekly midwife checks and, by the second week, my blood pressure dropped back down. However, after getting home from a trip seeing family, I started to feel groggy and very tired. I had a routine consultant appointment the next day. My blood pressure was very high and I was sent to stay in hospital. Even at this point and with all my knowledge as a midwife, it didn’t kind of click that the situation was serious or what might happen next.

Being unwell in hospital

I started to have other symptoms of pre-eclampsia such as pain at the top of my stomach (epigastric pain) and overactive reflexes. I also had some panic attacks which I think could have been linked. Before finding out I was pregnant, I had been taking antidepressants. I had stopped the medicine and my doctors thought at first that this might have caused my blood pressure to rise. I went back on the anti-depressants at a lower dose to see if my blood pressure would settle down again. I also started taking blood pressure medicine in hospital – I took one called nifedipine because I have asthma and so couldn’t take the standard treatment of labetalol. I had blinding headaches as a side-effect of nifedipine. I was given magnesium sulphate through a drip to reduce the risk of me having a fit, but the infusion was painful and I had problems with the cannula. Being a pregnant patient gave me a lot of insight into the other side of my job as a midwife. There was some uncertainty about my diagnosis in hospital. I was told that I had pregnancy induced-hypertension but I knew that I was being medically treated as having pre-eclampsia, and this diagnosis was later confirmed.

Giving birth

At 7 months (32 weeks) into my pregnancy, my doctors suggested I have a planned c-section. I didn’t want this because I knew that my baby would have to stay in hospital and I wouldn’t be able to drive for six weeks after the operation. I live in a rural area and it would have been very difficult for me to get to the hospital to see my baby. I persuaded the doctors to induce me and, the next day, my waters were broken. 

I coped well with the pain of labour at first but then I started to feel a need to push when my cervix was not dilated enough. There were no anaesthetists available for an epidural and I didn’t want morphine as I was worried about the effect it could have on my unborn baby. It was very painful and I had a bleed which was frightening. I later learnt that this bleeding was caused by the placenta coming away from my uterine wall. The baby’s heartbeat was lost at one point and it looked like an emergency c-section would be needed. However, a low heartbeat was detected and I vaginally delivered my baby after an episiotomy (when a cut made to increase the size of the vaginal opening) and with forceps. The placenta needed to be delivered quickly to stop me from having a serious bleed (a haemorrhage).

My baby’s health

My baby boy, Beau, was taken to SCBU (Special Care Baby Unit). He was given some support with his breathing. I saw Beau a few hours later but I didn’t get to hold him for a few days. My baby picked up an infection, and doctors thought it might be MRSA at the time. This meant there were even more restrictions on any physical contact I could have with him. Maybe because of my job as a midwife, I was allowed to give Beau a special wash to reduce the infection risk. Doing this helped me feel more in control of the situation. I was discharged five days after giving birth. It was difficult being separated from Beau at home. In the hospital, I had been only a short walk away from him. I worked hard to build up my breast milk supply and after a few days, I was breastfeeding Beau without him needing any extra tube-feeding. Beau was discharged from hospital after three weeks.

Messages to others

I encourage other pregnant women to seek help if they are worried about anything. I think medical professions should spend more time explaining about pre-eclampsia to women who have been diagnosed with the condition, as well as giving them information about both the pros and cons of birth methods (e.g. c-sections/caesarean sections, vaginal deliveries).

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