Please Note
There is no way for me to know which of these (if any) were the actual cause of preeclampsia prevention in my second pregnancy, but I wanted to share what I did under the guidance of multiple healthcare providers that I have deep trust in.
Preeclampsia in My First Pregnancy
I had preeclampsia AND postpartum preeclampsia during my first pregnancy in 2021. My blood pressure slowly started creeping up right around the third trimester, as well as abnormal swelling.
I went to the ER at 38 weeks with blood pressure well over the 160/110 threshold. They induced me, which ended up in an unplanned (and now that I know better, unnecessary) C-Section. My blood pressure did go down slightly after birth, but not completely back to normal. They released me, and a day later I was back needing a Magnesium drip and a 5 day hospital stay.
For my second pregnancy I changed everything about my care, and took a much more preventative approach.
Changes in My Care
I had such a traumatic delivery with my first I knew I wanted a different form of care this time around.
Instead of going the OBGYN route again, I went with a small group of just two midwives. They are primarily home birth midwives. Initially I was planning on the hospital route with them, but at my 28 week appointment I switched to the home birth route as I realized most of my fears for my second pregnancy all stemmed around the “what if’s” of the hospital.
Regardless of the hospital or home birth route, being cared for by such a small midwife group drastically decreased my anxiety. The environment alone was nothing like an actual doctors office.
Each visit my midwife would spend at least 30 minutes (sometimes even more) talking with me. And she would take all my vitals, blood work, doppler, etc. herself.
Ever since my first, I have struggled with “white coat syndrome,” but never once did I struggle with that here.
Pathogen Saliva Testing
I took Direct Diagnostic’s HR5 high risk pathogen saliva test before I got pregnant. My results showed high levels of Fusobacterium nucleatum (Fn) which has been linked to multiple pregnancy complications such as preeclampsia (1).
Initially I tried treating it the “natural” way, which did not work. I am not usually one to go the antibiotic route, but knowing it could ~potentially~ help my odds of not developing preeclampsia again, I decided to take the risk. I did one round of antibiotics, which significantly brought down the Fn levels.
1 Vander Haar EL, So J, Gyamfi-Bannerman C, Han YW. Fusobacterium nucleatum and adverse pregnancy outcomes: Epidemiological and mechanistic evidence. Anaerobe. 2018 Apr;50:55-59. doi: 10.1016/j.anaerobe.2018.01.008. Epub 2018 Feb 2. PMID: 29409815; PMCID: PMC6750227.
Baby Aspirin & L-Arginine
Baby Aspirin is one of the top researched preventive measures shown to prevent preeclampsia (1-4). I began taking two Baby Aspirin’s every night at around 5 weeks.
There is also emerging research that L-Arginine may lower the risk of preeclampsia by promoting vasodilatation through increased production of nitric oxide (5). I started at 20 weeks with 1,000 mg/day, and upped it to 2,000 mg/day at 36 weeks.
When it comes to any medication or supplement during pregnancy I always recommend consulting with your trusted provider first.
Sources
2 health.harvard.edu/blog/preventing-preeclampsia-may-be-as-simple-as-taking-an-aspirin-202111092634
3 Wang Y, Guo X, Obore N, Ding H, Wu C, Yu H. Aspirin for the prevention of preeclampsia: A systematic review and meta-analysis of randomized controlled studies. Front Cardiovasc Med. 2022 Nov 9;9:936560. doi: 10.3389/fcvm.2022.936560. PMID: 36440041; PMCID: PMC9682183.
4 Ren Y, Zhao Y, Yang X, Shen C, Luo H. Application of low dose aspirin in pre-eclampsia. Front Med (Lausanne). 2023 Mar 8;10:1111371. doi: 10.3389/fmed.2023.1111371. PMID: 36968826; PMCID: PMC10030847.
5 Hegde CV. The Use of l-Arginine in the Management of Pre-Eclampsia and Intrauterine Growth Restriction. J Obstet Gynaecol India. 2012 Feb;62(1):1-2. doi: 10.1007/s13224-012-0146-8. Epub 2012 Apr 20. PMID: 23372281; PMCID: PMC3366568.
High Protein Diet
One of the first symptoms of preeclampsia is excess protein in the urine. This usually means that the mom is not getting enough protein in their diet, causing the body to break down its own tissues to try and nourish the baby with enough protein - which is then excreted in the urine. I aimed for 100-150g of protein a day - although, most days I barely made it to 100; and many days didn’t even reach that goal.
One study showed that pregnancy diets high in protein were found to be associated with reduced odds of preeclampsia (1).
1 Zhu Y, Liu Y, Fu W, et al. Associations of dietary patterns and pre-eclampsia: a matched case–control study. British Journal of Nutrition. 2023;129(2):247-254. doi:10.1017/S0007114522001210
Hydration + Electrolytes
Research shows (1) that dehydration is a strong predictor of gestational hypertension (2) and preeclampsia (3). For most people water alone doesn’t quite cut it, and electrolytes are needed.
Electrolytes help keep the amount of water in your body balanced, as well as maintain pH levels and help move nutrients in and out of the cells. Electrolytes also help the muscles, nerves, and organs work properly.
I aimed for 60-80oz of water a day. For electrolytes, I would either add Nectar electrolytes to 16 oz of water and/or I would place a few flakes of Celtic salt on my tongue before every cup of water.
Sources:
1 Lusambili A, Nakstad B. Awareness and interventions to reduce dehydration in pregnant, postpartum women, and newborns in rural Kenya. Afr J Prim Health Care Fam Med. 2023 May 15;15(1):e1-e3. doi: 10.4102/phcfm.v15i1.3991. PMID: 37265162; PMCID: PMC10244926.
2 Valensise H, Andreoli A, Lello S, Magnani F, Romanini C, Romanini C. Multifrequency bioelectrical impedance analysis in women with a normal and hypertensive pregnancy. Am J Clin Nutr. 2000;72(3):780–783. 10.1093/ajcn/72.3.780
3 Yasuda R, Takeuchi K, Funakoshi T, Maruo T. Bioelectrical impedance analysis in the clinical management of preeclamptic women with edema. J Perinat Med. 2003;31(4):275–280. 10.1161/CIRCULATIONAHA.114.009029
Daily Exercise
According to a 2003 study, regular physical activity during the first 20 weeks of pregnancy can reduce the risk of preeclampsia by 35%. The risk may decrease further with more intense activities that use more energy (1). A 2016 study found that women who were active for more than 8.25 hours per day had a significantly lower risk of preeclampsia than those who were active for less than 4.2 hours per day (2).
I aimed for two days of cardio and two days of strength workouts a week. I didn’t do anything crazy - usually just 15-20 minute videos on YouTube. My favorite are Juice & Toya.
Sources:
1 Recreational Physical Activity During Pregnancy and Risk of Preeclampsia
Tanya K. Sorensen, Michelle A. Williams, I-Min Lee, Edward E. Dashow, Mary Lou Thompson and David A. Luthy
Originally published28 Apr 2003https://doi.org/10.1161/01.HYP.0000072270.82815.91Hypertension. 2003;41:1273–1280
2 Spracklen CN, Ryckman KK, Triche EW, Saftlas AF. Physical Activity During Pregnancy and Subsequent Risk of Preeclampsia and Gestational Hypertension: A Case Control Study. Matern Child Health J. 2016 Jun;20(6):1193-202. doi: 10.1007/s10995-016-1919-y. PMID: 26910608; PMCID: PMC5538351.
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