When I was pregnant both times, I developed preeclampsia and had two very big 10 pound babies… (no gestational diabetes) Both I was made to give birth naturally, and as a result, suffered a prolapse of my bladder! How can I manage these two conditions through a 3rd pregnancy, which I’d like next year? It scares me…

Katie

Hi Katie,

This is a tough question, not helped by the fact that there is limited research in this area. The risks of complications from prolapsed pelvic organs, such as the uterus or bladder, will depend upon a variety of factors, including the severity of the prolapse, general maternal health, etc.
You also have the added complication of having developed preeclampsia in your two prior pregnancies. Combined, these two conditions would label you a “high risk” pregnancy if you have another baby.

You definitely have an increased risk of developing preeclampsia again, so talk to your doctor about steps you can take to reduce your risk. Research suggests that taking a low-dose aspirin (50-150 milligrams) each day helps reduce the risk – but again, check with your doctor first to see if this is appropriate for you. In addition, studies on folic acid supplementation in the second trimester show a reduced risk of preeclampsia in women who took the supplements in this period.

Strive, too, to eat a healthy diet (I have also heard – anecdotally – that eating a macrobiotic diet, ideally from before conception, but definitely during pregnancy will help to lower the risk of developing preeclampsia) and will help you to gain only a moderate amount of weight in pregnancy. You should also regularly do your pelvic floor muscle exercises throughout pregnancy.

Make sure you attend all prenatal visits, have the appropriate screening tests and work with your caregiver to control high blood pressure and treat other early warning signs of preeclampsia. If you contract any infection (which as you have two children at home could be quite likely!!), be sure to consult your caregiver for early treatment as infection may increase your risk of preeclampsia.
During your actual labour, be sure to urinate frequently, so as not to put extra pressure on your bladder.

I know this is a lot of information to take in – but don’t be disheartened or scared at the prospect of having another baby. Before you decide to conceive again, I would suggest you seek out an obstetrician that you feel really comfortable with and who is supportive of your desire to have another baby. If necessary, “shop around” and seek out a second or even third opinion ideally before you get pregnant as ensuring you are in the best physical shape possible before you get pregnant, as well as maintaining excellent health and wellbeing during your pregnancy will be key to ensure you are minimising your risk factors.

Once you have found a great doctor, discuss your case with them so you can make informed decisions about the risks in your particular situation. Having a great support team around you will make all the difference in the world.
Good luck!

Tanya Strusberg is a Lamaze Certified Childbirth Educator (LCCE) and teaches prenatal education to pregnant women and their partners in Melbourne.

She and her husband Doron have two beautiful children, Liev and Amalia.
To learn more visit www.birthwellbirthright.com

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Disclaimer: The information contained in this column is of a general nature only and does not constitute formal medical advice. Any specific medical problem should be referred directly to a qualified health professional.