Something’s Not Right: My Experience with Postpartum Preeclampsia

African American women are three times more likely to die from preeclampsia. I had chronic hypertension, which is a risk factor, but it was well-controlled and monitored so I had no reason to believe this disease would impact me.

I’ve never had an easy delivery. That’s probably why the first thing I said to my husband when he greeted me horizontally in the operating room just prior to my second son’s c-section was, “Never again.” I had just spent the better part of twenty minutes hunched in my obstetrician’s arms as an anesthesiologist jabbed me with a really, really big needle in my spine.  He had trouble finding my epidural space. The result of which was a two-week long spinal headache.  However, six years later, one day before the 2016 Election, I found myself once again laying in the same position preparing for the birth of our third son.  Don’t get me wrong. This little guy was planned. He was wanted.  However, that didn’t stop the anxiety from practically eating me alive as I prepared for his birth.  I was prepared.  That is, I knew what to expect.  However, I also knew all the things that could go wrong.

This was my third c-section.  I had considered VBAC. However, during monitoring my son’s heart rate dropped so I would have had to be induced at 37 weeks. Since labor via induction can be harder on a previously scarred uterus, I chose a third c-section as the safest option for baby and me.  Surgery went well.  I had scar tissue that complicated things but my son was perfect.  He was 7 lbs 10 ounces, 19 inches and screaming his head off.  10 fingers. 10 toes. A head full of hair and placed right in my arms.  The days following my c-section were brutal but nothing out of the ordinary. As the remaining effects of the epidural wore off, the pain returned with gusto but I was on three different pain medications so it was manageable. We stayed in the hospital four days and were released with a clean bill of health. I had no swelling, my incision was healing already, and all of my vitals, including my blood pressure, were great.

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The first warning sign came the day I got home.  It was a Thursday.  As I was parked in our recliner, surrounded by members of our immediate family, I noticed the beginnings of extreme swelling in my legs and feet.  By the following day, my feet had blown up so big, I couldn’t fit any of my shoes or socks. My feet had even gotten too wide for my husband’s socks (he wears a size 15 shoe).  Even more concerning, when I pressed into my feet with my fingers, they left deep imprints (I later learned this was pitting edema).  The swelling was so bad I could feel my skin stretching.  I called my doctor and she told me it was probably normal. However, I would be further evaluated at my postnatal check up the following week.

My second warning sign happened a few days later. I developed a horrible headache. Even with the pain medications, I couldn’t find relief. As a migraine sufferer, I assumed it could be a migraine.  With a new baby in the house and not much sleep, a headache seemed natural and like nothing to worry about.  Plus, it was a Saturday and my appointment was on Tuesday.  I figured any concerns could wait a few days.

When I finally made it in to the doctor’s office, I was surprised to find my pressure was elevated.  It was reading 160/92 which was a sharp contrast to the perfect readings I had gotten all throughout my pregnancy (find out more about normal blood pressure readings here).  My doctor assumed my pressure was elevated due to the excess fluid and put me on a higher dose of labetalol, a pressure medication to help lower my readings. I was already on a small dose to regulate my chronic hypertension before pregnancy.  She also tasked me with monitoring my pressure at home.  Luckily, I owned my own cuff so I was able to record my readings at home.  I had heard of preeclampsia (a pregnancy complication characterized by high blood pressure and signs of damage to another organ system) but it was rare (though possible) postpartum.  I asked my doctor about it anyway and she tested my blood and urine just in case.  All the tests came back negative.

Two days later, I woke up with an excruciating headache.  I took a pressure reading and it read 174/112.  My husband had just run out to the grocery store, and I called him and told him we needed to go to the hospital.  Everything in my body was telling me something was wrong and the reading confirmed it.  I called my doctor and they told me to go straight to labor and delivery.

When we arrived at the hospital, almost a week to the day we had been released my pressure was 186/121.  I was scared, my head was pounding, and I could barely see straight.  The doctor’s immediately gave me IV blood pressure medication and put me on Magnesium to avoid a seizure or a stroke.  Although the emergency meds worked, I spent almost another week in the hospital trying to find the right medication combination to safely release me from the hospital.  I maxed out on two medications before finding the right combination, and was given IV rescue medications twice.  At one point, my pressure was being checked every fifteen minutes.  It was rough but I survived.  In the end, I was diagnosed with atypical postpartum preeclampsia, a rare and life-threatening condition if left untreated.  My condition was atypical because I never showed signs in my blood or urine. I also developed it almost two weeks after giving birth.  Most women develop symptoms during pregnancy or within 48 hours of giving birth.

