What about your understanding of pre-eclampsia? Had you heard about it before it happened to you?

I had heard of it, but again it was one of these things where I’sd sort of, looked on the, when I found out I was pregnant I’sd looked on the NHS website, you know, a bit about pregnancy, followed those things where it said, Week one your baby’s doing this, week two your baby’s doing this, and that sort of thing. And it was something that had come up and I’sd not really paid much attention. I knew a couple of people that had had it but they’sd had it very late on, sort of 37, 38 weeks and had had a few days in hospital before their baby was born. But hadn’st really ever given it much thought.

Did you have any knowledge of pre-eclampsia previously?

Not really. It was something that was discussed in sort of my midwife appointments later on, and when I was discussing sort of pregnancy history with my mum, and also my aunt my mum’s blood sister they both said that they had been hospitalised at the end of their pregnancy due to high blood pressure. But at that time pre-eclampsia wasn’st a phrase that was used; it was just you’sve got a bit of blood pressure; we need to keep an eye on you. So, I relayed that to my midwife and it was pointed out that I could be a candidate for it with being an elderelderly pregnant woman as well being nearly, you know thirty eight at delivery. So, yeah it was always classed as something that could be a risk, and to look out for high blood pressure or protein in my urine.

Over the course of a pregnancy, blood pressure does not typically stay absolutely steady. It usually starts at a certain level. During the middle of the pregnancy, it would usually slightly and gently fall. And towards the end of the pregnancy, the blood pressure will slightly and gently rise roughly back to the level where it was at the start. However, we have to track these blood pressure changes by checking blood pressure at each routine check because this is the method by which we work out if, instead of these normal changes, a woman is starting to develop hypertension in pregnancy or pre-eclampsia.

When we measure blood pressure, there are two separate numbers. The first is called systolic blood pressure and the second is call diastolic blood pressure. The reason you have to take two separate measurements is because, over the course of one heartbeat, how high or low the pressure is inside a blood vessel changes. When the blood has been forced out from the chambers of the heart into the large blood vessels of the body, the blood pressure initially is relatively high. When the heart muscle subsequently relaxes, so that the chamber can fill up with more blood to be pushed out over the next cycle, the pressure is relatively low. So we look at both numbers because both are important and sometimes we look at the difference between the two.

And where have you heard about BP, blood pressure being dangerous to the baby and the and the mother?

I was a physiotherapy student. I was a medical student and during my studies I heard it obviously and all that, that it’s not good, high BP is not good

It’s not good for any human being to have a high BP and pregnant women are at more risk because two lives are connected to one another, at that time. So a high BP can affect the mother as well as the baby also. So that’s why I knew about the blood BP a lot before that because I am connected to a medical profession.

And did you know anything about a condition called pre-eclampsia before your pregnancy?

Yes, I know about it. I heard about it but not much. No, I don’st have much information about it but I know that it is a condition.

My mum had pre-eclampsia when she was pregnant with me.

Okay.

So it was something we’sd kind of been told about when I was little and then, when I was pregnant with my first child, obviously, having high blood pressure and eventually, having pre-eclampsia symptoms, at that point as well, I did learn quite a lot. I knew it was a very dangerous condition and, thankfully, everybody in both cases was fine so yeah, I did we did know quite a bit about it. I was quite.

Pre-informed.

So how much did you know about sort of hypertension and pre-eclampsia before the trial?

I’sd heard about pre-eclampsia.

Okay.

I hadn’st heard about hypertension. A friend of mine had pre-eclampsia in her first and second pregnancy but at different times so that’s how I that’s how I knew of it. But I didn’st know the symptoms of it so well, you know, swelling and protein in the urine, and that kind of thing, didn’st know that at all. So I wouldn’st have known what to look out for and you know, it can strike at any time whether you’sre having your blood pressure done or not. So yeah, that was that was really my only my only awareness of it was somebody else having had it and even then, I wasn’st clear about what it was.

I didn’st realise it was life threatening. I’d heard lots of peoplemy sister had had pre-eclampsia at like 37 weeks, 36 weeks and you know they put her on blood pressure medication and they took the baby out ta da.

