Nervous about pre-eclampsia if I have another baby...

[tankgirl73]

Not sure if this is the best forum for this post -- I'm not currently pregnant, nor have I recently delivered or suffered a loss, and it's not about my fertility... So mods please move it if it belongs somewhere else.

Anyway, DH and I are currently undecided if we're going to have another baby or not. Part of me really wants one (especially when I'm fertile heh), but we're also already very busy, not raking in the millions, and getting older. I'll be 37 this year, which isn't OLD old, but it's starting to cross over into the point of "I'll be 50 before the kid is a teenager". Plus we're now living in a province where midwifery is not yet legal, and other junk like that we'd have to deal with. But another baby... *sigh*...

BUT. Beyond finances and issues of age or fatigue, my greatest fear would be about my health. Before I got pregnant with my DD, I was pre-hypertensive. Blood pressure was on the way up, was not yet 'officially' hypertensive but was being watched. When I got pg, it went down to normal levels so all was well. We planned a home waterbirth with a wonderful midwife.

At about 38 weeks, my BP (which I had been monitoring at home) shot up, stayed up for over 24 hours, and we ended up transfering to hospital for an induction. It went well, DD was healthy, transfer to hospital and back to midwife after birth was smooth, no complaints. And my BP went right back down to normal levels.

But looking back at things now, I realize I don't know if it was just pregnancy-induced hypertension, or actually pre-eclampsia. To the best of my recollection, we never did a urine test for protein. I think it wouldn't have made a difference in how we proceeded. But now I don't know what actually happened to me.

If we had another -- I'd worry about the same thing happening again. I'm still pre-hypertensive and it's still getting higher. (It's the genetic, nothing-you-can-really-do-about-it type, unfortunately). I'd still want to try for a homebirth, but with no midwives I'd have to do it solo. Which I'm not sure I'm really up to doing. If I did end up with hypertension, we'd have to avail ourselves of the oh-so-wonderful hospital system here, again without my midwife by my side...

But even if we get through all those things, I'm still left just thinking... geez, can't I have just ONE birth be the way I'd planned it? My son was induced (swept the membranes at a checkup) without my permission when he was "late". Then my daughter was induced (with my permission this time) when I had health issues. I don't want to go through that again, I want to sit at home and birth a baby myself, when the BABY decides it's time to be born gosh darnit.

A major risk factor for pre-eclampsia is a previous episode of pre-eclampsia. Which I don't really know if I had or not.

I also read some interesting stuff on research regarding pre-eclampsia, miscarriage, and immune reactions to the father's genetic material. To get into TMI, DH was my "first" back after high school, but then we split up and I married my first husband, my son's father. Then he and I divorced, and DH and I found each other again. We were using barrier protection until we decided to have DD, so my immune system could very reasonably have been reluctant to accept his DNA. Since she was born, however, we've moved on to "natural" contraception so I've now had lots of exposure to his, um, little fellows. So if that theory holds out, perhaps odds are lower now.

But... I still also have the risk factor of pre-existing hypertension.

Sigh. I don't think I'm even asking a question, I'm just venting, hoping perhaps for experience and wisdom from the mamas here? I just wonder, "is it worth it"? So many unknowns. Sigh.

[sanguine_speed]

I definitely don't have all the answers, but I too was induced with my first for PIH and pre-eclampsia. It is far, far more common in a first pregnancy than a subsequent pregnancy. But, it is also true that having a new partner reverts some of that 'first baby' risk back. So your second pregnancy was higher-risk than most people's second pregnancies.
You are at higher risk than average, I'd imagine, but it's not necessarily inevitable.

Also, my experience has been that I think they went ahead with an induction just because I was "full-term" anyway, not because I truly required an induction.
In fact, right now, my BP has been creeping up, and it's not cause for panic. It was 140/100 last week, this week it's 160/100, and I have gone to the hospital for consult and I'm 38 weeks but no induction. Everything checks out, and my BP does fluctuate (it dropped at the hospital to normal again).

Though, like you've said, you don't have access to a midwife, so you may end up in the "may as well induce as you're full-term" attitude even if your BP is only slightly elevated.

It's obviously only up to you, but if I were you, I would probably not make a decision about having another baby based on a previous episode of pre-eclampsia, especially with a successful and relatively positive induction in the past. Well, obviously not because I'm on my third baby since...

But it also sounds like maybe you're hesitant because you don't have access to midwifery care this time?

The decision to have another baby or not isn't easy!!

[tankgirl73]

Yes, a large part of the hesitancy is because of the lack of midwifery here, I think.

And I just thought of something, reading your reply -- before I got PG with DD, I was nervous about having another baby even then, but for different reasons!

With DS, I had 4th degree tears... basically reconstructive surgery to 'put me back together'. I remember overhearing the plastic surgeon say to my OB, "do you think this bit goes here?" I couldn't sit up for days, I was uncomfortable for weeks... I tore the vaginal wall clear through to the rectum. Years later, after everything was healed, I was convinced that some bits just weren't in their original locations anymore lol... (in fact I'm quite sure of it! I have some minor issues related to it...) Plus, of course there's lots of scar tissue there.

I wasn't worried about the same thing happening again, really. I was worried about the scar tissue not being as strong as the regular skin... not stretching properly. So I guess I was worried about having similar problems, but from a different cause. I worried that I'd be too nervous about tearing, come birthing time, to be able to relax properly and allow my body to birth.

My midwife checked me over and said that everything looked good down there, though. And I learned about waterbirthing, and all that good stuff. Come birthing time, even with the unplanned induction and hospital delivery, I gave birth squatting, she slipped out in three pushes, I had something like 2 or 3 teeny tiny tears that each required one stitch. I didn't even feel them when recuperating. It was a complete and utter non-issue. I walked out of the hospital with my newborn baby in my sling less than 7 hours after delivery.

It was such a non-issue that I hadn't even thought about it again since then! I'd actually forgotten about how worried I had been about my scar tissue. Intriguing.

[RedOakMomma]

My OB recently told me that taking doses of D3 during pregnancy lowers the risk of pre-e. I would guess there are plenty of other things you could do proactively, too.

[thefreckledmama]

If I were you, I would start looking into dietary and exercise changes you could start making now, in preparation for pregnancy, that could lower your chances of developing pre-e later on. The Brewer Diet is something you should look into, it's been shown to help prevent pre-e, and I know from personal experience that following it helped me stop spilling protein when my blood pressure started creeping up the last couple of weeks.