Pre-eclampsia and high blood pressure in pregnancy
What can help reduce future cardiovascular risks for women after pregnancy?
This summary features experience of:
- Managing high blood pressure after birth
- Monitoring blood pressure at home
- Diet, exercise and weight after hypertensive disorders of pregnancy
- Infant feeding and cardiovascular health
The following section draws on new interviews which were conducted in 2025 with 20 women affected by hypertensive disorders of pregnancy (HDP), such as pre-eclampsia.
Mothers and babies affected by conditions like pre-eclampsia are more likely to develop high blood pressure and cardiovascular problems (such as heart disease) later in life. Many of the women we spoke to said they had not been told about this link between HDP and longer-term cardiovascular health.
Research suggests that good blood pressure control in the postnatal period, eating well, staying active, maintaining a healthy weight, and breastfeeding may help reduce these risks for mothers. However, for the women we spoke to, it could be hard to focus on their own health after giving birth.
Managing high blood pressure after birth
Many of the women we interviewed found managing their blood pressure after birth challenging whilst recovering physically, coping with lack of sleep, and caring for a new baby.
Huma found it harder to remember to take her blood-pressure medication after giving birth because there was no longer a risk of it impacting her baby.
Huma found it harder to remember to take her blood-pressure medication after giving birth because there was no longer a risk of it impacting her baby.
Yeah, it was, like, I was, like, if it could help me in a way, like, if it’s, like, before that the thing it was all the thing... all the thing it was for the baby. Like, I was, like, I don’t wanna harm my baby, so if it’s good to take this medication and in a way it’s... I can... I can keep my baby safe. And so that was the motivation before the delivery. And after that, honestly, I wasn’t that regular in taking the medication. Even they asked me to take it regularly, but I was so busy with oth... other stuff and we... I didn’t took it regularly, honestly.
Some also described problems with follow-up care, including getting conflicting advice, difficulties accessing medication, and uncertainty about who was responsible for their care.
Samantha was told she could stop taking her medication after giving birth. However, her blood pressure became dangerously high. There was disagreement and uncertainty about which healthcare professionals would manage her blood pressure (read by an actor).
Samantha was told she could stop taking her medication after giving birth. However, her blood pressure became dangerously high. There was disagreement and uncertainty about which healthcare professionals would manage her blood pressure (read by an actor).
I sort of explained that I was just told to not take the medication anymore, and she [the doctor] was quite shocked to say, “Well, you can’t just go cold turkey. You know, who’s... who’s reviewing this?” And I was... sort of said, “Well, nobody really.” So, she’s: “We’re gonna have to re-prescribe you the medication.” Huh. Which was super-annoying ’cause I did sort of say to them, I was like: “Can I just self-discharge and go home?” I was like: “I have the medication at home. I’ll just go and take it.” But I had to sort of... they were like: “Well, if you discharge, you’re probably gonna have to come back wait.” So, I was like: ‘oh, I just want to be at home with my baby.’ And they re-prescribed me the labetalol, which I then had to take whilst I was there, and then I had to sit around and wait [chuckles] for another blood pressure monitor to see if it had bought my blood pressure down, and which it had, so I was then able to, like, go home at that point. So, then I was taking that again I think three times a day. And then there was kind of this, like, up in the air of, like, who’s going to manage the overseeing of that, shall we say. And they didn’t know whether it would be the midwives or the GP, or what. So, I wasn’t really sure, so I got in touch with a GP and sort of explained the situation and said, you know: “Is this something that you’re going to manage?” basically. And then luckily, like, the GP said, “Yes.”
For some women, difficult life circumstances made it harder to access treatment and follow-up support.
Mercy, who was seeking asylum, was moved to another city shortly after giving birth. She was unable to get more blood-pressure medication because her new GP could not access her previous records (read by an actor).
Mercy, who was seeking asylum, was moved to another city shortly after giving birth. She was unable to get more blood-pressure medication because her new GP could not access her previous records (read by an actor).