I didn’t want something to be wrong. I know that sounds silly but after giving birth, all I wanted to do was live and breathe my new son.  Even now, just writing about it fills me with anxiety.  When I started swelling, something deep inside of me told me something was wrong.  However, I was almost too afraid to know because I didn’t want to be rehospitalized and ripped away from my family.  Nonetheless, I knew letting the fear of knowing paralyze me wouldn’t change anything.  The sooner I acted, the more likely I would be able to get control of what was making me sick.  Ultimately, even though I was hospitalized for another week, my husband and newborn were allowed to stay with me so I didn’t lose any days nursing him and bonding with him.  Most importantly, however, I am ALIVE.  I feel so thankful I listened to my body and had the support of my family and doctors who recognized something was wrong and acted quickly. I will likely be on a large amount of medication for the next month or so but my awesome team of doctors assured me I will be fine.

The fact is African-American women are three times more likely to die from preeclampsia. I had chronic hypertension, which is a risk factor, but it was well-controlled and monitored so I had no reason to believe this disease would impact me.  It would have been easy to ignore my symptoms as sleep deprivation or just another part of postpartum recovery.  However, if I had, I may not have lived to tell my story.  Often women in our community are celebrated for our strength and independence.  Our strength is a source of pride.  Seeking help can make you feel vulnerable and weak.  However, as a survivor, I know recognizing my vulnerability saved my life.  No matter how strong we believe we are, recovering from birth takes time.  As new moms, our bodies have spent close to a year building a life.  If I could lend any advice it would be to listen to your body. Lean on your support system and allow yourself to heal.  Be your own advocate. Be vigilant.  Ask questions and remember, no symptom is too small or question too silly.  If any healthcare professional makes you feel like it is, find someone else. Remember, the most important thing is for you to survive to raise that tiny human.  He/she is depending on you to make it through.

For more information on Preeclampsia, visit preeclampsia.org.

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About The Author

Faye McCray is anMcCray_AuthorPhoto (1) attorney by day and writer all the time. Her work has been featured on My Brown Baby, AfroPunk, AfroNews, For HarrietMadame NoireBlack Girl NerdsBlack and Married with Kids, and other popular publications.  Faye also has a number of short stories and a full length novel available for purchase on Amazon.  Most importantly, Faye is a proud wife and mother to three beautiful and talented young boys who she is fiercely passionate about raising. You can find Faye on Twitter @fayewrites and on the web at fayemccray.com.

 

 

Advocating for Women: One Mother’s Path to Becoming a Doula

With c-sections births occurring far more frequently and rising hospital costs, many women are exploring alternative birth options. One option is hiring a doula. I had the opportunity to discuss this option with Briana Green, a Doula and phenomenal mother of two girls who turned her challenging birth experience into an opportunity to advocate for other moms.

The night I gave birth to my first son, the doctor I’d carefully hand-picked was unavailable. I went through 26 hours of non-progressive labor, had an emergency c-section, and spent 5 hours recovering without my son, who had been rushed to NICU… or my husband, who I’d forced to go with him.  I wasn’t the kind of mom who had a detailed birth plan. However, what I experienced certainly was not what I had envisioned.  Every thing turned out fine but for a long time, I couldn’t talk about the experience without growing emotional.  At the time, there was so much about my experience I didn’t understand.  I was given medications I didn’t have the opportunity to research and had major surgery without really understanding the lifelong consequences.  Although my second birth experience was far less traumatic, it’s still hard to look back on my first without wishing I had made different choices.

As I near the end of my third pregnancy, I consider myself far more informed.  In addition, I have gained a healthy respect for my first birth experience and the time it took to move past it.  Often described as Birth Trauma or Postpartum PTSD, some women suffer from a painful psychological toll following a traumatic birth experience.  With c-section births occurring far more frequently, particularly in our community, and rising hospital costs, many women are exploring alternative birth options.  One option is hiring a doula.  I had the opportunity to discuss this option with Briana Green, a Doula and phenomenal mother of two girls who turned her challenging birth experience into an opportunity to advocate for other moms.

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Q. Tell us a little about yourself. Where are you from? Where do you live? How would people who know you describe you?

I am a lawyer by trade and have also worked in real estate. I am a mom of two beautiful girls ages 10 and 4. I am from and currently live in Prince George’s County, MD. People usually describe me as a very laid back person and loyal friend. I am a bit of a straight shooter, too.

Q. What is a doula?

A doula can be described as a support person for women during pregnancy, labor and delivery, and the immediate postpartum period. Doulas are not medical providers; however, due to the nature of our business, we do have knowledge of the medical processes taking place during labor and delivery. Doulas are primarily women although I have heard of a few men in the field. We provide education prenatally, arming expectant moms and their partners and in some cases families with information about the labor and delivery process, breastfeeding, newborn care and hospital procedures. This allows our clients to make the best choices for themselves during their pregnancies and ultimately during labor and delivery and the care of their new baby. We help mothers draft detailed plans for their birth and help them implement the plan as much as possible during their labor and delivery.