And I didn’st know, one, that you can get it as earlybecause they think obviously it started at twenty two weeks when my ankles swelled up. I didn’st know you could get it that early.

And I simply didn’st know it could take my life and I could lose my baby. I wasn’st aware of any of that because with my first pregnancy I had never experienced that. In fact up until then I didn’st know anybody who’d experienced pre-eclampsia so early; I didn’st even know our local hospital, which is seven miles from me, had a special baby care unit because I hadn’st need to know that. So it was all quite frightening.

Doctors and scientists have been thinking about high blood pressure in pregnancy for many, many years. We’sre still not absolutely sure what the cause is. We know that some women are more likely to get blood pressure problems in pregnancy. For example, women with some medical conditions, women in whom blood pressure problems runs in the family. Women whose mother had pre-eclampsia are more likely themselves to develop pre-eclampsia. But, although we understand it quite well what types of women might be more at risk of pre-eclampsia, in truth, all women can potentially can get pre-eclampsia in pregnancy. There’s been a lot of focus from the scientific community, over the last few decades, about the reasons why women might get pre-eclampsia. We still don’st know for sure but we think there are a lot of factors involved here. Some of them might be inborn factors that women are born with, some might be factors that are acquired over time, for example, a change in weight or having diabetes. We think that there’s probably something which goes wrong at the microscopic level in the ways in which cells interact with each other and pass messages to each other. Blood pressure can go up if blood vessels respond to these messages in certain ways. For example, if the diameter of a blood vessel narrows, that might lead the pressure to rise [phone buzz] and that rising blood pressure then later shows itself as pre-eclampsia. So there’s going to be a lot of focus in the next few years about why it is that some blood vessels narrow in their diameter.

I don’st know if it’s from just public perception of having a baby, because I remember even before I’d be pregnant you hear, ‘Well you’re not you know pregnant women, well they’re not ill, they’re not’ you know when people are like, ‘Oh I’m pregnant and I’ve got this, that and the other,’ that kind of thing.

But it’s like I’m not, you knowbut it actually is a big thing, it’s huge, it’s huge having a baby and people just under-estimate it massively, and I don’st, you know yeah it’s funny, it is big. And there’s I don’st know if there’s still thatthat kind of that school of thought, like not until you’sve had a baby you realise but then you don’st want to scare other mums off, so no-one really tells you the true picture of what’s happening.

Because I remember me and my [national patient charity] group, we were likeI said, “Do you know I’m going write a book called The Truth, and really what it’s like.” And then as time passes you’re like, ‘No, I don’st want to scare my friend who’s just about to go through all this. I’ve got two pregnant friends now. That’s, you know they know what I went through and they know it’s hard but they didn’st go through it so it’s fine; they don’st know how I feel, but I wouldn’st scare I’m not going to go through and scare somebody, so I think that’s where it all just gets watered down again.

You’re just confused, helpless in a way because I didn’st know anything about the condition. So, confused because I didn’st realise it could happen at so early, and you just think, ‘That can’t be right, you know I’ve never heard of that happening to anybody. And I think even when you’re pregnant you’re never given much information on pre-eclampsia. It’s sort of skimmed over [laughs]. Whoosh here’s a page of a book. I had this pregnancy book, I can’t even remember what it was, and it had a wee section on pre-eclampsia, and it certainly didn’st tell me anything that happened to me so it kind of sugar-coated it a bit where that’s actually and it definitely didn’st mention you can get it so early.

The pregnancy books are really designed for the third trimester pre-eclampsia which is where it mainly occurs. So yeah, it was very confusing and very, very frightening.

As I said to you that, you know I wasn’st really that au fait with pre-eclampsia full stop.

Yeah sure.

And then you’sveyou know so it’s a sort of assumed knowledge and then you’sve got a variant or whatever you know and so just sort of filling in some of the back story really, the bits that you didn’st have.

And then, you know you get that classic situation where you’sve had something happen to you and it’s like, ‘Oh so and so’s sister had it and she was really poorly and thenoh and blah blah blah,’ and then suddenly everybody’s coming out the woodwork, because you know like people keep it to themselves until there’s a common thread of, you know like other people having had it so.