Third Trimester Tales: In which I develop preeclampsia

My second trimester was relatively uneventful. I felt great, had plenty of energy, and was eating well. The only cause for concern in trimester 2 was my weight gain – which was taking place more rapidly than hoped for – and the swelling in my legs – which started during a hot stretch of summer during which I was also training the county WIC staff in Baby Behavior (thus standing for longer lengths of time than usual.)

Apart from my pride (which really wanted to have perfect weight gain – I am a dietitian after all!), no harm was done, I figured. Excess weight gain is normal (even if not always healthy) in the second trimester, when feeling better leads to eating more – and when I’m pretty sure a fair bit of the gain is fluid? Well, fluid gain is also normal during the second half of pregnancy – especially for first time moms and those who are working on their feet or in a chair all day long. I checked my blood pressure a few times with my handy sphygmomanometer and didn’t worry too much – blood pressure was normal.

I was a day short of 27 weeks when I wrote of my dream of owning a pig. At that point, I had no expectation that a pig would be anywhere in the near future. Daniel had been looking around for land for a while, but I wasn’t in any hurry – and we’d resolved that unless a property was just right (and had the potential for a pig), we wouldn’t be really seriously looking until sometime next year.

At 27 weeks, 1 day Daniel found a piece of land he thought showed promise. He’d called the county and was reasonably sure we could put a pig on it. Would I be okay with taking a look that evening? The realtor told us to go right ahead and explore the property – and so we did.

At 27 weeks, 3 days we made an offer on the land.

At 28 weeks – the official start of my third trimester – we wrote a large check and bought ourselves a 2.4 acre lot outside of town.

At 28 weeks, 2 days I walked to the library and picked up a couple dozen books about evaluating builders, building houses, and running a homestead. That same day, the swelling in my legs went from nonpitting (not leaving a hole when I pressed on it) to pitting edema (leaving a hole when I pressed on it.) I knew that I needed to take it easy.

I woke up Sunday, at 28 weeks 3 days with a splitting headache and already sore, swollen feet. I really needed to take it easy. But it was a Sunday and we help out in the Preschool Sunday School classes on Sundays – and then there was the worship service – and the parade of homes just happened to be that weekend and what better chance to start to evaluate the builders in our area? We tromped through a dozen houses, taking notes on the quality of the construction. My legs were crying out by halfway through, so Daniel forbade me to climb stairs after that point. The headache continued. I stepped on the scale at the end of the day (not my usual pattern) and discovered that I’d gained 7 pounds from my morning weight.

Monday morning (28 weeks 4 days), I woke up with the same headache and knew I needed to call my midwife. Headache, pitting edema, very rapid weight gain. Those were symptoms of preeclampsia. I took the day off work and left a message with my midwife to call me. By the time she called back, the headache was gone but I’d already told her enough for her to be concerned. I didn’t have another appointment scheduled before our family trip to Williamsburg, but she wanted me to come in anyway.

At 29 weeks, we went in for a quick visit – which confirmed that I’d had a lot of weight gain and that my blood pressure was high (and not responding to positional changes, even more scary). But so far, I wasn’t spilling any protein in my urine. My midwife gave me some dietary suggestions, some supplements to start, and orders to spend as much time as possible resting during our vacation. She also told me she didn’t think I should plan on going back to work full-time after vacation. We scheduled a follow up for as soon as possible after my return from vacation – and I scheduled an appointment with my OB right after that.

We had a lovely vacation with Daniel’s family. I rested a lot, rode a wheelchair around historic places (now THAT’S an adventure), and ate absolutely nothing fun (pretty much just meat and nuts and fruits and vegetables – with no added sugar or salt). At the beginning, I was optimistic. I was doing everything right and I actually ended the day without any pitting one day.

At 30 weeks, we went about to all the drugstores in town to check my blood pressure – and couldn’t find a single store with an in-store automated blood pressure machine. So we bought ourselves an automatic cuff (much easier to push a button and let it check, rather than using the manual cuff and stethoscope that was still in Wichita) and I checked my blood pressure. It was high, still quite high. What’s more, my urine had started frothing – which could mean something as simple as dehydration, but could also mean protein in the urine.

This morning – 30 weeks, 5 days – we went in for our follow-up prenatal visit. I peed in the cup, ran the dipstick myself and confirmed my fears. I was spilling protein, majorly. Furthermore, I’d gained 9 lbs by my midwife’s scale in the 12 days since I’d last seen her. We still had a while to wait before we saw her, so I sat with Daniel in the waiting room, grieving over the homebirth I knew I had little hope of anymore.

Preeclampsia. The diagnosis I was afraid of, now the reality I must cope with.

I couldn’t sing it but my mouth could still say it, whispering hoarsely through the tears into Daniel’s chest:

“Whatever may pass and whatever lies before me
Let me be singing when the evening comes:

Bless the Lord, O my soul,
O my soul, worship His holy name
Sing like never before, O my soul
Worship His holy name”

~From Matt Redman’s “Ten Thousand Reasons”