When Preeclampsia Doesn’t End After Delivery: My Story About Preeclampsia and What I’ve Learned

Preeclampsia is one of the common complications of pregnancy. It is defined as high blood pressure first seen after 20 weeks of pregnancy with other organ involvement (this is usually picked up first by the presence of protein in the urine, a sign that the kidneys aren’t filtering the blood as well as they usually do), Maris Toland, (MD), an obstetrician-gynecologist at Dartmouth Health, tells SemicHealth. 

In this true life story, Vivian, a 37-year-old mother with five children, shares how she was diagnosed with high blood pressure (hypertension) during her fourth pregnancy, her challenges with subsequent pregnancy, how she navigated the situation, and what this experience taught her.

Here is her story. 

This is the year 2021. I am 33 years old and pregnant for the fourth time. It was a smooth pregnancy journey until I went for my routine antenatal check at 37 weeks gestation. 

The nurse told me my blood pressure was high. She assigned me to a bed and asked that I get some rest. After a while, she checked my blood pressure again, and the device showed it was still high. 

I was ushered in to see the doctor, who checked again to confirm the blood pressure reading. After confirming that it was still high, the doctor asked that I be admitted to the hospital ward immediately. 

The next day, I was induced to give birth since I was already 37 weeks gone. I gave birth to a bouncing baby boy. The doctor went ahead and prescribed me some medications I was meant to continue taking after delivery for managing the blood pressure. 

However, I got back home and stubbornly refused to take the drugs. It might sound silly, but I told myself I'm too young to be on blood pressure drugs. My logic was that since it was the pregnancy that brought about the hypertension and I had given birth,  there would be no need for any drugs. 

After some months, my blood pressure returned to normal, or so I thought. More months passed, and we entered 2023. I became pregnant again but totally forgot about the blood pressure issue I had in my previous pregnancy. 

Alas, at 21 weeks gestation, my blood pressure became high again. My doctor placed me on blood pressure drugs. Since I still had a long way to go with the pregnancy, I decided to take the drugs. However, I still wasn’t taking it as consistently as I should. 

I was always going for my antenatal checkups, but each time the nurses took my blood pressure, the readings showed my blood pressure was going higher. My medication dose was increased, but that made only a little difference. 

At 33 weeks gestation, I started experiencing the following symptoms:

• Dizziness
• Swollen face
• Difficulty sleeping at night
• Faster than usual heartbeat
• Difficulty breathing well, especially when lying down

By this time, I had started taking my treatment seriously and taking my drugs as I should. But, being frank to myself, I think I handled it late already. 

At 35 weeks gestation, my blood pressure was extremely high—up to the reading of 200 and above. I became really worried, especially as my doctor said I had to deliver the baby right away.

At first, I argued, saying my baby wasn’t mature enough yet and I didn’t want to have a premature baby. But the doctor insisted, explaining that this was the best option for me and my baby. 

I later agreed and signed the consent form for a cesarean section. I had a successful surgery, but since it was a premature birth, my baby had to be admitted into the baby intensive care unit (ICU). The days following childbirth were not easy for me.

Three days after surgery, I still couldn’t breastfeed my baby as my breasts weren’t producing milk yet. I guess the blood pressure drugs I was taking, and stress contributed to that. I was also in pain, but despite that, I always had to walk the corridor to check on my baby in the ICU. 

Wondering what happened with my blood pressure?

It did not go down this time despite the fact that I was taking the prescribed medicines. At this point, I realized that blood pressure problem is real. 

I know I could have done better managing the condition, but I guess some experiences occur to teach us lessons. And this time, I learned to take my health more seriously and not be nonchalant when it comes to treatment for health issues. I told myself I have to be more careful. 

After discharge from the hospital, I continued to take care of my little one and to take my blood pressure drugs. Nearly two years have passed now, and the good news is that my baby is doing well. 

However, I am still taking blood pressure drugs. I don't know when I will stop, but one thing I know is, I will always talk to my doctor first and not refuse to take my drugs willingly. I now know better.

Health experts are not exactly sure why some people develop preeclampsia

Despite advances in research, healthcare experts still don’t have a perfect understanding of why preeclampsia happens, and there is no widely accepted opinion as to what causes it.

One big culprit that is suspected is the placenta as the primary problem, and it may be triggered by an overactive immune response, and/or pre-existing cardiovascular risk factors, says Dr Toland. This is not surprising, considering that cardiovascular disease and preeclampsia share many of the same risk factors. 

This means if you have a cardiovascular disease (a medical condition that affects the heart, veins, and arteries), you may be at a higher risk of developing preeclampsia during pregnancy. Examples of cardiovascular diseases are stroke, heart attack, and high cholesterol. 

Preeclampsia is typically diagnosed by measuring blood pressure at a routine doctor’s appointment. Not everyone with it would experience symptoms, and for those who do, symptoms may vary from person to person. However, Toland notes that some of the common symptoms associated with it are:

• Headache
• Swelling in the feet/hands/face
• Changes in vision (seeing flashing lights or dark spots), and 
• Pain in the upper-right abdomen

Preeclampsia affects growth of fetus and can cause preterm birth

Preeclampsia is associated with poor blood flow through the placenta, the organ formed in the womb during pregnancy that delivers oxygen and nutrients to the baby. 

If preeclampsia develops earlier in the pregnancy, this poor blood flow can mean a fetus that doesn’t grow as much as expected (a condition called fetal growth restriction), Toland explains. She adds that later in the pregnancy and labor, poor blood flow through the placenta can mean the fetus doesn’t tolerate the stresses of labor, and a cesarean section may be needed. 

If preeclampsia is diagnosed very early, we try to manage it as long as possible to allow the fetus to grow as much as possible, but often, this is a reason we recommend early delivery. If unrecognized or untreated, preeclampsia can affect every organ in the body and can make patients critically ill—putting both mother and fetus at risk of death.

Preeclampsia may not go away immediately after childbirth

While preeclampsia can get worse in the first week postpartum, it usually resolves by 12 weeks after delivery. However, for some people, it may last longer than that. 

It is recommended to continue treatment even after childbirth, as preeclampsia is a risk factor for developing high blood pressure and other cardiovascular conditions later in life. Some people with it may go on to develop eclampsia, an onset of seizures or coma that occurs in people with preeclampsia.

Precautions and getting medical care for preeclampsia

Toland suggests that before you plan on getting pregnant, ask your doctor if you have risk factors for preeclampsia and what you might be able to do to reduce those risks. Also, getting a good blood pressure cuff to measure your blood pressure at home during pregnancy is a good idea. 

Also, if you have a horrible headache that won’t go away, don’t ignore it—call your doctor, she advises. 

Regular exercising and eating healthy diets may also help manage or prevent this condition. Consider diets rich in vegetables, fruits, whole grains, nuts, plant protein, and low-fat dairy, such as the DASH and Mediterranean diets. 

It may also be best to avoid the Western diet. Research suggests that this diet, typically characterized by a high intake of processed foods, red meat, refined grains, and pre-packaged foods, may increase the risk of preeclampsia.

*Real name was changed to Vivian to maintain the anonymity of the source. This story is based on true events, as told to SemicHealth correspondents, but may have been modified for grammatical and editorial accuracy.