So, I went to the... I went to the GP to get my medication and they told me it’s not in the record that you are having a... the medication, that high blood pressure medication. I said, “But my BP is high.” And this thing, I will be having it, I just finish with the one I have, and so over two weeks, three weeks now, I’m not having none and my BP is still going high. They said they didn’t see it in the system, and for that reason, they are not giving... giving it to me. That was how they left me. From that two month, my baby was two months plus, I stop taking the medication. But this thing was still in me. I can still feel my hand. I can still feel that BP in my blood... and everything and I keep going to my GP. I go, I do some check, I tell them it is high, they... they keep, like, telling me it’s not in the system. People should put it back on the system. If it’s not there, why don’t you just see that my BP is high so you can start with the medication. They didn’t actually do it. So, I started doing, like, home remedies for myself because I... I need a strength for my baby, since they are not understanding me.
There was a feeling for some that healthcare professionals were less concerned about their blood pressure now that pregnancy was over. Charlotte’s blood pressure increased again after her GP advised her to stop taking medication a few months after birth. She felt her concerns were no longer being taken as seriously “because I'm not pregnant now […] All they say is ‘you're a bit young to have high blood pressure’”.
Bev, who had been cared for by a specialist team during pregnancy, struggled to understand why this support ended despite her needing to be readmitted to hospital for ongoing blood-pressure problems: “If there’s specialist care, it should be specialist post care”.
Monitoring blood pressure at home
Some of the women had monitored their blood pressure at home after birth. It could be reassuring and help keep their blood pressure under control, especially when healthcare professionals reviewed their readings and advised them about what to do next.
Emma found home monitoring combined with support from her GP worked well.
Emma found home monitoring combined with support from her GP worked well.
And did you check it [BP] after birth at all?
Yeah, I had to take it... I had... so the doctors, after I got signed off from the... no, actually, when I left the hospital after giving birth, they told me to contact... take my tablet for a week, and take the two tablets a day for a week, and then contact the doctor. So, I contacted the doctor’s and she asked me to continue to take it twice a... once a day and to monitor it on, like, this system that they had. So, obviously, took the tablet once a day. I wrote the readings in the chart thing that they gave me, and then at the end of the week, they all got sent off, and then she just messaged me back saying, “Take it every other day and then you can stop taking the tablet,” because my blood pressure was normal.
OK, yeah, so they adjusted it based on your home readings.
Yeah.
OK.
Yeah.
And did you find that all worked quite well, or...?
Yeah, it was... it was, yeah, easy. And they sent me a text message to remind me to take it, so luckily, that was good, so then I took it and then put the reading in, ’cause if not, I think I probably would have forgot. Huh. And that was easy – the system – you text message.
Others found home blood-pressure monitoring more difficult, especially when they felt unsupported or were unsure about when and how to seek help. One woman was asked to upload her readings to an app and assumed that healthcare professionals were monitoring it: “I just presumed if they were really high it would alert somebody”. It was concerning when she asked a midwife if that was the case and the answer was unsure.
Access to a blood pressure monitor could be a challenge. Some people who had been loaned blood pressure monitors during pregnancy needed to return them soon after giving birth. Jessica was advised to monitor her blood pressure after leaving hospital but was not given a monitor so “I had to get it myself”. Mariama, who could not afford to buy her own monitor, sometimes relied on symptoms such as headaches or blurred vision to judge when her blood pressure was high. She occasionally took extra medication without discussing it with her healthcare professionals.
Monitoring blood pressure at home was sometimes anxiety provoking. Ellie, who developed post-traumatic stress disorder after severe pre-eclampsia, felt home monitoring would have been too triggering earlier on because “one of my flashback issues was the blood-pressure cuff”.
You can also read more about other experiences of self-monitoring blood pressure during pregnancy here.
Diet, exercise and weight after hypertensive disorders of pregnancy
Maintaining a healthy diet and weight, and exercising regularly, are linked to better cardiovascular health, and women are often advised to focus on these after having hypertensive disorders of pregnancy.
However, many of the women we spoke to found this difficult in the weeks and months after giving birth. Recovery, lack of sleep, emotional stress, caring for a baby, financial pressures and other responsibilities often took priority.
Ellie thinks that advice about weight loss after having a baby is mismatched with the situations and priorities of new mums (read by an actor).
Ellie thinks that advice about weight loss after having a baby is mismatched with the situations and priorities of new mums (read by an actor).
But nobody has ever said to me about weight loss strategies or anything like that. Yeah, I'd probably be a bit offended and go, huh, thanks. But I wouldn't snub it because I know that it's, it's correct... I'd probably [have] gone ‘I've just had a baby, for goodness sake. Do you think I've got time to prepare all this healthy food? The only thing I've got time to have is a crisp sandwich’... Because I just think I've just had a baby, for goodness sake. I've just been through a really traumatic time. I'm not going to focus on broccoli right now.
