Some questions for 2nd timers (or more)

This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!
mercadmj
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Re : Some questions for 2nd timers (or more)

Postby mercadmj » Sat Feb 26, 637684 11:21 am

Hi there!

I'm a mother of 4 and in my 5th pregnancy now. I just wanted to note that in my first 2 pregnancies, I did not have pe or hellp, but in the 3rd I had a sudden onset of HELLP (no PE) and in my 4th had mild PE. I found out the reason I did not have it in the first two was because I was smoking cigarettes at that time. Later (10 years after) when I developed HELLP I did not smoke and haven't picked it up since, but feel a temptation just to avoid PE. Doctors say no, but if I lived in a 3rd world country, I would start smoking. I think we are much safer here. Anyways, I'm only 2 months along now, so waiting to see the outcome of this pregnancy. So far, all babies are healthy and I recovered fine. I hope you can find the comfort you are seeking with making your decision. I'm sure it is very scary for us all, but I look at it as a sacrifice in the name of LIFE and LOVE. There is no greater Love than to lay down one's life for another.

Marie.

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annegarrett
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Re : Some questions for 2nd timers (or more)

Postby annegarrett » Thu Nov 27, 637681 12:51 pm

Hi adgirl,

I am glad to hear you got a consult. I can appreciate your feelings about episiotomies. I had one the first go round and it was unpleasant healing from it--but I think given the scope of the situation, it's a relatively minor issue. :)

As the posters have said--MOST women do not get it again. It is true that having had it before is the biggest risk factor for getting it again. The fact that you got it so close to term is actually excellent news as most women will get it again in a manner relatively similar to their first experience--maybe a bit earlier. AND you know about your post-partum experience so your doctor and you can watch for that. I had that as well--one week postpartum 180/120 back in the hospital with #3 and then exactly the same experience with #4. The thing is that with #4--I didn't question my need to go in as I had in #3 (which was very traumatic). I went straight in and the doctors, having experience with me, were very proactive treating me postpartum. Many experts I know pretty much deliver upon diagnosis (140/90 and 300 mg of proteinuria after a 24-hour urine) if the woman is at or past 36 weeks. They frankly don't think it is worth the risk to wait. So if you have a doctor is has a similar philosophy, there's a chance you would deliver a bit earlier but having a history of delivery at 38 weeks--even two weeks earlier would still bring a very healthy, good-sized baby who would likely not need NICU support (it's always tricky to be sure but it's a good bet.)

As for dying? I know that fear well. I wanted a written guarantee that I would not die. What I got was a doctor who watched me like a hawk and I watched myself. And, obviously, I didn't die.

I don't have any stats to back this up--so don't make a decision by it--but I do hear from people who have lost the mother and so far, I know of only a few who died in a subsequent pregnancy. Most were in their first pregnancy and either died because there was nothing to be done, or because they were not delivered soon enough--that is why most doctors will err on the side of delivering earlier--because preeclampsia gets worse in most cases the longer you wait.

I don't know--but I believe--that having the information we have here, and the support, combined with a diligent mom and a good doctor--prevents deaths. So I can't decide for you, but know you are in the right place to weigh the options and make the best choice for you.

Take care,




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Re : Some questions for 2nd timers (or more)

Postby cmartin04 » Thu Nov 27, 637681 12:50 pm

Hi,

I agree with the other ladies. Just my 2 cents and my experience. I had my first daughter when I was 32, developed Pre-E and HELLP at 30 weeks and had to deliver immediately by c-section(after 30 hours of failed induction). My daughter was fine, no complications and she is a healthy 4 1/2 year old. It took me about a month of being on blood pressure medication before it went back down again. It never did go back to where it was before I was pregnant.

