Last year, on 29 October, I sat down to watch the news with my morning coffee and discovered it was World Stroke Day. Nothing of particular interest or concern to me, so I was about to change the channel when I heard a representative from the Stroke Association explain that women suffering from hypertension during pregnancy are at a much higher risk of stroke than others. Many do not realise how serious the condition is, and how crucial it is to get blood pressure levels under control during this time.
I was one of those “many.”
Three-months prior, I had given birth to a beautiful baby girl, after months of suffering from pregnancy hypertension. Eventually, I was induced early to end the pregnancy, but when my daughter went into distress, I ended up having an emergency caesarian. Of course, through all of this I did realise that things were not progressing normally, but I would be lying if I said that I appreciated just how dangerous pregnancy hypertension can be.
A huge amount of focus and spotlight is laid on its counterparts: the dreaded pre-eclampsia; gestational diabetes; I even knew more about Group B Streptococcus (GBS) and anything else the hospital deemed serious enough to warrant a poster about all over its walls. But pregnancy hypertension never seemed to me as grave a condition. On its own, I always got the impression that it wasn’t going to be a huge cause for concern. But if it was a precursor to pre-eclampsia, for example, or if the baby was going to be affected as a result of persistently raised blood pressure, then it would be.
It turns out that if (fortunately) none of those things actually transpire and you just have high blood pressure, you are in a sort of limbo, neither here nor there. Perhaps even doctors are perplexed by it; a 2014 study published in the British Medical Journal admits “we still do not know the most effective, safe and cost effective way to manage it.” Similarly, in the UK, NICE guidelines advise that pregnant women with uncomplicated chronic hypertension should not be offered treatment to lower their blood pressure. None of this makes it any easier to experience; swollen feet, dizziness, feeling heavy-headed and much more still come with the territory.
So if you find yourself in this situation, here is some information on what you can expect from someone that has been through it:
Frequent cardiotocography (CTG) scans: this involves having a device placed on your bump for anywhere from 30 minutes to one hour, which monitors the baby’s heartbeat to ensure your raised blood pressure is not affecting the fetus.
At first, hearing your baby’s tiny and super-fast heartbeat is incredibly satisfying. But sitting in that chair often twice and sometimes thrice-weekly, when you’re getting bigger and bigger and more uncomfortable, the novelty begins to wear off. Don’t get me wrong; each time, going home with the confirmation that our baby was fine was of course an indescribable relief, but often I would be in hospital for up to four hours before getting that confirmation, and it was exhausting. If you get called in for a CTG scan, be sure to take a book, or your fully-charged smartphone to keep you occupied. Also, keep a light snack and some water handy too.
Lots of blood tests and urine samples: pre-eclampsia can come on suddenly, and as high blood pressure is one of the main symptoms, even one-week old blood results are deemed too old. You may be asked for a fresh sample at every appointment, as I was, just to see nothing has changed in a matter of days. There was one point at which I had plasters on both arms and my hands, and the nurse was perplexed about where to draw further blood from! This is worth being prepared for if you shudder at the thought of needles.
Getting told to “relax” a lot: as far as possible, doctors will try not to medicate you unless your blood pressure constantly remains higher than a particular threshold. So you will be told to do things such as elevate your feet, reduce sodium in your diet, and most popularly, relax!
With pregnancy hormones raging in your body, you might take this personally, as if it is something that is in your control and by not relaxing, you are purposely putting yourself and your baby at risk. Try not to take it this way and remind yourself that this is just “one of those things” that happens; it’s certainly not your fault. If you do as advised, you and your baby will be OK.
Being induced before your due date: ultimately, when you have pregnancy-induced hypertension, ending the pregnancy is the best way to deal with it. Your doctors will try to get you to full-term safely, but be prepared that at or after 37 weeks, they may suggest inducing labour. Of course, this comes with its own risks too, so make sure you fully understand the process, discuss all of your concerns, and feel 100% comfortable before agreeing.
Most women will get through pregnancy-induced hypertension safely, and it will be a distant memory as you watch your healthy baby grow. But if you find yourself in the situation I did, feeling like you are not well, but also not ill enough to warrant any actual treatment, rest assured that you are not alone. Try to stay positive and keep looking towards that finishing line; it’ll creep up on you quicker than you think!
Did you suffer from hypertension during pregnancy, or any other complications? I’d love to hear your experiences and any advice you may have in the comments below 🙂