What to Know About Postpartum Preeclampsia From Someone Who Had It

My son was born on a Wednesday. My first words as a mother were, "He is so cute!" His delivery was quick, and he was healthy, so we were soon whisked away to rest and bond in a recovery room.

By Friday, it was time to go home. Since my mom was staying at our house, my husband left the hospital to pick her up. My son was in the nursery, as was the custom at the time. I was alone and so grateful for a shower. I quietly sat on the edge of the hospital bed, finally clean, finally dressed in my own clothes, waiting for the nurse to bring my son down to me. That was my last memory before the seizure.

I didn't know it then, but I had developed postpartum preeclampsia.

What Is Postpartum Preeclampsia?

Postpartum preeclampsia is a serious condition related to high blood pressure and excess protein in your urine after having a baby. Often, preeclampsia occurs during pregnancy, but sometimes it can happen following delivery, and it can affect anyone—regardless of whether or not you experienced preeclampsia while expecting.

Postpartum preeclampsia typically sets in a few days after birth, though it can occur up to six weeks. Research suggests that postpartum preeclampsia affects up to 27% of pregnancies.

Eclampsia, specifically, refers to a complication of preeclampsia where seizures are present.

Signs and Symptoms of Postpartum Preeclampsia

In the days following delivery, a birthing team will monitor you for any worrisome signs or symptoms that could point toward complications. However, even after you return home from the hospital or birthing center, you'll want to alert a health care professional right away if you experience any of the following:

• A severe headache that won't go away
• Changes in vision or blurry vision
• Swelling in your face
• Pain in your abdomen or shoulder, specifically on the right side of your body
• Nausea/vomiting
• Quick onset of weight gain

A small percentage of people with postpartum preeclampsia will experience a seizure. This is what happened to me prior to my diagnosis. If you experience a seizure, or have shortness of breath, trouble breathing, or notice you are seeing spots, be sure to seek emergency help by calling 911 or having someone take you to the emergency room.

What Causes Postpartum Preeclampsia?

In short, medical experts are not entirely sure what causes postpartum preeclampsia. However, as Sarosh Rana, MD, MPH, a professor of obstetrics and gynecology and section chief in Maternal-Fetal Medicine at the University of Chicago, points out, there are some risk factors that could increase one's chances of developing this condition. Some of those risk factors include:

• Having high blood pressure during pregnancy or experiencing chronic high blood pressure
• Obesity
• A previous diagnosis of diabetes
• Previous history of preeclampsia, or family history of preeclampsia
• Being pregnant with multiples

"The chance of developing new-onset preeclampsia after birth is lower compared to parents who already have diagnosed hypertension or preeclampsia before delivery," Dr. Rana adds.

How Is Postpartum Preeclampsia Treated?

While postpartum preeclampsia can be scary, it's important to know that it is treatable. Most treatments for this condition include medication that can help lower blood pressure, along with possible IV medication to help ward off seizures. Most medication for postpartum preeclampsia will be safe for breastfeeding, but be sure to consult a health care provider.

My Experience With Postpartum Preeclampsia

A hospital employee retrieving my breakfast tray saw me seizing and called for help. When my husband and mom returned, I looked at my mother and asked, "What are you doing here?" I also asked where my father was, yet he had passed away three months earlier, and I didn't remember any of it. I didn't even remember having a baby. I would later find out that my mom was deeply troubled that I didn't ask for my son much that day. The doctors reassured my husband that my memory would slowly return.

My first memory after the seizure was my husband showing me pictures on the back of our digital camera. It was 2007 before we had taken the plunge to buy smartphones. I remember staring at the tiny screen on the back of our camera. Pictures of me holding a baby. I had a baby. I had a son. Yes, I had a son. I remember. Slowly, more details flowed back in.

The Doctors Were Perplexed By My Case

"Why does my shoulder hurt?" I kept asking. In a bizarre turn, I dislocated my shoulder during the seizure. I must have grabbed the bedrail. We will never know because I had been alone. But I was one of the lucky ones. I was lucky that I was still in the hospital, lucky to have been in bed when I seized, lucky that I wasn't holding my baby, lucky that I wasn't still in the shower as I had been minutes before, and lucky that I didn't have a stroke.

Doctors seemed perplexed by my case as my blood pressure had only gone up to 138, while 140 is the clinical cut-off for concern. A magnesium sulfate IV was started to prevent another seizure, and mother-infant bonding took the back seat. When a neurologist arrived, I was told my blood pressure had not been high enough to signal a preeclampsia diagnosis; however, my obstetrician said the seizure, protein in my urine, and blood pressure combined made a clear case for postpartum preeclampsia. Since I had not shown symptoms of preeclampsia during my pregnancy, I was told I had new-onset postpartum preeclampsia, which I had never heard of before.

Why More People Need to Be Educated About Postpartum Preeclampsia

One common misconception is that delivery cures preeclampsia. It does not, and Dr. Rana believes we need to do more to educate birthing parents and doctors on the risk of preeclampsia after birth.

"Many providers are not even aware of the risks associated with preeclampsia that persist after delivery," she says. "Risk of postpartum hypertension, stroke, seizures, and lab abnormalities are high within the first several days to weeks after delivery but can persist for up to 12 weeks. The old paradigm that preeclampsia is 'cured' by delivery is wrong. It can persist after delivery or even appear for the first time after delivery. Women are still at risk for short-term and long-term complications such as chronic hypertension, cardiovascular disease, stroke, and kidney disease many years after delivery."

Dr. Rana also points out that Black birthing people are at a higher risk of hypertensive disorders, and that pregnancy-related deaths are at a higher rate for Black people; this disparity also points toward the need for more awareness from providers.

"At the University of Chicago, under my leadership, we have created a program especially for postpartum women as a form of a bundled approach," says Dr. Rana. "We are calling it systematic treatment and management of postpartum hypertension (STAMPP – HTN). We provide education to all postpartum patients and providers throughout the hospital, creating protocols for management of high blood pressures and preeclampsia before, during, and after delivery. The idea is that we empower patients and their families with knowledge and improve access to care."