I was very scared to get pg again. Didn't make up my mind for 3 1/2 years. I decided to talk to a high risk OB and they did all the tests to determine if I had any underlying conditions. I didn't, luckily. Still, she couldn't give any guarantees that I wouldn't get it again, but I felt better about wanting to have another one. I ended up pg last Oct. and went to my regular OB/GYN. I think she was nervous about my history because she wasn't my doc with the first pg. But, she agreed to monitor me and if I got bad, she would send me to the high-risk OB. She definitely watched me close, but I wouldn't have wanted it any other way. My blood pressure did go up towards the end (I think partly from stress), but I never got pre-e. She wouldn't let me go past my due-date and wouldn't induce me (because of the first c-section), so I had another c-section the day before my due date. Another healthy baby girl. [:)] I did have to go on bp meds again for a couple weeks, but then it went back down. So, there are no guarantees, but if your Dr. monitors you closely, maybe that would give you little more reassurance.

BTW, I took baby aspirin the whole time I was pg, took extra C & E in the beginning and took multivitamins before I got pg and during. I've heard studies that taking multivitamins before and not just during could help. Don't know how reliable that info is, tho.

I wish you the best of luck and peace in whatever decision you make.

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Re : Some questions for 2nd timers (or more)

Postby adgirl » Thu Nov 27, 637681 9:36 am

I have met with a new OB/GYN recently, although from what I'm reading here and what he told me, my original doctor did everything exactly right -- he's a well renouned (sp?) doctor in the area. I had thought he had me pushing too long and that may have contributed to my son's TTN, but everyone seems to agree that my old doctor handled everything perfectly. The new doc I met with didn't raise my confidence level much about PE though. He felt that I had about a 40% chance of recurrence (I don't know where he got that number), and that it could come sooner or later and either more or less severely. When I asked him if he thought I'd be risking my life by having another child, he basically said that there is no crystal ball and that all pregnancies carry some risk -- as does leaving the house!!! I realize that he's telling the truth and we really won't know what will happen until we get there, but he didn't make me feel great about it.

He said he has counselled some patients to not have any more children and that I was not one he would tell that to based on my history, but no guarantees of course. One thing I really didn't care for was that he didn't want me monitoring my blood pressure at home -- that I should come to his office for that b/c of getting bad readings at home. If I hadn't been monitoring at home last time during post partum, I could have ended up in a much worse situation!!!

Also, he's big on episiotomies which in the grand scheme of things is not a big deal as long as baby and mom are healthy, but that seems like a dark ages kind of procedure. I thought the medical community in recent years had decided no episiotomy was the better course of action...

Anyway, we'll be having another preconception meeting next week with my old OB. He is considered to be a great doctor, so I'm interested in hearing what he has to say too. He's got a big ego though which puts some people off, but may be just what I need. A doctor who believes that he can handle ANYTHING that happens...I know there are no crystal balls, I just want some kind of reassurance -- I'm sure all of you know what I'm going through and it really helps that there are others out there who know what I'm feeling!!!
a

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Re : Some questions for 2nd timers (or more)

Postby kelly w » Thu Nov 27, 637681 2:38 am

I agree with Julie that a consult with a high risk OB might be the best thing before you make any final decisions.

Your odds of not getting PE again are pretty good too. That is something to consider as well. I think a good high risk doc could really help you understand what your real odds and risks are. Also, lining up a really knowledgable and reliable OB ahead of time could really reduce your stress the next time around - just knowing you have someone really capable watching out for you just in case has really been helpful to me. [:)] [of course, if your old OB was awesome, you don't need this advice. [;)]]

My biggest fears about trying again have always been just what you said - leaving my children without a mom. As I get older and risks get even higher, it is a serious thought. But, again, consulting with a really good maternal-fetal doc gave me the confidence to try again after a pretty bad time last pregnancy. And I do feel like I have competent care this time - which makes a difference. If something does go wrong, I feel I'm in good hands.

But, the bottom line is that I have never regretted my decisions to get pregnant again. Each new baby is just such a joy - each one adds so immeasurably to my life and the life of our whole family - that I have never had any regrets. [OK, I DO regret that I can't just have easy pregnancies and 2 hour labors at home....LOL! [:D]].

But in the end each one has been so worth it. [:)]

Good luck to you as you try to make a decision!

