I Had Pre-Eclampsia

A mom and newborn baby doing skin-to-skin. Image source.

[content note: medical stuff. Childbirth is kinda gross.]

I recently announced the birth of my little daughter. Here's the story of how I had pre-eclampsia during that pregnancy.

First of all, I'm in China, and so I should mention that in China, most of the doctors work at hospitals, rather than at a separate doctor's office. So you go to a hospital for all your normal medical appointments and checkups. Just want to point this out, because in the US, if you say you're "going to the hospital", oh no must be something serious, but in China, it's not, it's just normal doctor stuff.

Towards the end of the pregnancy (after 34 weeks or so), the hospital policy is that pregnant patients should come once a week for prenatal appointments. And at every appointment, towards the end of pregnancy, they measure your blood pressure and take a urine sample. This is because they are testing everyone for pre-eclampsia- the first signs of pre-eclampsia are high blood pressure and protein in your urine.

So I went for my regular appointment, when I was 36 weeks + 1 day pregnant. (A full term pregnancy is 40 weeks.) And at that appointment, my blood pressure was high. And there was protein in the urine sample. They measured my blood pressure several times at that appointment, and had me do a second urine sample. The second one had protein too.

So the doctor, let's call him Dr. L, wanted to do more tests to find out if it was pre-eclampsia. Because pre-eclampsia can be dangerous, so, very important to do the tests to diagnose if I had it or not. He said I should collect all my urine for 24 hours, and then bring it back to the hospital and they would test that. The nurse gave me a huge bottle to collect it in. Kinda gross!

The next day, I stayed at home the whole day and collected all the urine. And the day after that, in the morning I brought it back to the hospital to get tested.

Oh also, my husband wasn't in Shanghai at that time- he was traveling. So anyway, I get back to the hospital with my big urine bottle, and the doctor that day was Dr. Z, who was very serious about the possibility that I might have pre-eclampsia. 

So yeah turns out there was definitely too much protein in the urine, and my blood pressure was too high.

Dr. Z only speaks Chinese- which is fine because I speak Chinese, and also usually my husband comes with me to the prenatal appointments, and he is Chinese. The doctors tend to like to talk to him because they can just talk to him in Chinese and he obviously understands everything. (And some of the doctors at this hospital speak English very well, some don't speak English at all, and some are at various points in between.)

So Dr. Z told me I had pre-eclampsia, and she looked it up in a dictionary app on her phone to show me the English name, because she didn't know what it was called in English. Then she told me to call my husband and she would tell him the situation over the phone. And sometimes I kinda feel like, "hey why don't they just talk to me, it's my medical status," but I really can't complain because my husband does an amazing job with this. He doesn't have the attitude like he's in charge and I can't make decisions myself. Instead, he's exactly the support person you'd want to have in this situation. He knows my medical concerns, he listens to me and takes me seriously, and he communicates those things to the doctors. Seriously, 10 out of 10.

Plus it's not like the doctors don't talk to me. When I ask them questions in Chinese, they tell me the whole situation. So that's good.

Dr. Z tells him over the phone that I will have to stay in the hospital, and I will have to get steroid shots to help the baby's lungs develop faster, and we will try to make it to 37 weeks and then deliver the baby. (At that point I was 36 weeks + 3 days. 37 weeks is the point where they figure they can deliver the baby and the baby will be healthy.) And I understood most of that in Chinese but not all of it, so yeah it was nice having my husband involved and able to talk to me about it too. And Dr. Z told him he should come back to Shanghai if possible.

Dr. Z also printed out some information in English about pre-eclampsia for me, which was nice. I had read about it before, so I basically knew what it was, but wow it's a different feeling when you actually have it. Dr. Z was really serious about it, and she kept asking me if I had headaches, or felt dizzy, or had blurred vision- which I did not. I told her I feel fine, I don't really have any symptoms. But she said I'm not fine, I will get worse if they don't treat this.

What is pre-eclampsia? Mayo Clinic defines it this way:

Preeclampsia is a complication of pregnancy. With preeclampsia, you might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range.

Left untreated, preeclampsia can lead to serious — even fatal — complications for both the mother and baby.

Early delivery of the baby is often recommended. The timing of delivery depends on how severe the preeclampsia is and how many weeks pregnant you are. Before delivery, preeclampsia treatment includes careful monitoring and medications to lower blood pressure and manage complications.

Preeclampsia may develop after delivery of a baby, a condition known as postpartum preeclampsia.

In the information that Dr. Z gave me, it said the only cure is to deliver the baby. 

So that day, they set me up with an IV with blood pressure medicine (magnesium) and I just hung out there in the hospital the whole day, getting the medicine. In the evening, I got a steroid shot to help the baby's lungs develop. (The lungs are some of the last organs to fully develop during pregnancy. It's really great that medical technology has advanced enough that there's a steroid shot available to accelerate this, if you know your baby is going to be born premature. This has saved a lot of babies' lives.) They said I would have to have 4 shots, with 12 hours between each one. It hurt.

And my husband got a flight back to Shanghai that night.

The next day (36 weeks + 4 days pregnant) was basically the same. I got an IV bag of blood pressure medicine all day. I had a headache, and the doctor said it could be caused by the medicine rather than being caused by the pre-eclampsia. Also the nurses measured my blood pressure frequently throughout the day. And the second and third steroid shots.

