What You Can Do
Norlisa and Gordon Keffer of Lynnwood, Washington, were undergoing infertility treatments when Norlisa was diagnosed with chronic hypertension. Her doctor immediately referred her to a perinatologist, or maternal-fetal medicine specialist, who stabilized Keffer's blood pressure and followed her during her pregnancy.
Keffer gave birth to full-term twins—Mary Frances and Samuel—with no problems. However, in the month after delivery, she was twice hospitalized with postpartum preeclampsia. Today, both she and her babies are doing well. "I think it's really important to find the right doctor," says Keffer, who feels that her perinatologist's careful monitoring and treatment was essential in getting her through a high-risk pregnancy.
The Keffers have always wanted a large family and plan to try for another baby—or two—soon. They've also been to their perinatologist for a preconception visit—a good idea for anyone planning a pregnancy, but doubly important if you've had preeclampsia. While there are no treatments available today that can guarantee a preeclampsia-free pregnancy, preconception planning can help you tilt the odds a little more in your favor.
What You Can Expect
Your preconception appointment will include a thorough history of your past pregnancies and other health issues. Your doctor may want to test you for underlying conditions such as hypertension, kidney issues, or autoimmune disorders, although there's no conclusive, "one-size-fits-all" list of tests. If you do have an underlying condition that could raise your risk of pregnancy complications, your doctor will be working closely with you to get your health under control before you become pregnant again.
Your obstetrician may also refer you to a perinatologist for testing and specialized care. In fact, "if a woman has had a particularly traumatic experience with preeclampsia, such as the loss of a baby, a very early delivery, or a near death experience, we strongly encourage she go straight to a perinatologist," says Garrett.
For a list of specialists in your area, check the Society for Maternal-Fetal Medicine or the North American Society for the Study of Hypertension in Pregnancy.
Finally, note that it's important to feel comfortable with your medical team. "I would actually 'shop around' if needed," says Keffer. "If you have that comfort level in your doctor, you're not going to have to spend as much time thinking, 'Oh my gosh—what if something goes wrong?'"