Finding motivation and opportunity to exercise was challenging in the context of busy lives. Mercy was also put off from walking with her baby because of bad weather and worry that her son would get poorly being out in the wet and cold.
Some women sought foods that were comforting or easier to prepare when exhausted. Jemma, who is diabetic, found dietary advice hard to sustain, saying “who doesn’t like a bit of chocolate cake?” As Tessa explained, “you’re sleep deprived, you’re adjusting to being a new parent… you’re too tired to cook. So, what you gonna cook – pasta, mashed potatoes, stuff that’s easier.”
Family routines and food preferences also shaped what women ate. Bev said it helped that her wife supported and was “on board” with her efforts to eat more healthily. Others found this harder, particularly when preparing meals around other children’s preferences.
Charlotte, whose children are autistic and prefer “beige food”, explains that she doesn’t have the time or energy to cook additional meals for herself (read by an actor).
Charlotte, whose children are autistic and prefer “beige food”, explains that she doesn’t have the time or energy to cook additional meals for herself (read by an actor).
My diet's horrific and always has been, but I've been like that since for the last 20 years... I mean my diet's not terrible, like I don't live on takeaways and stuff like that. I just have a limited diet. I also have ADHD, so the executive function to cook a meal just for one person or and obviously the kids are autistic, so they live on a pretty beige plain diet like it tends to be cooked for them and then I'll add some veg in depending what veg each person eats and then add my own veg in, obviously. But I think because their diet is so limited, I'm not going to cook a nice fancy meal just for me. By the time it gets to the evening, I've got no desire to cook for anyone at all, let alone cook, start cooking loads of separate meals.
Some women described how financial pressures affected their food choices and exercise options. Mariama, who sometimes relied on food banks, said it was difficult to follow dietary advice she had been given after her eclamptic fit because “you cannot say, ‘I don’t want to eat this.’ If you don’t eat that, you’re going to stay hungry, so you eat what you see”. Samantha knew of “mum and baby fitness classes and things like that, but sometimes they come with a cost [... but when] mums are on maternity leave and maternity pay isn't great”.
Some women questioned whether weight was a reliable measure of health and felt the emphasis placed on it could be judgemental and failed to reflect different body shapes and experiences.
Kadri’s past attempts at weight loss had negatively affected her mental wellbeing and she did not want to return to this after having a baby.
Kadri’s past attempts at weight loss had negatively affected her mental wellbeing and she did not want to return to this after having a baby.
You know, that stress on the... that stress on the body, dieting is stress on the body, and it doesn’t even work. And for me, it’s like, you know, doctors, would they recommend a medication that is proven to not be effective 95 percent of the times, but causes significant side effects? You know, the stress of dieting, physically and mentally, is enormous. The social isolation it can cause. You know, when I was in my dieting days, like, I couldn’t go out with my friends because I would have to think about, well what was actually, quote on quote: ‘safe for me to eat’, that wouldn’t mess up my diet plans. You know, I would be totally... like, my life would be totally ruled by what I could and couldn’t eat. My mental capacity was totally spent on planning my meals, and because I was hungry 90 percent of the time, I actually could not really think of much else.
Tessa felt that weight advice was based on White body norms and placed unrealistic expectations on women of colour (read by an actor).
Tessa felt that weight advice was based on White body norms and placed unrealistic expectations on women of colour (read by an actor).
Even if I worked really hard and starved myself, the most I could probably get down to is a 14 at my age and bearing... bearing on other things, but this build comes from my grandmother in Jamaica, she had this sort of build. She was big busted, big backed, yeah? And then the other people in my family are, you know, on the Caribbean side are like... my dad wasn’t, but some of the others, they’re, like, six-foot three Black men, big, tall Black men. So when... when I’m looking at where my build’s come from and where my health’s come from, they... they go grey later. Do you know what I mean? They have good skin. They tend to have freckles. I’ve... I’ve come from that side. I don’t... I don’t even look like the side of my mum’s family, even though they probably have more weight management issues than my Caribbean side did, but my build comes from my Caribbean side. So, I’ve always been at the top of, like, 24, 25 BMI, even when I was at my fittest. So, it’s like, it’s... it’s... it’s a slog for... for what... for looking at that as a measurement and then looking at, OK, what does healthy actually look like for me? You know?
