Pre-eclampsia and high blood pressure in pregnancy

Janine

Female
Age at interview: 33

Brief outline: Janine had an emergency caesarean with her 1st child at 30 weeks due to pre-eclampsia. She had a good physical recovery but felt ‘in shock’. 13 years later she was keen and confident enough to experience vaginal birth with 2nd child. She had a short but intense labour, birth was painful but ‘amazing experience’.

Background: Janine has one daughter aged 13 and a baby son. She is a homemaker and her partnerwho works as computer software engineer.

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Previous pregnancy and birth

Her first experience of childbirth dates back 13 years. She was 19 at the time and living with her parents. At a routine scan at 30 weeks, there was concern about her baby’s small size. Further tests found her to have high blood pressure and excess protein in her urine. She was advised to have bed rest in hospital, where she would be closely monitored for the remainder of her pregnancy. Four days after she had been admitted, her blood pressure rocketed and she was told that a caesarean was the only safe option to stop the pre-eclampsia from getting any worse. She was less scared about the operation itself than about the quicker than expected arrival of parenthood. Having so little time to prepare herself emotionally for her new role as a mother left her feeling slightly unreal about what was happening to her. She received a general anaesthetic and didn’t see her newborn daughter until a day after the birth. After the birth, She had a reaction against the painkillers and had to stay in hospital for another six days. Born 10 weeks premature, her daughter weighed only one pound fifteen ounces and had to stay in the Special Children and Babies’ Unit (SCBU) for seven weeks. Coming home without her baby was a horrible experience. She expressed breast milk while her daughter was at SCBU, but had difficulty breastfeeding her once she returned home. It took her a while to develop the confidence to handle a small baby and she didn’t feel that her daughter was really ‘hers’ until several weeks later. Physical recovery was much easier than coping with the emotional side of things. Her scar healed very well and didn’t make her feel any different about herself.

Second pregnancy and birth

Her second pregnancy 13 years later and with a new partner has been a very different experience. Due to her previous pre-eclampsia, she had weekly midwife appointments and felt a bit anxious until she had gone past the 30 week point. However, having a family to look after did not allow her too much time to worry.

She decided early on in the pregnancy to have a trial of labour as she was keen to experience vaginal birth and felt confident and empowered by her partner’s support. Her midwives and doctor encouraged her plans, but she was disappointed that the hospital would not allow her to attempt a water birth even though her scar dated back 13 years. She only attended one antenatal class and decided that she would be better served by reading up on labour and pain relief at her own initiative. Having a keen interest into child development in general, she read up widely around the different stages of her pregnancy and watched TV programs about pregnancy and birth. She also had a very good relationship with her midwife and felt comfortable about ringing up with questions as they arose. She briefly considered a planned caesarean when it was suggested that her baby might be breech but a scan closer to the due date showed his head and body to be in perfect position. 

Her contractions started early in the morning of her due date but were bearable until they came at 6 minutes apart. She came into hospital at 2pm when labour became increasingly painful. She used gas and air but found that it made her contractions dip, so continued with breathing techniques only. When she had dilated to 8cm her waters broke and she requested an epidural, but by that stage the midwife judged labour to be too advanced. Her son was born after 3 hours of intense labour. Giving birth vaginally was more painful than she had imagined but also a very emotional experience. She was amazed when her son was placed on her chest directly after the birth and watching him take his first breaths felt very special. Comparing the experience to her previous caesarean, she felt that bonding came much more naturally. Her recovery was very quick and she was able to return home with her baby the same day. She is grateful to have had a ‘comparatively easy’ vaginal delivery and thinks she might have another child. 

Generally, she thinks health professionals should be careful not to rush women during appointments and make sure that the details and measurements they provide them with are accurate as otherwise they are likely to cause much undue anxiety. For women, she thinks the best policy might be to keep an open mind and ‘go with the flow’.

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