My Son's Birth Was Nearly Perfect, But Days Later I Almost Died. These Are The Symptoms You Should Never Ignore.
Our second night home from the hospital was still an awe-inspiring flurry of excitement. My husband and I were snuggled in bed with our perfectly healthy newborn baby boy, who was fast asleep on my chest — his temperament proving calm and easily soothed. We were surrounded by my two sisters, who’d flown in from California, cooing at their new nephew, while carefully propping my feet up on a pillow after noticing how swollen they were.
“It’s normal,” I reminded them. “The doctor said it might take a few days.”
They didn’t question me, and we laughed about my new “cankles.” I thanked them for the takeout they’d picked up earlier, and we hugged goodnight.
I swaddled our son to my chest and tried to relax in my newfound maternal bliss. I became fixated on my breathing when I couldn’t find a comfortable position. It felt laborious and burned when I inhaled. I chalked it up to new mom anxiety and the additional, however cute, 7.4 lbs. sleeping on top of me. But as the clock approached midnight, and my breathing still felt uncomfortable, I began to feel a thundering headache — an all-encompassing pressure wrapped around my head. I had experienced migraines in the past, but this one felt different. When I looked down at my feet and ankles, the swelling had grown worse.
I tapped my husband, who was somewhere in between awake and a new-parent haze of sleep.
“Something doesn’t feel right,” I said and asked if he still had the blood pressure cuff his mother, a neonatologist, had given him a few weeks earlier. My husband was on a new health kick, and he wanted to have one, so she had offered him the one she had lying around at home.
“I’ll go get it,” he said, stumbling out of bed.
When the numbers on the monitor appeared, a mixed look of confusion and concern swept across his face.
“I think you should call your doctor,” he said, now cradling our son. “This seems really high.”
Great, I thought.
I had already been that pregnant person constantly calling the doctor to ask, “Is this normal?” with every new phase. Apart from having suffered from extreme nausea, a condition known as hyperemesis gravidarum, throughout my pregnancy, everything had always been normal.
Fearing that I would sound like an overly anxious new mom, I left a casual I-know-I-probably-shouldn’t-worry message for the doctor on call, set my phone down, and headed to the pantry for a midnight snack. I picked up my phone 10 minutes later to two missed calls and a voicemail from my OB-GYN telling me to go to the hospital immediately. He said he had called labor and delivery and that they would be expecting me.
At that moment, I was more concerned (and annoyed) about putting our son back into the car. Was it even worth it? I assumed that when we got back to the hospital, a nurse would hand me blood pressure medication and send us home. Instead, I was diagnosed with a life-threatening condition known as postpartum preeclampsia, and I learned I wouldn’t be leaving.
Postpartum preeclampsia is a serious and sometimes fatal condition related to having high blood pressure in the days or weeks after giving birth. It can lead to seizing, a stroke, blood clots, excess fluid in the lungs, organ failure, brain damage, and death (this is when it turns into eclampsia).
Unlike preeclampsia, which can occur during pregnancy, postpartum preeclampsia is diagnosed after childbirth and often appears without warning. It is easy to assume, as I did, that after the ordeal of pregnancy and childbirth, the risks associated with preeclampsia have passed. According to one review of medical literature about the condition, somewhere between .3 to 27.5% of all people who give birth in the U.S experience postpartum preeclampsia. This range can be partially explained because “the majority of reports on postpartum preeclampsia are limited to smaller case series, thus the overall incidence has not been reliably ascertained in a prospective fashion.” Regardless, there is an urgent need to define and understand it better.
I had no prior history of high blood pressure, diabetes or obesity, common risk factors for preeclampsia. My son was not born via IVF, which some evidence has shown may increase the risk of preeclampsia. I was, however, 37 years old and considered “advanced maternal age.”
Because of my age, I was induced at 39 weeks. We arrived at the hospital, excited and nervous on a Sunday afternoon. My son was born the following night. After pushing for over an hour, my doctor gave me the option of a C-section after he discovered that our baby had flipped, making him “sunny-side up.” I chose the C-section to avoid putting him in any distress or the very probable scenario of a C-section becoming an emergency.
We entered the OR calm, if a bit nervous and teary-eyed, as any major surgery poses risk. Within five minutes, we met our beautiful baby boy without any complications. It was the most joyous moment of our lives. We spent the following four nights at the hospital taking the advice of friends who said, “Stay as long as possible and take advantage of the nursery” so we could rest.
I felt relief that I wouldn’t have to use a peri bottle, and my incision didn’t bother me. I didn’t need narcotics for the pain, and I was healing well. Those next few days were spent with more awe and wonder, skin-to-skin contact, learning to breastfeed and pump, warm visits from family and friends, check-ins and checkups, and snuggles. I remained healthy and on track to be discharged without any concerns. By the fifth day, we were ready to go home and nest into our new roles as mom and dad. No one could have predicted (with the lack of research and data available) what would happen next.
On that sixth night, when we arrived back at Labor and Delivery, two nurses came rushing into the room before I could even begin to explain my symptoms. They told me to undress and lie down, and then began simultaneously hooking me up to an IV of hydralazine, a medication used to treat high blood pressure, and inserting a catheter without anesthesia. The nurse inserting the catheter was so nervous about how severe and fast my blood pressure was climbing that she missed on her first attempt. I screamed as my distraught husband tried to comfort me and our crying newborn.
I began to feel afraid and confused about the urgency of what was happening and kept telling the nurses, “my head hurts — please do something about my head.” There was no time to explain why I was being poked and prodded. I was only told, “we need to get your blood pressure down and there is no time for anesthesia.” I had no idea that at that moment I was at severe risk of having a lethal seizure or a stroke.