The next day (36 weeks + 5 days pregnant) I got the 4th steroid shot. My blood pressure was okay, so the doctor (let's call her Dr. Y- every day it's a different doctor on shift) said we didn't need to be in such a hurry to deliver the baby. Maybe we would make it to 37 weeks. (But we wouldn't go beyond 37 weeks- when you have pre-eclampsia, you really can't stay pregnant. It just becomes a matter of how to balance the benefits the baby gets from spending more time growing in the uterus, vs the dangers to both the pregnant person and baby if the pre-eclampsia gets worse.)

So that day, Dr. W (there are a lot of doctors in this story) told me that we would put a string with some kind of medicine to start contractions, into my vagina. Also, it seems I've somehow figured out the cheat code to get all the doctors at this hospital to believe me about how I used to have vaginismus and I don't want people just sticking stuff in my vagina whenever. (Yeah you know all my blog posts about having bad experiences with gynecologists? Most of those were at this hospital.) I have no idea how I finally managed that, but I guess there's a note in my medical records about it now, and the doctors took it seriously, and thought up all kinds of workarounds to minimize the amount of times they would have to stick things in my vagina. Which is great! Anyway so Dr. W said I can try to stick this string in there myself. So I did that, but then in the end I did need her help to do it because I couldn't get it right. 

So for the whole day, I had contractions, but they weren't painful, and weren't very frequent, so, the baby was not born that day.

The next day (36 weeks + 6 days pregnant) Dr. Y said that the contractions had opened my cervix enough that I was ready to start inducing labor, and the baby would be born that day. So, an anesthesiologist came and gave me an epidural (which I was really nervous about). The epidural is anesthesia that goes into the space around your spinal cord, and it makes you unable to feel pain in the lower half of your body- but you're still totally awake. This is what they typically give you when you're giving birth, and it worked really well for me.

Also Dr. S broke my water using a big hook that looked like a crochet hook. The reason for breaking the water is to make the contractions come faster. Later I also got pitocin through an IV, which makes the contractions faster.

So then after that, I kind of sat around for a while. The contractions continued, and got more frequent, but I didn't feel any pain. I just watched tv and ate lunch and sat around.

Then the midwife told me I was already fully dilated and could start pushing my baby out. And I was really surprised! It felt like it happened pretty fast! Dr. S came in, and she said once I started pushing, the baby would be born within 20 minutes- and I was really surprised about that, because for my first child, I pushed for 2-3 hours. But since this one is my second child, Dr. S said it would be a lot faster.

So then I started pushing, and it wasn't even that hard, and the baby was born after 15 minutes. (Also, since this baby was born early, she has a smaller head than my first baby. Which made things much easier!)

When she came out, the umbilical cord was around her neck, and she wasn't breathing, so she was quickly handed off to a team of doctors and nurses who suctioned her face a bunch, and then she started breathing. (Yeah while I was pushing the baby out, a whole bunch of doctors and nurses came into the room, and they all have specific roles I guess, like which ones take care of me and which ones take care of the baby. They have a whole system and they did a good job.)

Then they put the baby on my chest for skin-to-skin. (Skin-to-skin means right after the baby is born, the baby will lay on the mom's chest- this helps the baby and mom to bond. Or, if for some reason the mom can't do it- for example, if she had to be put under general anesthesia and isn't awake- then the dad and baby can do skin-to-skin.) Everyone left the room except for me, my husband, and our baby, and we got some time to just hang out with her. She seemed comfortable laying on me, and also not really sure what to make of being born.

But, also, a nurse told me that my baby would have to go to the NICU. Because she was premature, and because she wasn't breathing when she came out. So after the skin-to-skin time, a nurse came and took her to the NICU. After a few minutes, they said my husband was allowed to go to the NICU and see her, so he did that. She ended up staying there about 4 hours, and they decided she was fine, so they brought her back to us then.

Oh, and then, once I wasn't pregnant any more, all my pre-eclampsia symptoms totally disappeared. The nurses continued to check my blood pressure frequently over the next few days, and it was normal.

So that's the story of how my little baby was born. She was born early, at 36 weeks + 6 days, because I had pre-eclampsia. Throughout the whole thing, I wasn't really worried... Even though pre-eclampsia can become life-threatening for both the pregnant person and baby, I didn't feel like I was that sick. I just sat around in the hospital and watched tv for several days, and everything turned out fine.

In other words, it's really good that the doctors always do urine tests to check for pre-eclampsia, for all pregnant patients in the third trimester. They really took this seriously when my results weren't normal and they started to suspect it could be a problem, and they caught the problem before it became a life-threatening emergency. They caught it early enough that they had time to give me medicine for the high blood pressure, and make a plan about how to deliver the baby so that both me and the baby would be safe and healthy.

I'm grateful to the whole medical team, to modern science for inventing the blood pressure medicine and the steroid shots, and whoever suctioned my baby's face to get her to breathe (I have no idea who that was, I was in the middle of getting stitched up). Pregnancy can be dangerous. It's really great that nowadays the medical technology is very good, and everything can work out just fine, even with something like pre-eclampsia which can potentially be life-threatening.

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Related:

What Pregnancy Taught Me About Being Pro-Choice

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Every time you ask a woman about pregnancy or childbirth she’ll go “Oh it wasn’t so bad, I was actually really lucky. All that happened was—“ and then tell the most terrifying story you’ve ever heard.

— Moira Donegan (@MoiraDonegan) January 14, 2024