Louise’s story

It’s almost 1 year since the birth of our child. Everything had been going well during pregnancy. I had been prescribed low dose aspirin due to my age and the fact this was my first pregnancy. I was struggling with swelling, but that’s normal for pregnancy, except I hadn’t realised how much of my body had begun to hold water. The midwives didn’t seem concerned and I didn’t have any protein in my urine dip test or any other signs of pre-eclampsia. At my last antenatal appointment my blood pressure was high, but just under the threshold to be checked.

The swelling was no longer going down over night or when I had my feet up. I would be left with pitting on my legs if I rested anything on them. When I had questioned my midwife she told me this was just normal for pregnancy even though I no longer had anything that fitted on my feet. My urine output was low compared to the amount I was drinking and I didn’t think to mention anything about the fact I couldn’t move my right leg out of bed anymore without lifting it with my hands. Over the next few days I monitored my blood pressure and it stayed high so we phoned up to go into day assessment to be checked.

Another dip test didn’t show any protein in my urine, but my blood pressure stayed high. My urine was sent for analysis and a blood sample was taken for testing. I was given blood pressure medication with a side effect of bad headaches and monitored a bit longer whilst the results came in. The blood tests came back in the normal range but the urine analysis results were indicating that I probably had pre-eclampsia. I was given an appointment to come in the next day to check my blood pressure again and an induction date for when our baby was due.

On the way home I took some paracetamol as I was developing a headache which I assumed was due to the blood pressure medication I had been given. At home the consultant phoned us back with the last of the results which had showed that there was protein in the urine and I did have pre-eclampsia. I was given a sooner induction date and as I had no other symptoms it was thought I should be alright until the next day. Unfortunately in the next hour things became worse. My headache became much worse and it felt like I had a migraine. I was feeling sick and struggling with the pain of the headache so we contacted the hospital to say we were coming back in.

I could no longer keep my eyes open and was sick continually on the way to the hospital. It felt ages until someone came out of maternity and saw me. They promptly took me in and started monitoring our baby as well as looking after me. Everything was a bit of a blur for me. I had loads of people around me. They put up curtains and tried to dim the lights for me. I hadn’t clicked that my aversion to having my eyes open was a visual disturbance as at every midwife appointment I had only been asked if I had seen spots in front of my eyes. They gave me some blood pressure medication but I was sick soon after. My blood pressure had increased even more. They gave me an anti-sickness injection, but I continued to be sick until after our baby was born. They were busy trying to get a cannula in which took 9 attempts. In the end they had to get an anaesthetist to do it using ultrasound as the only way. I had become dehydrated with being so sick and the pre-eclampsia had shut down my veins. Every time they found a vein it would blow.

Nick sat beside my head the whole time, helping me every time I was sick. Neither of us realised how serious things were at this point. The only thing I could do was trust the health staff around me to help me feel better. My head hurt so much and I was so sick that I just wanted our baby to be born. Once a cannula had been inserted we were transferred from the ward to a private room. I had no sense of time as I felt so unwell. People were around me doing things and occasionally asking me questions. They took some blood to be tested again and I was given IV anti sickness medication, IV paracetamol for the headache and IV labetalol to control my BP. At some point the registrar came back and told us that I had severe sudden onset pre-eclampsia. Until this point we had thought it was just a side effect from the medication earlier as we had been told that bad headaches were one of the side effects. We were also told that the only solution was to proceed with a caesarean section that night. Throughout all this our baby had been doing ok.

We were lucky as we were at 37 weeks 3 days so it wasn’t considered premature, but they still wanted us to have a steroid injection to help with the baby’s lungs. The registrar came in to explain this to me and the possible side effects from doing so. I was struggling to follow because of how I was feeling, but it had to be my decision to have the injection and not Nick’s. We were given some time to think about it and someone else gave us a quick run through of what had been said. We decided to have the injection, with only a short time before the caesarean. They are normally given longer before and when the baby is much younger. Around this point there was a staff handover for the night shift.

An anaesthetist came to see me to discuss whether they would be doing a spinal block or general anaesthetic. Luckily my bloods came back and although they were a lot worse than earlier in the day, they weren’t to the stage that I had to have a general anaesthetic. I was also put on a magnesium sulphate drip to prevent seizures, with the feeling of burning as this was first administered. My blood pressure was being monitored every minute up until the point of the C-section to see when it was low enough to proceed. Nick had already been given a gown to get into. I was beginning to feel a little bit better at this point, probably from the IV paracetamol that was giving me relief from the headache. At 2200 they took me to the theatre and I was sat on the bed so the spinal block could be given. There were about 10 people in the room with me. Once the spinal block had been given, the anaesthetist checked how far it was working. I was then quickly laid down on the bed and sheet put across. The anaesthetist checked with cold spray that the spinal block was working correctly.
Nick was able to sit by head.

During the C-section my blood pressure dropped a lot, leaving me with a strange sensation of whether I would make it and what will be will be. They gave me oxygen at this point. I remember hearing our baby crying when he came out and Nick then being invited to see him. I felt bad because through all the evening and during the operation I had no connection or interest with our baby. I didn’t want to hold him, I couldn’t hold him, with IVs on both sides of me. I’m glad Nick was there to do that and he later told me he had been able to cut the placenta cord. We later found out our baby had pooped in the womb, so there must have been some level of distress for him towards the end.

After our baby had been born my blood pressure came back up and I remained on blood pressure medication for the next couple of months. I was able to see Nick and the baby before being sick for the last time. Once they had stitched me up we were taken through to the recovery room where I held our baby for the first time. Still a very strange sensation after what we had been through. It all felt so unreal. This was the first point I started to feel well again. Because of the swelling and pre-eclampsia I was not allowed fluids so could only have 75ml an hour and my urine output was measured. I lost several litres a day over the next few days. We were taken to a room and had 2 midwives with us until the 8am shift change. They were taking regular observations of me which eventually went down to every hour but meant I couldn’t really get any sleep. They were also doing bloods every 6 hours which was almost impossible as I was still very dehydrated so they had to use ultrasound to find a vein.

We spent another 4 days in hospital, thankfully in a room Nick could stay with us. For me it was almost impossible to get out of the bed or easily lift our baby from the cot to our bed. With no sleep for 36 hours and with how ill I felt this beginning to parenthood was a real struggle. It was almost impossible to stay awake to look after our baby at night. We had problems with feeding and eventually found our baby had intolerances to various foods, but not until we had gone through several weeks of distress. It was strange going home for the first time, already utterly exhausted.

Needless to say this didn’t come close to any of our birth plans. We now have a very happy boy who we love and enjoy. Despite having an idea of some of the symptoms of pre-eclampsia we still didn’t recognise it. For me, I was only having a couple of the symptoms and required blood/urine tests to diagnose pre-eclampsia and the side effects of the medication meant we didn’t recognise the sudden onset. We are ever so grateful to the care we had at the hospital that day as things could have been very different. We were very lucky. Our baby was fine and I recovered, although there maybe increased cardiovascular risks for later in life. So many other people have a different, less positive outcome.