Every pregnant woman needs to know the signs and symptoms of preeclampsia so she can be a good partner in her prenatal care and an advocate for herself. In a 2006 Preeclampsia Foundation survey, less than half of respondents said that the signs and symptoms of preeclampsia were definitely described to them during their doctor visits. 35 percent could state that such information definitely was not given to them during doctor visits. I'm a firm believer that printed materials detailing the signs and symptoms of preeclampsia should be given at the first prenatal appointment, along with explanation from a doctor.

My pregnancy had gone smoothly until my 29 week appointment, when I had a higher than normal blood pressure reading. I was told to come in a few more times that week for blood pressure checks. My blood pressure continued to gradually increase, but no one seemed overly alarmed. Though they never mentioned preeclampsia, the midwives told me that sometimes it's normal for pregnant women to have an increase in blood pressure toward the end of pregnancy. They asked about other symptoms, like my vision. I always said I did not have any visual disturbances. Although I was having instances of blurry vision as early as 24 weeks into my pregnancy, I assumed that this was due to low blood sugar or not eating enough, not something worth mentioning.

At 30 weeks, my stomach measured less than what it should have been, given my previous growth. My blood pressure continued to increase, though slowly and still within “normal” range. I was scheduled for an ultrasound and a test to measure the protein in my urine. My test showed that my protein levels were high. My kidneys were leaking more than three times the normal amount of protein into my urine. My doctor told me to wait until the scheduled ultrasound three days later. I never made it to the ultrasound. The following day, I awoke to a slightly swollen face. The day after, I woke up to a severely swollen face, as well as swollen hands and body. I felt like something wasn't right. I felt a bit anxious, but didn't want to be the overbearing pregnant woman that couldn't handle pregnancy. I drove myself to work that day. By 11:00 a.m. I could barely keep my eyes open, and I was unable to type or hold a pen as my swelling was getting worse. I finally decided to call the midwives. While on the call I started having an intense burning pain behind my breastbone that radiated back between my shoulder blades. The pain was nearly unbearable. Assuming it was heartburn, and nothing more than some pregnancy swelling, I decided to drive myself to the hospital. At the hospital my blood pressure was 180/120 — a level capable of causing strokes and seizures. It was then that I was diagnosed with severe preeclampsia. I was 31 weeks pregnant.

I was admitted to the hospital and my condition stabilized somewhat, but an ultrasound showed that my baby, whose growth had stopped two weeks prior, was in serious distress. I was given two injections of steroids for her lungs over a 24 hour period, and was immediately induced after the second injection. The doctors expected her to weigh 3 pounds and 13 ounces. But when she was born, she weighed 2 pounds and 7.5 ounces and had to be resuscitated because she wasn't making any noise. Her first squeaks would come hours after her birth. She did well in the neonatal intensive care unit (NICU). Her stay was 27 days, but it seemed like months to us. She weighed 3 pounds and 8 ounces on her release date – 5 ounces less than what they thought she would weigh at birth.

I spent the first week after Avery was born in the hospital recovering. I had postpartum liver irritation, as well as weak muscles from being in bed on magnesium sulfate. It's difficult work recovering from a birth, let alone a birth involving preeclampsia. My kidneys returned to normal function quickly. During her first month in the NICU, Avery experienced a few different setbacks. The first week or two were the most critical as she suffered from respiratory distress syndrome, and her lungs needed to finish developing. She had a significant heart murmur. Her heart defect didn't cause much concern until she was 18 months old, when she began sleeping more than 18 hours a day, and wasn't growing well. Her doctor said she had developed pulmonary hypertension, and the left ventricle of her heart had become enlarged due to the open artery. She had heart surgery at age two to correct the problem. She recovered within 24 hours and has not had any other heart problems since. She also had a common disease of the eyes because she was born premature, but since her procedures, her eyes have healed well on their own. She was diagnosed with a severe dairy and soy protein intolerance at two months of age, but she outgrew the intolerance at about age three. She was diagnosed with sensory integration disorder at about 10 months of age and she now has occupational therapy for it. She is able to better cope with her sensory needs as she gets older. She is still small for her age at 3 and a half years old and 28 pounds, but is on track developmentally. Looking at her now, you would never know she was a preemie with health issues. Life during those first two years was emotionally and financially difficult to say the least. She was unable to attend daycare for the first 18 months, and could only be left with a nurse if her dad and I needed to be out of the house at the same time. I was planning on returning to work soon after her birth, but instead I quit my job to care for her. The financial strains of preeclampsia are extensive.

I don't have any remaining health problems as a proven result of preeclampsia. I have however, found out a lot about my own health and the human body in general. Much of what I have learned has come from my doctor, as well as reading medical journal abstracts and studies that are posted on the Preeclampsia Foundation community forums. After my experience with preeclampsia I wanted to know what had happened to me. I consulted with a maternal-fetal medicine (MFM) specialist, or perinatologist, who ran a slew of tests that required 19 vials of blood. We discovered I have some minor kidney damage, as well as a blood clotting disorder. It's suspected that this clotting disorder contributed significantly to my severe preeclampsia so early in the pregnancy. We haven't made a decision about having more children, but should we ever try, I'll be on a mixture of blood thinning agents to reduce the risk of getting preeclampsia again. I would also have my pregnancy monitored by a perinatologist/MFM.

During pregnancy, regular checkups are very important. This consistent care can help keep you and your baby healthy, spot problems if they occur, and prevent problems during delivery. It's important to talk with your doctor. Report any and all changes, no matter how small, and understand which symptoms or changes are urgent and require that you tell your doctor right away. Listen to what your doctor says, be truthful, don't leave out or distort information, and report all medications that you take. This includes natural supplements, herbs, and over the counter medications. And of course, keep all of your appointments — every one is important! Become a partner with your doctor to manage your care.

I volunteer for the Preeclampsia Foundation in several capacities. I began participating in the online community, known as the Forums, soon after my experience, and continue to volunteer as a moderator. I also joined the Preeclampsia Foundation's newsletter, “Volunteer News,” as a writer and editor. In 2007, I began hosting an annual Awareness Walk in Madison, Wisconsin. We raise funds for the Preeclampsia Foundation that go directly to research grants and projects to raise awareness. I have lectured to local businesses and schools about the signs, symptoms, and dangers of preeclampsia. I have also lectured to the medical community in a grand rounds setting as well as at a perinatology conference. In 2008, I took on the role of National Awareness Walk Coordinator, helping walk coordinators in 18 cities in the U.S. and Canada organize an Awareness Walk in their locations. The walks are expected to raise $80,000-$100,000 to fund research and other Preeclampsia Foundation programs.

It's not about coping; it's about remaining vigilant and proactive once you have been diagnosed with preeclampsia. It is important for women to:

• Understand what the signs and symptoms are.
• Know what your doctor's thresholds for blood pressure readings and symptoms are.
• Be your own best advocate for appropriate testing and monitoring.
• Ask that you be seen at your doctor's office if any symptoms concern you.

Some women develop life threatening symptoms in a matter of hours, while other symptoms can linger for months. Don't be a hero by not reporting changes and symptoms in order to buy your baby more time developing inside of you. Sometimes, as was the case for me, babies are healthier after delivery. I developed a placental abruption that was life threatening to my baby, even though my symptoms stabilized. Had we not been in the hospital at the time, the outcome would have been disastrous. Listen to your body and your intuition. If you feel off, or feel that something is wrong, advocate for yourself and your baby. Sometimes an unwell or anxious feeling is the only symptom women report.