Many felt that advice to lose weight after giving birth would have felt unrealistic and insensitive, given the challenges they were facing, and would have added pressure, guilt and feelings of blame at an already difficult time.
Chichi, who was balancing full-time nursing studies, part-time work and caring for two children, described how difficult weight loss felt and the emotional impact this had on her (read by an actor).
Chichi, who was balancing full-time nursing studies, part-time work and caring for two children, described how difficult weight loss felt and the emotional impact this had on her (read by an actor).
People don’t add weight to it... for fun – they don’t enjoy adding weight – sometimes it’s just beyond their control. And they think about it every day. They’re already traumatised by looking at themselves in the mirror.
I know how many times I’ve had to change my clothes and how many times I’ve had to change my lifestyle, and... and not... it’s not something I thought about and it’s not something that I wanted to lose my shape, or lose... wear bigger clothes to hide my stomach. Because I had diastasis recti after as well, so my stomach open, and it’s... I’ve got a big tummy; I have to wear big clothes just to cover it.
Charlotte worried that too much focus on diet and exercise could lead healthcare professionals to overlook other possible causes of high blood pressure (read by an actor).
Charlotte worried that too much focus on diet and exercise could lead healthcare professionals to overlook other possible causes of high blood pressure (read by an actor).
There’s no, like, consideration for actually there might be, like, an actual real condition causing it. And I think that’s more the worry, not: oh, you’ve had too much salt in your diet. You’ve not ran a marathon this week. Like, what if there’s actually something seriously wrong that’s causing the high blood pressure? But everyone’s so focused on... it goes back to that everyone was so focused on the pre-eclampsia, everyone’s so focused on blaming, oh, you... me, for not going for a jog every morning, that we’re ignoring the possibility it could actually be loads of other things.
Some of the women we spoke to felt that advice about diet and exercise should focus less on weight loss and more on nutrition, enjoyment, mental wellbeing and finding activities that realistically fit into everyday life. Many felt physical activity was more sustainable when it was enjoyable or easy to build into daily routines, such as walking with children, rather than feeling restrictive or punishing.
Kadri thinks women should be informed about health risks and ways to reduce them, but that health promotion conversations should not centre on weight.
Kadri thinks women should be informed about health risks and ways to reduce them, but that health promotion conversations should not centre on weight.
So, for me, like, the weight management just needs to go out of it. You know, actually, how can we support people, even if they’re a higher weight, into movement? You know, how can we add nutrition into diets without talking about how to... you know, what needs to come out of it, or what needs to reduced? Like, there’s so many other ways of going about it, and how about we start talking about movement more in terms of joy and mental health, and, you know, running around the way that we did, like, when we were kids, you know, not a care in the world, just moving, because we wanted to move our body and because it brought us joy and enjoyment in itself.
Taylor developed a walking routine with her sister after they both had babies.
Taylor developed a walking routine with her sister after they both had babies.
Yeah, so normally... I mean, it’s not exercise-exercise, I suppose, but since she was about three months old, me and my sister, who also has the baby, we would do two three-mile walks almost every day and put the girls in their pushchairs and off you go. It’s something we can do during the day and I can take her with me, it gets her outside, it could... it sort of fits all criteria’s for both of us. It’s nothing major, but it... it’s something... something better than nothing.
Tessa similarly described enjoyable forms of movement, such as Zumba, as easier to sustain than gym-based exercise. Ellie said she had “never found something that worked” for her or that she genuinely enjoyed doing.
Several women stressed the importance of timing, kindness and feeling emotionally ready to make changes. As Sonia said, “I am doing it at my own pace, and when I do that, I am going to receive good results”.
Emma described lifestyle changes that had helped her lose weight before pregnancy and was confident she would return to these habits when she felt ready.
Emma described lifestyle changes that had helped her lose weight before pregnancy and was confident she would return to these habits when she felt ready.
I mean, before I got pregnant, I did lose four and a half stone. I did gain quite a bit of it back on when I… [sighs] when I was pregnant. So, I do... I do... I do know like I can eat... [sound: baby noise] oh, that’s OK. I can, like, eat healthy, and I know, like, what a balanced, nutritious diet is. It’s just getting back... like, my head back into it and eating... eating healthy.
