May is Preeclampsia Awareness Month!
It’s May, which means it’s National Preeclampsia Awareness Month. Chances are you’ve probably heard of preeclampsia, but what is it?
Preeclampsia falls under a broad category of pregnancy “hypertensive disorders,” which is a fancy name for high blood pressure. Preeclampsia is the new onset of high blood pressure that often occurs AFTER week 20 of the pregnancy and frequently near the delivery date. (ACOG, 2019)
Preeclampsia is often diagnosed when a pregnant woman is found to have both high blood pressure and protein in her urine. (ACOG, 2019) Physicians often consider preeclampsia as two blood pressure reading of 140/90 mmHg or higher, or one blood pressure reading of 160/100 mmHg or higher.
High blood pressure can impact many different functions of the body from the brain (increased risk of stroke), the kidneys, the liver, and more.
Preeclampsia can present with some or all of the following symptoms, or sometimes, no symptoms at all (ACOG, 2019):
Swelling of the face (especially around the eyes), hands, ankles, or legs
Weight gain of more than 5 pounds in 1 week
Severe headache that won’t go away even after taking medication
Changes in vision like seeing spots or flashing lights, partial or total loss of eyesight
Nausea or vomiting suddenly
Right-sided pain under the rib cage
Difficulty breathing, gasping, or panting
It is extremely important to contact your healthcare provider immediately if you experience any of these symptoms. If untreated, preeclampsia can progress to eclampsia. Eclampsia is a medical emergency and can cause significant harm to both the mother and the baby. Eclampsia can cause seizures, kidney failure, liver damage, stroke, blindness, and death of the mother and/or baby.
While anyone can have preeclampsia, some are more at risk than others. The following increase your chances of getting preeclampsia (ACOG, 2019):
First pregnancy/never having given birth
Pregnant with multiples
Pre-eclampsia in previous pregnancy
History of high blood pressure
Pre-gestational diabetes or gestational diabetes
Autoimmune disorders like systemic lupus erythematosus or antiphospholipid antibody syndrome
Maternal age >35 years
Assisted reproductive technology
EXERCISE AND PREECLAMPSIA
But, there’s some good news: we can use exercise to help prevent preeclampsia! Be sure you talk with your physician before starting any exercise program (whether you are pregnant or not). For most women, exercising while pregnant is safe, but it does temporarily increase your blood pressure while exercising. If high blood pressure is poorly controlled, aerobic exercise is not recommended because it can cause progression to preeclampsia.
Overall, exercise can help to lower blood pressure. Researchers have found that exercise can reduce the risk of gestational hypertension (high blood pressure), preeclampsia, and diabetes. This exercise can be started in early pregnancy or even before becoming pregnant! Aerobic exercise can include activities like swimming, walking, running, and spinning.
While you are exercising, it can help to lie on your left side to help maximize blood flow to the uterus and placenta. It is important to avoid holding your breath while exercising, too. You can count sets and repetitions out loud to prevent breath holding.
Exercise is also very important in the postpartum period. Labor and delivery (whether vaginal or c-section) is hard on the body and can benefit from rehabilitation just like any other injury. Make sure you work with you physician (and maybe even a physical therapist) to return to exercise safely.
There are a few things to keep in mind when exercising postpartum. You may need to slowly return to pre-pregnancy activity levels (and that’s okay!) You have a new baby to care for and you are recovering from labor and delivery—give yourself some time to take it slow.
Breastfeeding your new bundle of joy comes along with high nutritional demands. When exercising, you may need to increase your caloric and nutrient intake to prevent disorders like osteoporosis. Working with a registered dietician can extremely helpful to make sure you and your baby are getting all the necessary nutrients.
While exercising after pregnancy you may have your first episode of leaking (urine or fecal matter). This can be extremely embarrassing and overwhelming, especially if this has never happened before. Remember, this is common but it IS NOT NORMAL. It is a sign that your pelvic floor muscles are not functioning properly. Find a pelvic floor physical therapist to help stop leakage and prevent symptoms from getting worse!
Here are some helpful resources for safe exercise and blood pressure in pregnancy and postpartum:
Ask your healthcare provider for a referral to a pelvic therapist to help you exercise safely and to prevent any pelvic floor symptoms.
Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.
Watch this video from The Preeclampsia Foundation about taking your blood pressure at home.
Check out our interview with Dr. Krystle Howard, PT, DPT on postpartum return to exercise considerations for the pelvic floor.
Check out our interview with Emma Brockwell, PT and Grainne Donnelly, PT on return to running postpartum.
Sign up for our email newsletter!
Visit our Instagram page for more on pelvic health and pregnancy.
Visit our Amazon store for pregnancy and postpartum products.
Have you, or someone you know, experienced preeclampsia? Please join the conversation in the comments section below.
By Emily Reul, PT, DPT
1. Irion JM. Medical management and physical therapy management of high-risk pregnancy. APTA Section on women’s health.
2. The ACOG. Practice Bulletin. Clinical management guidelines for obstetricians-gynecologists: gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133(1):e1-e25.