What is Postpartum Preeclampsia?
Mixing two seemingly oxymoronic pronouns, the term “postpartum preeclampsia” doesn’t sound possible. How can you have a pre-condition post-pregnancy?
While not medical advice- if you have questions, please ask your doctor- here is a quick summary of some Google searches and my personal account of the condition.
We’ll start with defining preeclampsia. According to webmd.com, preeclampsia is a condition that occurs during pregnancy, usually after 20 weeks, marked by high blood pressure, protein in urine and other organ dysfunction, and swelling. It may resolve after giving birth, but may also result in eclampsia. Eclampsia, according to Wikipedia, is a condition that occurs if preeclampsia doesn’t resolve, and is marked by seizures.
Postpartum preeclampsia occurs when preeclampsia isn’t resolved by giving birth, but has not yet resulted in eclampsia. Postpartum preeclampsia, according to webmd.com, is rare, but is also marked by the same symptoms of preeclampsia: high blood pressure, organ dysfunction, and swelling.
Postpartum Preeclampsia Almost Killed Me
I had preeclampsia with my first-born, Charlie. 16 months later, I did not have preeclampsia with my second child, which is common. My doctor told me that subsequent children with the same father reduces the likelihood of preeclampsia.
With my third child, I developed postpartum preeclampsia. And despite the raised eyebrows of some of my nurses, all three of my children have the same dad.
To say the experience was traumatic is an understatement. I switched doctors at 32 weeks because my insurance changed, and I needed to find an in-network provider. I’m noting that here, and will circle back to that later: it’s important. After having my daughter, I noticed at the hospital that the postpartum support belt that I wore after both of my other pregnancies wasn’t even close to fitting around my body. I assumed that maybe I had just gained too much weight. I gained over 20 pounds in the last 2 months of my pregnancy, but because nobody at the doctor’s office mentioned it to me- I assumed they were being polite and I was just eating too much.
The swelling toward the end of my pregnancy was so severe that my arms were going numb. My doctor said that the swelling was likely putting pressure on my veins and causing the numbness. I drank more water. I exercised. I watched how much sodium I was eating. I just thought that putting my body through three pregnancies in three years was doing its damage.
After our baby was born, I did not feel well at the hospital. I had a sharp pain in my upper right shoulder that had been there for almost the entire third trimester and would not go away. I honestly thought I had just gotten so big that my body couldn’t figure out how to carry the weight. I want to really stress the swelling and rapid weight gain because my blood pressures were within normal ranges. I’m pretty sure that’s the tell-tale sign of preeclampsia, but my mine were okay. One nurse had even jokingly remarked that they were surprisingly low for having two under two at home.
I went home with my new baby and went right back into mom mode. After I got home, I realized my maternity pajamas actually seemed tighter than they were before I had her, and I still couldn’t get my postpartum belly band around my waist. I was drinking a lot of water, but the swelling seemed to be getting worse. They say it gets worse before it gets better, so I was uncomfortable, but not necessarily worried.
By Friday morning, though, it felt like an elephant was sitting on my chest, and one of my legs was more swollen than the other. Breathing was laborious. You know that feeling you get in your chest and lungs when you hold your breath for too long? It felt little like that. I couldn’t take a full breath; I had trouble talking; and the swelling was so bad that I couldn’t make my hand into a fist. I called my OB’s on-call service, and I cried when I talked to the on-call doctor. I didn’t know how to explain that I know that swelling is normal, but I didn’t feel normal. I didn’t know how to explain that I knew I was anxious and sleep-deprived, but it wasn’t just shortness of breath I was feeling.
Not knowing what was going on was scary. But let me tell you the truly terrifying part.
I was leaving to go the hospital, walking out the door as my mother was urging me to go faster. I looked at my son who was sitting on the couch watching TV. I didn’t say goodbye to him because I didn’t want him to want to come with me. I stared at him really hard and tried as much as I could to imprint the image into my brain, just in case I didn’t see him again. I don’t mean for that to sound dramatic, but I didn’t know: I didn’t know if a blood clot was going to reach my heart or my brain or however it is that blood clots kills you, or if I was having a heart attack, or if my lungs were going to explode like they felt they were on the verge of doing.
With chest pain, I was admitted right away. As it turns out, I wasn’t totally wrong about feeling like I was dying. The ER doctor took one look at me and knew I had postpartum preeclampsia. I was put on a diuretic right away to reduce the swelling, and some other things (I don’t really remember). My kidneys and liver had started to fail, and my lungs and heart were surrounded by fluid, which was what was making it hard to breathe. I was re-admitted to Labor & Delivery and was on a magnesium-sulfate IV for a couple days. I think it was a couple days, I honestly don’t really remember. Thank God for my nurses, who were so kind to me. My body was so sore, and I was so sad. I missed my baby, my husband, and our other two kids. I wanted to feel better, but I also just really wanted to go home.
After 12 hours or so, the swelling started to go down. One of the nurses came in and looked at me and said, “You look so different.” That’s when it occurred to me nobody knew what I really looked like, so they didn’t know what I was supposed to look like. I showed her a picture of myself with my two sisters, and she said to me, “You’re in this picture? Which one are you?”
Like I said before, I switched doctors at 32 weeks because my insurance changed. I am convinced that if I had been able to stay with the same doctor, my condition would have been caught much earlier than it was. Because my new doctor had not seen me at the start of my pregnancy, she didn’t have an accurate baseline to compare me to. My mom and my husband could tell the swelling wasn’t normal: I looked markedly different than I actually look. But trying to explain that you’re pregnant and swollen, or just had a baby and swollen, is like trying to explain you went swimming and got wet. Everyone is swollen. But without a good visual baseline, my health care providers had no way of knowing that my swelling was abnormal for me.
I am so grateful the on-call doctor sent me to the ER. I wish I would have listened to my body, though. I wish I would have been a better advocate for myself and not so laid back. I knew I did not feel well, and while I don’t know what could have been done because my blood pressures were within normal ranges, I wish I would have done something–maybe asked to test for protein in my urine when I noticed the swelling was getting out of control. My advice here is to not make the same mistake I did. Honor your body, and listen to it.
I am convinced that having to switch providers so late in my pregnancy almost killed me. It is shameful that prenatal decisions have to be made based on insurance and not health. Consistent and affordable prenatal health care should be readily accessible by all women. I feel like because I was reduced to a number, to a code, to “in-network” or not, I almost lost my life. My kids almost lost their mom. My husband almost lost his wife. My parents almost lost their daughter. It is shameful. We are a developed nation who has to do better by women. Women need affordable and reliable prenatal care so we can make decisions that are focused on our health and the health of our babies.