“The goal of a doula is to empower mothers so that they may make the choices they deem best for them and be active participants in their birth experiences. Doulas help moms learn to advocate for themselves with their care providers.”

The goal of a doula is to empower mothers so that they may make the choices they deem best for them and be active participants in their birth experiences. Doulas help moms learn to advocate for themselves with their care providers. During labor and delivery we may ask questions or be a sounding board for the mother and her family as they face any given choice. We also provide physical support for moms in labor, helping them manage their contractions by utilizing techniques such as massage, counter pressure, acupressure, and the application of heat and/or cold. Doulas are trained in techniques which in some cases can speed or optimize labor by encouraging optimal fetal positioning. Some doulas specialize in postpartum care working more intensively with moms after delivery as they adjust to having a new baby at home. They provide support in the home with meal preparation, newborn care, and breastfeeding support.

Q. How long have you been a doula?

I have been a doula for almost two years.

Q. Why did you decide to become a doula? How did your previous experience lead you to becoming a doula?

After the birth of my first daughter, I was disappointed in my labor and delivery experience. I was in law school at the time and did as much research as I could.  However, I couldn’t devote as much time to it as I would have liked. I made some choices during that labor that resulted from me not being fully informed on their consequences. The result of which left me with an unsatisfying experience. With my second pregnancy and labor, I was much more informed and made what I consider better choices. However, upon reaching the hospital very near delivery, things fell apart. I needed someone there who was knowledgeable and able to help me advocate for myself as I was in no condition to do it alone. Having another informed voice there making suggestions or asking questions would have made a world of difference.

As a result of my birth experiences, I had a desire to be a support for other mothers to help them have the experiences they desire. I studied all things birth in my spare time. I was a resource for my pregnant and breastfeeding friends. Eventually, I took the plunge and decided to get certified as a birth and postpartum doula. I strongly believe that if a mother feels her voice was heard and she made the choices that were best for her along the way, she will consider it a positive experience even if things don’t go as planned. That is what was missing from my own birth experiences and it is what I wanted to help provide for other mothers.

 “I strongly believe that if a mother feels her voice was heard, and she made the choices that were best for her along the way, she will consider it a positive experience even if things don’t go as planned. That is what was missing from my own birth experiences and it is what I wanted to help provide for other mothers.”

Q. How did you prepare? How much time did it take?  

I took my training with a nonprofit organization in Washington, DC. My training included 14 weeks of classroom education, covering the physiologic and psychological processes of birth, holistic birth, hospital procedures, comfort measures, encouraging optimal fetal positioning, breastfeeding support, childbirth education, postpartum support, newborn care and much more. The training was very intensive. We also were assigned a mentor within the organization with whom we would attend our first births so we could get the hands on experience with an experienced birth worker supporting us along the way. Upon completion, I was provisionally certified as a birth and postpartum doula, child birth educator, as well as a lactation coach. There was a lot of follow up work to be done to gain full certification which included an extensive reading list as well as a requirement to provide birth support, postpartum support and breastfeeding support to a certain number of mothers.

Most programs are not this intensive. They generally include a shorter classroom period, which is generally an extended seminar over several days. The students receive the core information in supporting mothers in labor and postpartum. Students are then required to do additional study on their own, such as taking child birth courses and of course attending their required births, before receiving full certification. The prices for doula trainings range from on average $300-1000 depending on how much follow up education is needed for full certification from your certifying agency.

Q. I am currently eight months pregnant with my third son.  I am planning on a repeat c-section but am open to a Vaginal Birth After Cesarean Section (VBAC) if I labor.  Because of my past experience, I would feel safest in an environment where I am closely monitored by physicians and a surgical team. When I think of a doula, I think of a child birth experience free of excessive medical intervention.  Is that accurate? Who would be a good candidate for a doula?

Doulas assist mothers in all types of births. Doulas are not just reserved for intervention free births, home births or birth center births. I have supported moms with planned c-sections, emergency c-sections, inductions, multiples, high risk moms and/or babies, epidurals, breech babies, VBAC, fetal loss, the list goes on. You name it, I have probably seen it. A doula is equipped to support moms in any type of birth experience, planned or otherwise.  If a doula is experienced they are very skilled and familiar with working with hospital personnel to ensure that a mother has a safe and satisfying experience, even in high risk birthing scenarios that require medical intervention. If you ask me, everyone is a good candidate for a doula!

Q. How would I find a doula?

Many doulas work with agencies which you can find listed online. There are also online databases that list doulas and the services they provide. Another good way to find a doula is to speak with your care provider. Many OB/GYNs and midwives have contact information from doulas with which they have worked before or with which they have met in the office that they will pass along to you if asked.