So, four and a half stone, that’s quite a lot. How did you... how did you lose that weight? Was that through diet and—?
I just ate... ate healthier, and I did... I did a lot more... a lot more exercise, so I... I did swimming and I did Couch to 5K. I just... I didn’t cut out everything, I just cut down, like, eating loads of... and, like, loads of crisps. It was like... like, a luxury at the end of the week, like: ‘ooh, I’ll have a chocolate bar,’ or... And... and making stuff from scratch, instead of buying, like, jars, I’d make, like, Bolognese sauce from scratch, and make my own chips, just stuff like that really.
This was an important message for healthcare professionals too. Chichi reflected, “[some women are] already traumatised by looking at themselves in the mirror… so, yeah, just be kind to people”. Kadri appreciated healthcare professionals who treated her “as a person and not just the BMI, the blood pressure”.
Some women wondered whether weight-loss injections (GLP-1 receptor agonists) might help. Kadri was interested in their potential benefits but was unsure whether they would be safe while planning another pregnancy or breastfeeding. Chichi hoped they might help control her blood pressure, but worried about the cost, saying she would consider them “when I have the money”. Jemma, who had been prescribed one to manage her diabetes, felt disappointed that she had not lost as much weight as other people she knew taking them for weight loss.
Infant feeding and cardiovascular health
Research suggests that breastfeeding (which can include expressing breastmilk to give by bottle or feeding tube) is linked to lower cardiovascular risk for both mothers and babies. However, only one of the women we spoke to had been aware of this link. Samantha, who had not planned to breastfeed her second baby after struggling with her first, said she may have made a different decision had she known.
Some of the women we spoke to had wanted to breastfeed and were motivated by wanting to support their baby’s health, especially after difficult pregnancies or premature births.
After experiencing complications during pregnancy, Jemma was especially determined to breastfeed her third baby.
After experiencing complications during pregnancy, Jemma was especially determined to breastfeed her third baby.
So, what was it that made you want to breastfeed this time? I’m just curious.
I don’t really know. I think it’s because I wanted what was best for her. Because I also had strep B. Yeah, so I had strep B and that’s also another reason why she had to come early. And I had to have the... I had to have the course of antibiotics as well. So, I... I just wanted what was best for her ’cause I kinda worried about her health with all the health problems that I had going on, with the diabetes and the high blood pressure and then the protein and... and everything going on, I just sort of felt like she wasn’t gonna be 100 percent healthy. So, I thought breastfeeding’s best, I’ll do that for as long as I can. And... and, yeah, so I... I... that’s... I think that was why.
Some had expressed breastmilk for their babies who were premature or admitted to neonatal units.
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.
Breastfeeding went relatively smoothly for some, particularly if they had breastfed before or felt well supported.
Mariama described expressing milk for her baby after suffering an eclamptic fit four days after giving birth which left her critically ill (read by an actor).
Mariama described expressing milk for her baby after suffering an eclamptic fit four days after giving birth which left her critically ill (read by an actor).
So, what they did was, they were helping me, like, in pumping. So, yeah, I started by, like, pumping, and then they will take the milk for him, for where he was. And then it continue until when they... when I started, like, getting a bit better, and then when they... we... they will be... they will wheel me from where I was to where my son is and then I will... I will try to, like, giving him my breast. So that’s how I started bit by bit with the bottle feeding and then with the... Because before the bottle feeding, they were feeding him through the... how do you call this? This...?”
The tube?
Yeah, through the tube, yeah.
Other women we spoke to however, found breastfeeding quite challenging. Recovering from a complicated birth, being unwell, having a premature or unwell baby, being separated from them, and lack of support all affected feeding. Women described problems with latching, pain, exhaustion and low milk supply.
While some women found expressing helped them to establish breastfeeding or maintain milk supply, others found it painful, exhausting or difficult to maintain. Ellie, whose baby was in hospital for two months after being born at 29 weeks, described pumping up to eight times a day which she found unsustainable once home.
Medications were also a concern for some women. Jessica felt the blood-pressure medications she was given may have affected her baby, as “he was very drowsy to begin with once that went through my system”. Emma checked with healthcare professionals that it was safe to breastfeed while taking hers. Kadri developed a burning pain in her nipples after being prescribed labetalol during pregnancy and worried this would affect breastfeeding. She said her doctor initially dismissed the possibility that it was medication-related until she showed him an academic paper describing this as a side-effect. Her prescription was changed and the pain resolved before she gave birth.