Not a single medical professional informed me of this until I was wheeled off to a dark room with no windows as my headache became worse, and I was placed on a high dose of magnesium sulfate. Magnesium sulfate acts as a central nervous system depressant, suppressing abnormal electrical activity in the brain. I felt like I was lying beneath a semi truck. I could not lift my eyelids. I could not hold my baby. Several hours later, as I drifted in and out of consciousness, I saw my husband in the corner of the room with his head in between his knees, sobbing. It had been almost 24 hours since he had slept, and now he was not only worried about the health and safety of our newborn son, but for my health and safety too.
In the blurry distance, I could see one of the nurses comforting him while simultaneously cradling our crying son. I have little memory of what followed over the next 48 hours. I do, however, remember asking the nurse if I was dying. She looked at me with a half-smile and said, “You are doing well. You are not in the ICU. We just need to stabilize your blood pressure.”
“There are women with postpartum preeclampsia in the ICU?” I asked.
“Yes,” she said.
Most maternal deaths related to preeclampsia happen after delivery, making it more dangerous than preeclampsia during pregnancy, according to the Preeclampsia Foundation, the nation’s leading nonprofit dedicated to studying and raising awareness about the condition. What makes this even more terrifying for new mothers in the U.S. is that the first postpartum checkup usually isn’t until week six, the exact cutoff mark before which data suggests a woman is still at risk of developing postpartum preeclampsia.
When my OB-GYN walked in to see me for the first time after being readmitted, I looked up with heavy eyes and asked, “Why did this happen?”
“We don’t really know,” he replied.
He admitted that he’d seen an uptick in cases since the COVID-19 pandemic began but said that there isn’t enough data to know whether there was any correlation yet. Because I had been one of the rare individuals who had not yet tested positive for COVID, I figured it must have been something else. There is some data that women with a history of migraines, those who deliver via C-section, and women who are “advanced maternal age” are more likely to be diagnosed.
I am a white woman who received prompt medical attention. I did not need to advocate for myself in an institution many describe as one of the best hospitals in the country. I know not everyone is as lucky — or has the privilege I do.
Black women are more than three times more likely than white women to die from pregnancy-related causes and five times more likely to die from postpartum cardiomyopathy, a possible symptom of postpartum preeclampsia. The data linking Black women directly to postpartum preeclampsia is not clear, which is not surprising, considering there are massive gaps in the research of this very understudied, yet seemingly rising, and potentially lethal disease.
It is my wish that every pregnant person knows the signs of preeclampsia because even those with no risk factors can still develop this condition. Symptoms may include vision changes (seeing spots, blurriness, light sensitivity), a headache that won’t go away, shortness of breath, pain in your upper belly, nausea and/or vomiting, decreased urination, and high blood pressure. I didn’t know any of these were connected to postpartum preeclampsia when I was discharged from the hospital with my newborn son, and I had no idea how quickly they could appear.
Once my blood pressure stabilized and I was cleared to leave the hospital, my doctor asked me to continue using our blood pressure cuff at home. I had to check my blood pressure every day and keep a log for my doctor for two weeks. Any reading 160/110 or higher that appeared two times in a row meant I needed to return to the hospital immediately. If any reading registered 150 or higher, I was instructed to call my doctor.
Though I was happy to be back in the comfort of our home, I was traumatized by my experience. I had many anxious thoughts about dying and leaving my son behind. I reached out for help, sought therapy, and saw a cardiologist to make sure I hadn’t developed cardiomyopathy. Depending on which doctor you talk to, some might call my approach a radical act of self-care, and others might call it paranoia. But with the limited data available for women postpartum, I call it self-care.
I continued to heal and fell even more in love with my son and husband. I was so happy to be alive that the overnight feedings and tired mornings rarely bothered me. I spent my entire maternity leave in gratitude. After about three weeks, my blood pressure numbers went back to normal and have stayed that way.
Many months later, when I was ready to write this article, I found the discharge paperwork I was given after giving birth. A single loose leaf of paper slipped out of the stack. There was a list of general warning signs that indicated a new mother should “seek medical attention,” but nowhere on the piece of paper did it say, “possibly life-threatening” or “postpartum preeclampsia,” nor, to my recollection, did anyone specifically go over any of those warnings with me before we left.
The information felt minimized after all that I had gone through. I can’t think of one woman who — with all the information she is carrying in her new post-birth brain — would have bothered looking at that piece of paper twice, especially when she is already dealing with maternity leave paperwork, her new baby’s birth records, and learning to breastfeed, and so much more. We need more education and better information, and it needs to be available to every new mother and mother-to-be.
We live in one of the wealthiest countries in the world, but our health care system is a nightmare — and that’s if you’re lucky enough to have access to it. I shouldn’t feel scared to have a second child, but I am, even after my OB-GYN (whom I love) told me that I will be monitored more closely this time. What will happen to the women who won’t be? The ones who are never told about the signs? Those who don’t own a blood pressure cuff? Whose symptoms are dismissed? We must continue sharing our stories and ensure we don’t let each other — or ourselves — slip through the cracks.
Christina McDowell is the bestselling author of “The Cave Dwellers,” an American satire, and “After Perfect: A Daughter’s Memoir.” Her work has appeared in The Washington Post, the Los Angeles Times, LA Weekly, USA Today, O, The Oprah Magazine and Marie Claire, among other publications. She lives in Bethesda, Maryland, with her husband, photographer Elliott O’Donovan, and their son. To find out more, visit christinamcdowell.com.
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