Pre-eclampsia and high blood pressure in pregnancy

Recovery from pre-eclampsia after giving birth

Women we talked to recovered from pre-eclampsia or HELLP syndrome at different paces. For some, the signs and symptoms of pre-eclampsia stopped almost immediately after birth. Others found it took a few days or weeks, while some women found it took a few months. Their health was usually closely monitored with blood pressure readings and blood tests. Munirah’s blood pressure took about three months to return to the level it had been before her pregnancy. It took about a month for Helen X’s liver to return to normal after having HELLP syndrome. Kay found it was around four months before her kidneys recovered. 

Some women developed late-onset pre-eclampsia which complicated or delayed their recovery. Occasionally women had longer-term health concerns needing ongoing monitoring and treatment (see also the section on women’s future health). Sometimes there were other birth issues to cope with as well; such as stiches, bruising and scars.
Although women were often very pleased to be discharged from hospital, it wasn’t always easy to recover at home. Women often found it exhausting to look after their new babies at home as well as recovering themselves. But it was also exhausting travelling into hospital regularly if their baby was in a neonatal unit like SCBU (Special Care Baby Unit) or NICU (Neonatal Intensive Care Unit). Samantha X and her husband decided that he should save his paternity leave for when their baby came out of hospital, which meant she “was at home on my own during the day” and had to get taxis to visit her baby in hospital.
Checks and monitoring health

After being discharged, women continued to have extra checks to see if there were any issues related to their having had pre-eclampsia or HELLP syndrome. These checks were in addition to or sometimes combined with the six week postnatal check. Samantha X remembered having a midwife come to check her blood pressure daily for a week and then she had monthly checks by her GP for three months until “they were happy that my blood pressure was pretty stable”.

The checks usually involved taking the woman’s blood pressure, and some also had blood tests to check their kidney and liver function. For women who had had a stressful experience during pregnancy and the birth, these checks could be upsetting. Angela became very anxious whenever “the cuff went on” to measure her blood pressure and said this was “when I started to come apart slowly”.

Health checks were done either by the woman’s GP, at the time of home visits or back at the hospital. Some women whose babies were still in hospital preferred to have their checks there. Claire found it helpful seeing a midwife at hospital as she was there everyday visiting her baby in SCBU anyway. It meant that her postnatal checks “didn’t interrupt my time with my baby”. Paige hadn’t wanted home visits because “it meant waiting round for them [midwives] before I could go and see the baby”. However, getting to the GP surgery or the hospital could be tricky for women who had had caesarean sections as this meant they usually couldn’t drive for six weeks or so.
Taking medicines and self-monitoring blood pressure at home

Some women had taken medicines to lower their blood pressure when pregnant or during labour and birth, and these medicines were often continued. Others were started on medicines after birth. Aileen had pre-existing high blood pressure and went back to the medicine she had been taking before her pregnancy. This helped her blood pressure settle but it meant she couldn’t breastfeed whilst taking it. Angela took blood pressure tablets for six months before being told by her doctor that it was okay to stop.

For women taking medicines, the dose was usually decreased gradually as their health returned to their normal and stopped when it was no longer needed. Emma’s blood pressure medicines were “taken down very slowly so I had to keep going backwards and forwards from the doctor” for about a month. Kay was initially told she would be on blood pressure tablets long-term, but found things seemed to settle back to normal after a few months. Samantha X stopped her taking blood pressure medicines about three months after giving birth.
The number and frequency of medicines could be overwhelming. Kate remembered feeling like “a pill factory”, with medicines to lower her blood pressure, for pain-relief and antibiotics for a possible infection. She also had to give herself anticoagulant injections daily for six weeks, to reduce the chances of a blood clot. 

A few women, like Munirah, also started monitoring their own blood pressure at home after giving birth for a few weeks: “just to check and it had actually been quite consistent […] it was after about six weeks, we were quite happy with where the blood pressure was so we were like ‘we don’t really need to monitor it anymore’”. Women taking part in the BuMP research study were asked to continue self-monitoring for six weeks after having their babies.
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However, taking medicines could become yet another task added to an already long list of things women were trying to do. Kate remembered “being given a timetable of what was going to happen to me each day and each night and I remember saying to the nurse, “When am I supposed to sleep?” Because not only was I obviously feeding my baby, changing my baby, trying to play with my baby [but also] trying to eat some food [and] trying to get some exercise”. Emma made a chart with tick boxes to help her remember to take her medicines throughout the day. Claire set reminders on her phone.

Sometimes women forgot to take their medicines on time. Some said they didn’t feel so worried after their baby had been born and were less committed to taking medicines. Women who self-monitored their blood pressure often said it was reassuring to keep a close eye on their health. It wasn’t for everyone though – Paige thought about buying a home blood pressure monitor when she was discharged from hospital but ultimately decided against it “for my own sanity” as she thought using it might panic her.

Longer-term recovery

Most women we spoke to found their physical health returned to normal eventually, but some found there were longer-term health impacts and concerns. Some women also told us about lasting emotional impacts from their illness. Some women who were hoping to have more children in the future were also worried about the chances of developing pre-eclampsia in future pregnancies.

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