Jemma had to stop breastfeeding after being prescribed a medication for her diabetes that wasn’t safe to take while breastfeeding.
Jemma had to stop breastfeeding after being prescribed a medication for her diabetes that wasn’t safe to take while breastfeeding.
But then I had to stop when... when she was about... I think she was about four months old, I had to stop because I got prescribed a tablet that I had to take and you can’t take it during breastfeeding. And that was for diabetes, because my diabetes was so bad, that my diabetes nurse, she said, “You’ve got to stop breastfeeding,” and you’ve got to start taking this medication for my diabetes. So, I was a bit gutted because I really wanted to breastfeed up until she was about a year old. And I’m... I’m so gutted that I’m... I’m not breastfeeding. And it actually makes me really sad… Because obviously it was my first-time breastfeeding, I had such a good connection and it was such a nice bond and nice feeling, and... yeah, and when she was four months, I just... I just had to stop, and I didn’t wanna stop but I had to because of... so... but my health was bad, I guess.
Did the nurse discuss it with anybody like a pharmacist or a doctor about any potential [risks]...?
I don’t think... I don’t think so, no.
Several women felt that feeding or monitoring schedules for babies staying in hospital made breastfeeding more difficult. Bev said staff repeatedly told her “don’t feed her, we need to do her glucose” even though “she’s hungry.” Ellie felt her premature baby’s frequent tube-feeding schedule suppressed both his feeding cues and her own instinctive awareness of them.
A few women felt well supported with breastfeeding, but most said they did not receive enough help. Jemma felt staff assumed she did not need support because it was her third baby, even though it was the first time she had breastfed. Others felt healthcare professionals doubted their ability to breastfeed because of complications such as prematurity. Huma described repeatedly asking for help and being told “it gets very hard if the baby’s preterm”. Charlotte, whose daughter was slow to gain weight, felt judged for continuing to breastfeed and believed that if they “had the freedom to say just give her formula so she gains weight, they probably would have”. She thinks she probably wouldn’t have the confidence to continue if it had been her first baby.
Kadri felt pressured to formula feed her baby after she was classified as small for gestational age using a personalised growth chart that took Kadri’s body weight into account, which Kadri felt was unfair.
Kadri felt pressured to formula feed her baby after she was classified as small for gestational age using a personalised growth chart that took Kadri’s body weight into account, which Kadri felt was unfair.
She was just... she was small, but she was just over 3kg. And... and then this is again where... where... where my weight kind of comes into play because... So,... and... and I didn’t know this, is that they... they do like a personalised growth chart for the baby, when they’re... even during pregnancy, when they’re measuring you, and apparently if the mother is of a higher weight than they expect the baby to be of higher weight, that I don’t know what that’s really based on, and I actually even looked for research on this, and I couldn’t really find anything. I mean, my sources are limited, so... so maybe there... maybe there is. But, literally, only for this reason, they expected me to have... because of my weight, they expected my baby to be bigger than average at birth, and, actually, so when she ended up being smaller than average, the calculation came that... that she was, like, on, like, the, you know, third percentile, or something, so they were then very concerned about her weight, even though she wasn’t, like, that small. If you just looked at her compared to any other baby, she wasn’t really that small. And nobody had commented on any of that, or at least the midwives that saw us, you know, for two days on the... on the ward, you know, many of them... none of them, you know, seemed concerned, and she was doing fine. It was only until we were insisting on discharge and then were seen by this paediatrician who then said, “Oh, but she’s, you know, only on the third percentile,” and then was... then was raising a lot of concerns about making sure that she gains weight, and... and actually actively discouraged us from breastfeeding at the time because formula would somehow be magically better at her gaining weight, which I was really shocked about. But we were actually told that if we didn’t at least introduce formula on the... you know, as well as trying to continue breastfeeding, that she might die.