Kelly

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julie f
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Re : Some questions for 2nd timers (or more)

Postby julie f » Thu Nov 27, 637681 2:15 am

Amy,

I thought this link might be helpful to you, it's what our Experts have to say about recurrence rates: http://www.preeclampsia.org/forum/viewt ... erms=sibai
Here is another link that deals specifically with postpartum preeclampsia: http://www.preeclampsia.org/forum/viewtopic.php?t=224

Personally -
*I was scared of EVERYTHING during my 2nd. After we lost our son I knew that I wanted to try again, I can't explain the need. But, I was still terrified. I think my biggest fear was that I would lose another child or, cause him/her great harm by becoming pregnant again.
*In my 2nd pregnancy I was never diagnosed with preeclampsia. As soon as my bp started to shoot up, we were far along enough to deliver and thankfully Jack and I both did very well.
*How did we decide? Like I said earlier, we just knew. It was something that I had to do. I realized after we had and lost our son that there was nothing more in the world I wanted than to be a mommy. Currently though, we think about trying again and I have the same fears as you - leaving my son without a mommy... I don't know of any way to get around that fear but I think the best thing you can do is to be educated and surround yourself with a great medical team.
*I didn't experience postpartum pe but I am sure you will here from some with experience soon.

Have you had a preconception consult with a high risk OB? If not, I think it would be really helpful to you in making your decision, and giving you the best start to another pregnancy. There are several underlying disorders that can be associated with an increased risk of pe and if any are found, there are often successful ways to manage them during pregnancy.

Best of luck and keep us posted.

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Re : Some questions for 2nd timers (or more)

Postby cindergretta » Wed Nov 26, 637681 11:50 pm

My sister had pre-e post partum with her first. She has since had two more babies, pre-e free and one a homebirth! (She developed pre-e during pg and was induced at 37 weeks, but was re-admitted in her post partum period for pre-e.) I have had pre-e in 3 of my pgs and HELLP in one of them. No rhyme or reason to it for me. I had the pre-e in my 1st, 3rd, and 5th. Who knows? Pre-e is more common in a first pg. Rarer in a second. And more so if you don't have any underlying disorders or pre-existing conditions, like chronic hypertension. IOW, if your pre-e pg was the sum total of your health issues and since then you have gone back to being a healthy person, no chronic issues, your chances of repeat pre-e are lower. I have chronic hypertension (as does my sister) and Grave's Disease. She didn't repeat pre-e. I did.

For me, I have a desperate need to have babies! [:D] Up until I got HELLP, it was never too big a deal to me to decide to have another one. I think my pre-e experiences got worse with each pg that had pre-e. But I attribute that to getting older, developing Grave's, and the natural progression of my chronic hypertension, kwim?

If we ever conceive again, my dh and I are afraid of my dying. To be perfectly blunt. My pgs seem to get worse and worse. My sister's seem to get better and better. There are no really good answers. Just a vast array of experiences.

Good luck!!!

adgirl
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Some questions for 2nd timers (or more)

Postby adgirl » Wed Nov 26, 637681 11:20 pm

A bit of my history -- had PE develop by week 38 (protein at 36, elevate BP at 37, both at 38). Delivered at 38 weeks -- after a bout with TTN and jaundice, baby was fine -- now a perfectly healthy 2 1/2 year old! I was one of the lucky few who didn't get better after delivery. I was monitoring my blood pressure at home and it kept getting higher even with low levels of meds. I was in the ER 6 days post partum and had BP of 206/120 or something like that... they got it down to 140/90 within a few hours and sent me home -- anyway -- it was totally cleared up within about 12 weeks of weaning me off the drugs.

Now I'm wanting another child and scared to death!!! I don't really know what could have happenned to me the first time around, but I'm worried about leaving my little boy without a mommy if we try again.

On to the questions - what were your biggest fears about trying again??
If you had PE in first pregnancy, was 2nd more or less severe? What about time of onset?
How did you make the decision to try again?
Has anyone here had an experience of post partum problems in 1st pregnancy, and what happenned in subsequent pregnancies?


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