“This is a very intimate relationship and your doula should be someone with whom you are comfortable and someone you trust.”

Q. What is the average cost?

The cost for a doula varies greatly depending on geographical location. The range is from approximately $500 – $2000. Each doula will vary in what this price includes, but generally you can expect to receive at least 2 prenatal visits, continuous labor support starting at active labor, 1-2 postpartum visits and phone support.

Q. What are factors an expectant mom should consider in finding the right doula?

Moms should look for a doula who feels like a good fit personally for them. Feel free to interview more than one doula if the first one interviewed doesn’t feel like the best fit for you. This is a very intimate relationship and your doula should be someone with whom you are comfortable and someone you trust. Other factors to consider are the doula’s experience, particularly if you have a high risk pregnancy, you would want someone who is familiar with your specific needs. A doula’s philosophy is important to consider as well. For example, if you are a mom who is most comfortable with a medically centered birth you may not want a doula whose preference is for intervention free deliveries. You can find out a lot about a doula’s philosophy during an initial consultation.

Q. What has been your most memorable experience thus far?

I have had a lot of memorable experiences. I guess I will share my most recent memorable experience. Recently one of my clients delivered her 7th child in the car in front of the hospital! We couldn’t get her into the hospital. Her husband ended up catching the baby. Hospital staff came running out after everything was over. That was an interesting one and a first for me.

“Your birth plan should take into account that some things may not go as planned, and there should always be a Plan B. Go over your birth plan with your provider so that you can be certain that you are on the same page and none of your desires will contradict any hospital or birth center policies. Do not be afraid to advocate for yourself.”

Q. Any advice for expectant moms in developing their birth plan?

When developing a birth plan, I suggest that you get as much education as possible beforehand. Study the pros and cons of each choice so you can create an informed birth plan. At the same time, it is very important to be flexible. Understand that even the most well laid plan can go to pot in labor and delivery. That is why it is important to be well informed. Your birth plan should take into account that some things may not go as planned and there should always be a Plan B. Go over your birth plan with your provider so that you can be certain that you are on the same page and none of your desires will contradict any hospital or birth center policies. Do not be afraid to advocate for yourself. Sometimes your desires may not be what is typically asked of your provider, and they may say it is not possible to accommodate. However, sometimes with a little creativity you can find a way to come up with a plan that is agreeable to you both.

For more information on Briana Green and her amazing services, visit: www.sacredcirclebirths.com.

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About The Author

Faye McCray is anMcCray_AuthorPhoto (1) attorney by day and writer all the time. Her work has been featured on My Brown Baby, AfroPunk, AfroNews, For HarrietMadame NoireBlack Girl NerdsBlack and Married with Kids, and other popular publications.  Faye also has a number of short stories and a full length novel available for purchase on Amazon.  Most importantly, Faye is a proud wife and mother to three beautiful and talented young boys who she is fiercely passionate about raising. You can find Faye on Twitter @fayewrites and on the web at fayemccray.com.

20 Affirmations for Expectant Mothers

There are so many beautiful things about pregnancy. Your child will never be closer to you and that fact can bring you peace. However, it’s easy to get lost in worry and “what ifs” if you allow yourself to give in to all that can go wrong. Here are twenty affirmations to repeat if you find yourself overwhelmed with doubt.

There are so many beautiful things about pregnancy. Your child will never be closer to you and that fact can bring you peace. However, it’s easy to get lost in worry and “what ifs” if you allow yourself to give in to all that can go wrong. Here are twenty affirmations to repeat if you find yourself overwhelmed with doubt.

Dads, feel free to say them with your partners.

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  1. I am beautiful

  2. I am safe.

  3. I am protected.

  4. I am strong.

  5. I am worthy.

  6. I am intuitive.

  7. I am able.

  8. I am growing.

  9. I am confident.

  10. I am vulnerable.

  11. I am grateful.

  12. I am happy.

  13. I am healthy.

  14. I am powerful.

  15. I am peaceful.

  16. I am rested.

  17. I am responsible.

  18. I am hydrated.

  19. I am capable of love.

  20. I am loved.

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    About The Author

    Faye McCray is anMcCray_AuthorPhoto (1) attorney by day and writer all the time. Her work has been featured on My Brown Baby, AfroPunk, AfroNews, For HarrietMadame NoireBlack Girl NerdsBlack and Married with Kids, and other popular publications.  Faye also has a number of short stories and a full length novel available for purchase on Amazon.  Most importantly, Faye is a proud wife and mother to three beautiful and talented young boys who she is fiercely passionate about raising. You can find Faye on Twitter @fayewrites and on the web at fayemccray.com.