I was diagnosed with Preeclampsia at 30 weeks of pregnancy. I gave birth to my daughter 5 weeks later via urgent cesarean delivery due to worsening symptoms with higher blood pressure, a severe headache and visual changes. Thankfully my cesarean section was uncomplicated, but the first 24 hours after delivery were very challenging with a persistent severe headache, lack of sleep, and a baby in the NICU. My severe pain was absolutely minimized and I was essentially made to feel like I was drug seeking, when I asked for pain medication for the severe headache, or even just something to help with sleep as I had been awake for over 48 hours. I truly felt like nobody was listening to me.

Thankfully things improved about 2 days after delivery and my daughter was also able to return to my room from the NICU. I was discharged home 5 days after my daughter was born, not requiring any blood pressure medications at the time. I was told to monitor my blood pressure at home, but received very little education on symptoms to monitor for or when to call my doctor.

The day after I returned home, my blood pressure sky rocketed to 160-180/100's. I called my obstetrician and she called in a prescription for blood pressure medication, which she told me to start right away and call back if my blood pressure didn't improve. Four hours later my blood pressure had continued to rise and was now 180-200/110-120. I called the OB back and immediately went to the Emergency department (ED) with my sister-in-law, who is an ED nurse. My husband stayed home with our daughter.

Fortunately, I was quickly brought to a room when I told the triage nurse that I was 6 days postpartum with high blood pressure. Unfortunately, my nurse was not at all familiar with post-partum preeclampsia. I was barely assessed and my extremely high blood pressure was not treated. I am a Women's Health Nurse Practitioner and have 15 years of experience in perinatal nursing and I knew this was a postpartum emergency! I told my sister-in-law that we needed help and needed to see the doctor immediately. Eventually, I was given a dose of medication to lower my blood pressure, but it took well over an hour. I was also restarted on Magnesium Sulfate, but was given a dose much lower than needed for preeclampsia. I needed to receive a 4 gram bolus over 20 minutes and the pump was set for 1 gram/hour. I told my sister-in-law the dose and rate were wrong, because I work in this field and I know better.

She called the nurse and he reassured us "for preeclampsia we give a high dose of magnesium." I responded "I know! And that is not a high dose. I need the right dose to prevent seizures which is 4 grams in 20 minutes." The ED pharmacist also came to the room and didn't know the correct dosing. I was so afraid of what might happen that I wanted to adjust the medication myself. It took another 30 minutes to straighten this out and adjust to the correct dose. Then there was discussion of admitting me to the ICU.

All the while I was insisting that someone call OB as they are the experts in managing preeclampsia. I knew the ED providers were out of their depth and I needed to be readmitted to the OB service. I absolutely did not want to end up in the ICU where I would be separated from my baby, potentially for days. Thankfully, I work in the perinatal field and I knew what I needed. But I also knew what was at stake. I feared having a seizure or stroke right there in the ED. After several hours, I was ultimately readmitted to the OB unit. I spent 10 days postpartum in the hospital. I had a CT scan, MRI and multiple other tests to rule out stroke and seizure.

Ultimately my headache resolved with IV NSAID medications and I was able to go home. I am truly grateful to have survived this experience. I am thankful that I was able to advocate for proper care, but I fear for those patients that don't have the education or training to advocate for what they need. I hope to help change that.