Yeah, that was... that was one of the most shocking sides of... of... of the whole process, probably. Yeah, so... yeah, I... I guess the paediatrician has to assess the... the baby before you can be discharged. And admitted that this was... I don’t know if this was a trainee or a junior doctor, or... or I don’t know, but, yeah, basically, they wanted to keep us in the hospital, so when they no longer could use my blood pressure as a reason, they then insisted that the baby is too small and they have to monitor the baby. Which was a bit funny because, I mean, nobody had actually really been monitoring the baby all this time and suddenly this was an issue. And then actually the... we were discharged at, like, 9pm and had a midwife appointment at another facility the following morning, anyway, so it’s like: ‘well, really, what monitoring would you have done in this, like, period anyway?’ So, it was very... very confusing. But, yeah, so they were essentially trying to get us to stay, and so that’s what they tried to then use to... yeah, that basically your baby will die if, you know, you’re not... if the feeding doesn’t, basically, go. And I was insisting on breastfeeding at that point, and actually they scared us enough that when we got home, my husband went straight to the store to get formula.
Many women turned to friends, family or breastfeeding charities for support. Kadri found advice from a friend with breastfeeding experience to “find positions that really worked for us”, while Jemma said her mother’s help with latching was invaluable. Helen Melody, who had immigrated from another country, said she was “always on the phone” asking friends and family for advice.
While some women were able to overcome breastfeeding difficulties, others stopped sooner than they would have liked. Tessa felt stopping breastfeeding was the best decision for her mental health because it meant she was able to get more sleep at night, while others described feelings of guilt, sadness and failure.
Ellie, whose baby was born at 29 weeks, described the grief she felt when she could no longer continue expressing and breastfeeding after her baby went for a hernia operation (read by an actor).
Ellie, whose baby was born at 29 weeks, described the grief she felt when she could no longer continue expressing and breastfeeding after her baby went for a hernia operation (read by an actor).
And when we were managing a few feeds a day, it was breastfeeding, and he was doing really, really good with that. But then when we went and had his surgery and came back home, the stress and the overwhelmingness of everything, my milk supply just completely stopped, which was traumatic in itself because I’d already felt like I had failed him by him being early and him being in NICU (Neonatal Intensive Care Unit)and being away. I then... then I couldn’t supply him milk anymore, just was another... like, another thing that was just so hard for me to deal with. Because I was pumping for him eight times a day whilst he was in NICU and feeding himself sole... through... through my milk, through the... the tube feeds, and at home I just... I couldn’t; I couldn’t.
For Huma, stopping breastfeeding contributed to her postnatal depression and feelings of guilt, which were made worse by comments from other people.
For Huma, stopping breastfeeding contributed to her postnatal depression and feelings of guilt, which were made worse by comments from other people.
And how did you feel then about having to stop breastfeeding?
Yeah, it affects my mental... I feel, like, for maybe for a month or so, I feel like I’m not a good mother at all. No, I... I was, like, even some people they make me realise this thing. Like, one of my friends and she said, “Oh, you should have breastfed her.” This is like... I was like: “No-one... it’s not an option for me.” Like, it’s not a thing. Like, I am not doing it intentionally. I wants to. Like, no I... I don’t think so there is some mother in this world who intentionally don’t breastfed her baby. It’s... it’s like she... I... I tried my best. I... even people who met me now, even now they... they asked me that if you breastfed her or if she’s... she was on formula and I am like: “No, she took formula.” And they ask me the reason that why... why you didn’t breastfed her. Yeah, so... Yeah. Even so, I feel very low and I feel like it... it’s not, like, it’s... and it was not my intention. It’s like I tried my best whatever... whatever was in my knowledge, whatever I could do, I... I tried, but if I couldn’t, then... then this is not the thing that was in my hands. This... this is like I couldn’t do, but...
You can read more about other experiences of breastfeeding and expressing breast milk after pre-eclampsia and high blood pressure in pregnancy here
When breastfeeding is difficult or not possible, there are other ways to support babies’ health and development. These can include skin-to-skin contact, responsive bottle feeding, and using slow-flow teats to help avoid overfeeding. Some hospitals may also offer donor breastmilk from milk banks when mothers are temporarily unable to provide enough milk. Some women express and store colostrum during the later weeks of pregnancy so that it can be given to their baby after birth if needed.
For more about the women in the study click on the links below:
Bev, Charlotte, Chichi, Ellie, Emma, Helen Melody, Huma, Jemma, Jessica, Kadri, Lizzy, Mariama, Mercy, Mina, Samantha, Sonia, Taylor, Tessa.
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