Caring for you first
The month of May has a few national awareness campaigns. National Women’s Health Month, National Teen Pregnancy Prevention Month, Preeclampsia Awareness Month, Mental Health Awareness Month, Bladder Cancer Awareness Month, and more. The month of May also includes Mother’s Day. And so, I wanted to use this month to discuss the road to motherhood, and the potential challenges we can face on the health side of things, particularly with preeclampsia and how it can affect your health moving forward.
I was two months into my marriage, I had some friends visit from out of town, and we all went out one night. The next morning, I felt like I had been hit by tractor truck. I talked to one of my friends that afternoon and told her how horrible I felt, she said “well, we did drink a lot last night”. I responded with, yea, but I’ve felt similar to this for the past few weeks. She quickly responded with “oh! You’re pregnant!” What? Two months of marriage, and I’m pregnant! We planned on waiting and traveling sans children for at least a few years. Three home pregnancy tests later, it was confirmed times three, I was pregnant. Obviously, we didn’t do a good job at birth control, and I was taking a multivitamin, but not what was needed for those first 10 weeks of baby’s development. I started out nervous, not just because our marital journey was taking a shift by adding a new addition to it, but also, because I knew the science, and I knew that my body wasn’t in it’s optimal state to carry a baby.
That nervousness increased over the weeks, as I attended each prenatal appointment as scheduled. With each appointment, and each blood draw, there was another question raised about the health of my growing baby. Eventually, it became enough that I began seeing a Perinatologist (high-risk OB) throughout the remainder of my pregnancy. I had headaches throughout my pregnancy, I saw floaters (blurry spots), I knew something felt off. Whenever I took my blood pressure it was normal. Whenever I called the nurse advice line while having symptoms, I was dismissed because I have a history of migraines with aura. I knew something was wrong, but I was my only advocate, and I didn’t know enough to scream louder. The week before my last prenatal appointment, I was supposed to see Erykah Badu in concert. I absolutely love Erykah Badu! I’ve tried to see her many times before, and something always happened that prevented it. I felt off, again, and I ended up giving my tickets away, because I didn’t trust that I was well enough to attend the concert.
At 28 weeks, on a Friday morning, I had a prenatal appointment; at every prenatal appointment, they ask you to urinate in a cup at the beginning of the appointment. For some reason, that morning, I forgot and I went beforehand. By the time I got called in, I didn’t have the urge to go, but I had tea, and water, so I kept sipping. The nurse took my blood pressure and casually asked me what I had planned for the day, I told her I was going to work. She told me I wasn’t; my blood pressure was 179/118! For context, my normal blood pressure is around 110/60. At this moment, my body and actions went into autopilot. I asked questions, but I was at the appointment alone, my husband at work. I called my mother to come to the clinic, more so, for emotional support. They called an ambulance to take me to labor and delivery. Once there, they drew blood, and I was finally able to urinate, my protein content in urine was 7x the normal amount, and my blood test confirmed, I had severe preeclampsia.
Preeclampsia is identified as an increase in blood pressure with fluid retention (swelling in hands and feet), and protein in the urine. The risk of preeclampsia can lead to stroke, organ damage, seizures (eclampsia), or death; and risk to your baby include – premature birth or death. The on-call doctor that day, I had never met. She seemed nice enough, and encouraged me that they would do everything to keep my baby inside of me. Which is what I wanted to hear. But when I saw my Perinatologist the next morning, he informed me that I was going to have to have an emergency cesarean the next day. I asked, but why can’t I just do bed rest? Why can’t I do all the things to keep my blood pressure low? Why do I have to deliver my baby now? I was 29 weeks at this point. His lungs were at the end of development, which meant he hadn’t gained any fat yet. I was scared. Had any other provider given me the news outside of the Perinatologist who I had grown to trust, I don’t know how these events would have played out. He told me he would come back to sit and chat with me after he completed rounds. When he came back, he broke down the research to me. He explained how the state of the placenta is part of what causes preeclampsia during pregnancy, and that while I remained pregnant, both my baby and myself remained at risk for severe damage and death. He told me, he wouldn’t be able to live with himself, sending me home on bedrest, knowing that I could have a seizure and stroke out at any time.
I was my advocate, but so was he.
The next evening, I had my son via cesarean, at two pounds, one ounce. He went to the NICU immediately and I went to recovery and back to the prenatal side of the maternity ward for observation over the next day and some change. So it was two days before my husband was able to wheel me down the long corridor to the NICU, so that I could touch my baby for the first time. I knew before this, that I wanted to nurse, and I was encouraged that breastmilk would be the best “medicine” for my premature, low birth weight baby. I put ALL of my energy into pumping, to ensure I had milk for him to consume. I spent my entire days at the hospital, and if I wanted to visit over-night, my husband would drive me up there at 2 am, so I could check in. I was in full “mama bear” mode. I had no clue how to be a mother, yet, in those two days in the hospital prior to his delivery and every moment since, every decision I have made, has been to protect him at all costs.
Preeclampsia is a disease of the cardiovascular system, as 1 in every 12 pregnancies develop preeclampsia, eclampsia, or HELLP syndrome, and after development, you are 2x more likely to have heart disease, 2x more likely to have a stroke, and 4x more likely to develop high blood pressure later in life. Two out of three women who had preeclampsia will die from cardiovascular disease, and that increases if you also delivered preterm, had low birth weight babies, and suffered from severe preeclampsia more than once.
Fortunately, I did not experience preeclampsia with my second birth, however, I check all of the other boxes. Protecting my babies at all costs, includes protecting myself, so that I can be there for them. Which means, I have to take actionable steps to prevent these dire outcomes. Exercise; 10k steps per day and 2-3 days a week of strength training (check). Eating a heart healthy diet, as a vegetarian, I normally eat pretty well, but limiting fried and processed foods is also a must. No smoking, my dad smoked cigarettes and I never liked the smell of them, so that one is easy for me (check). Staying at a healthy weight, this can be a challenge for some, but if you’re getting your exercise in, and keeping a healthy food lifestyle (not a diet), then this should be ok (check). Talk to your doctor about taking low-dose aspirin, and stay on top of your numbers for blood pressure, blood sugar, and cholesterol (and check). These lifestyle changes can help prolong your life, to allow you to be present throughout your children’s lives.
To learn more about preeclampsia, visit https://preeclampsia.org/
