Bev
Bev has a history of “white coat hypertension” and was diagnosed with chronic (ongoing) high blood pressure during her second pregnancy. She gave birth by caesarean section at 37 weeks, and although her baby was small, she was healthy. Bev’s recovery took longer, as her blood pressure remained hard to control and she has had to remain on medication permanently.
Bev is a 39-year-old White English woman who lives with her wife and their two daughters (4 years; 6 months). She is a communications manager in higher education, though she was on maternity leave at the time of interview.
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Bev occasionally had slightly raised blood pressure outside of pregnancy, and while pregnant with her first child, which was thought to be “white coat hypertension” (when blood pressure rises in medical settings but is normal otherwise). However, at a routine 16-week midwife appointment during her second pregnancy, her blood pressure was found to be very high. She was diagnosed with chronic hypertension (ongoing high blood pressure), started on medication, and referred to a specialist team for the remainder of her pregnancy. Despite treatment, her blood pressure proved difficult to control and she required high doses of medication.
Bev monitored her blood pressure at home but was often unsure how to respond when her readings were high, particularly as they sometimes started off very elevated before settling after a few minutes. Later, she joined a research trial where she could enter her readings into an app, and a doctor would tell her what dose of medication to take based on the results. She found this reassuring and appreciated not having to make repeated trips to the hospital assessment unit, which she found stressful. She believes being in the trial helped get her blood pressure under control, but she was disappointed that the service stopped after she gave birth.
When she was 37 weeks pregnant, Bev was advised to be induced because her blood pressure was hard to control and her baby was measuring small. Bev chose to have a caesarean instead, as the thought of going through a long induction made her very anxious. A planned caesarean felt more predictable and manageable to her. Her daughter was healthy at birth, despite being small, and was quickly discharged from paediatric care.
Bev felt good following her caesarean and, because of this, thinks she may have done too much too soon. Her blood pressure was still high and the doctors wanted her to stay in hospital longer, but she chose to go home where she felt more comfortable. Although she was later readmitted due to very high blood pressure, she feels that having those few days at home helped her cope better with being back in hospital.
Bev chose not to stay in hospital on some occasions while pregnant and after giving birth, when doctors were concerned about her high blood pressure. Being in hospital made her anxiety worse: she struggled to sleep, missed her older daughter, who found the separation difficult, and found the lack of privacy challenging. Although she had initially been told she could have a private room to help manage her anxiety, she was later advised that it would not be safe because of concerns about her blood pressure. Looking back, Bev feels that choosing a planned caesarean section and deciding to go home when she did were the right decisions for her. However, she worried about being seen as difficult or ungrateful and found it stressful having to take responsibility for making those decisions herself. Her main message to other women is to advocate for themselves, even though she knows that can be hard, particularly for those who are worried about speaking up or being labelled as "difficult".
Bev felt the support she received from the specialist high-risk team during pregnancy was excellent, but this stopped after she gave birth. She noticed a big difference in the postnatal care, where she was seen by different doctors each day rather than professionals who knew her. She found the advice she received was sometimes inconsistent and confusing, and wished she could have continued to be followed up by the specialist team. Since being discharged from maternity care, her blood pressure has been managed by her GP. Although she’s been happy with the care there, it’s not a service focused on blood pressure related to pregnancy, which felt a bit odd to her. She doesn’t recall anyone specifically discussing the long-term effects of high blood pressure for her or her baby, though she is aware that she is more likely to have cardiovascular problems in the future on top of the ongoing high blood pressure that she still takes medication for.
Because of her history of anxiety and OCD, Bev was supported by specialist mental health midwives during pregnancy, which she found extremely helpful. They attended appointments with her and made sure her needs were communicated clearly to other professionals. Her wife’s support also helped her feel more confident in speaking up for herself. While her first pregnancy during the COVID-19 pandemic was very isolating, this time she has had the benefit of having family nearby.
Bev gained weight during her first pregnancy and found it difficult to lose afterwards. Looking back, she wonders whether this may have contributed to her developing high blood pressure in her second pregnancy. She had hoped to lose weight before becoming pregnant again but found it difficult. Since then, she has lost some weight, which she attributes to having more time while on maternity leave, attending a mother-and-baby exercise class, and the support of her wife with shopping and cooking.
Bev, whose second baby was born at 37 weeks but was quite small, found breastfeeding went smoother than with her first baby.
Bev, whose second baby was born at 37 weeks but was quite small, found breastfeeding went smoother than with her first baby.
How did the breastfeeding go initially?
Really good...
…smoothly from the start?
...yeah, yeah, and she’s obviously, like, so tiny and I was quite worried. And I guess the milk... the milk came in quicker, but I guess she took slightly longer to get the hang of it. But I’m talking, like, 24 hours. And then once she realised, she was just like: ‘oh, yeah.’ And she was just go... this tiny baby and she was just absolutely going for it and I was just so relieved that she didn’t struggle with that side of things. So yeah, she was... she was good with breastfeeding. And I think I was less stressed about it ’cause I breastfed before, I was a bit like... I was a bit like: ‘this... I’m gonna make... make this work.’ And she was... yeah, she was very good. She knew... she kind of was quite determined.