One of the questions we are often asked is: Am I going to die from preeclampsia? So let's talk about how rare that is and what we can to do keep ourselves safe.
First, if you are the partner, parent, sibling, or loved one of a mother who died due to a hypertensive disorder of pregnancy, we are so very sorry. We see you and remember your loved one along with you, and your losses drive our mission, to educate, advocate, and support women and their families to help all mothers get the care they need.
Second, it is very, very rare in most areas of the world for a woman to die from a hypertensive disorder of pregnancy if she receives timely and proper care. Most of the time, when a woman does die, it is because she was postpartum, considered a low risk mother, and her symptoms weren't recognized in time. None of the women in this group are low risk. We all have had preeclampsia, eclampsia, HELLP, and/or an underlying condition that increases our risk, and so we should be watched closely. Our chances of receiving the care we need are *excellent* when we are monitored closely and symptoms taken seriously. Close attention is the best way to keep us from dying.
So what can we, as well as our partners and other loved ones, do to keep ourselves safe? How do we advocate for ourselves?
Go to your appointments, including postpartum. Ask all the questions you need to ask. If your appointments are spread out or done via telehealth/phone, and/or if you see a group practice where you rotate through providers, remind them that you are a high risk patient, and ask what they see that tells them you do not need to be seen more frequently.
Monitor your BP (and blood sugar if you run diabetic) at home with a reliable arm machine.
Strongly consider getting the recommended vaccines (flu, TDaP, COVID, etc.) during pregnancy to provide protection for yourself and your newborn against severe effects or death from illness.
Know your call-in BP numbers (and blood sugar if applicable), both high and low. If you hit them, call. (This goes for the first six weeks postpartum too.)
Know how to reach someone when your doctor's office is closed.
If they tell you to go to the hospital, GO. We know it's sometimes expensive and inconvenient, but finances can be managed -- you are irreplaceable. We know you are worried about it being too early for baby to be born -- but baby needs you to be healthy too. Your doctors do not make recommendations for monitoring or delivery or magnesium sulfate lightly.
Know how to get to the hospital and where to go once you're there. Know who you can call if you can't reach your primary support person. If you have no other options, call an ambulance. If you don't live close to your hospital, know what other hospitals are nearby and what circumstances mean you should go to one of those instead.
If you get sent to the regular ER, request that they send you to L&D, MAU, OB section of ER, or whatever the space that cares for pregnant and newly postpartum mothers is in your area, that they run labs and evaluate for PE/HELLP, and/or that they have someone from L&D evaluate you.
Take your BP (and other) meds on schedule as recommended. Twice a day usually means every 12 hours, three times a day usually every eight, but it's good to clarify with your doctor. Set alarms if need be.
Do not refuse magnesium sulfate if recommended. We all know it isn't the most fun in the world, but it is the single most important thing for saving your life if you have eclampsia or severe features.
It is normal to be a bit nervous, but if you find that thoughts of dying are overwhelming, please talk to your doctor about safe meds and/or a referral to a therapist to help with the anxiety. Postpartum.net has resources too. We want you to be prepared and vigilant, but we don't want you to be overly worried either.
For partners, grandmothers, etc.: Listen to the pregnant or new mama in your life. If she mentions a headache or stomach pain, keep an eye on it. Know what her call in numbers are, and have the phone numbers to reach someone handy yourself (and know her doctor's/group's name). Know exactly what her diagnosis is, and encourage her to call if she is ever concerned or if she hits worrisome symptoms/numbers. Call for her if need be. If you have questions about her diagnosis or her care, ask them. Help her out around the house so she has the headspace to pay attention to her body's signals. Talk to your employer, childcare providers, and so on so that if she needs to be seen quickly, you can be with her.
None of this is meant to scare you. It is meant to empower you with knowledge in order to keep you safe. We are always here for you, and we love you all.