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I just recently had a friend who gave birth to her first child.  She had wanted a drug free birth, but, as is true to birth, things did not go as planned.  She ended up having pre-eclampsia and needing to be induced.  When one prepares for a completely natural event, and a snag gets thrown in, a trained doula is especially helpful.

Pre-eclampsia slideshow

For more information on pre-eclampsia and how it is treated medically, check out the link above that I found online.

For a mom with pre-eclampsia, a birth plan for her birth is still helpful.  It may need to be adjusted as the labor moves along, or other medical problems arise, but a good doula is able to adjust to these and role with them.  Most of these mother’s needs are similar to any other mother.  There are two needs, however, that become more prominent when supporting a woman who has pre-eclampsia.

The first one is anxiety or fear related to her medial diagnosis.  When a woman is told that she is pre-ecamptic, there begins to be a lot of talk about the safety of both the mom and the baby(as there should be).  The doula’s job, at this point, is to help the mom work through her fears that may result from this.

One thing that may help her to focus on, is what variables she can control.  Before labor begins, this can focus on what she can do to keep herself and her baby as healthy as possible.  This can include diet and exercise.  It can also include working on ways to help manage labor if an induction is necessary.  A doula can help the mother discover what ways help her cope best and plan on utilizing them during labor.

During labor, a big job for mom is to stay as calm and relaxed as possible.  Let her know that the medical professionals are there to worry for her.  She needs to just focused on staying as relaxed as possible because when she does this, it allows the baby to get as much oxygen as possible.  It also helps her to dilate faster.  This is important for those with pre-eclampsia because delivery is the only way that we know to stop it.

Advocating for the woman’s right to move around is also important when bed rest is not medically indicated.  Some hospitals have an automatic policy that all women diagnosised with pre-eclampsia need to be confined to bed.  This is not necessarily true, and can in fact slow labors down.  A good thing to do is ask if the woman can have a trial movement.   It can be good to see if standing or walking actually increase or decrease blood pressure during labor.  If one postion appears to increase the blood pressure, see if there is another one that might work.

If a woman needs to be on mag, movement may be more difficult, as magnesium can make someone feel very lethargic and tired.  At this point, fatigue becomes a paramount need and should be addressed.  I use orange oil quite often for fatigue and have found good results.  Sleeping as much as possible is also important.  If the woman wants to try different positions, make sure she is well supported.  This may also be a time to weigh the pros and cons of getting an epidural for medical purposes.  There are complications with epidruals, but there are also complications with a tired mom that has decreased coping mechanisms.  In all cases, this should be addressed with the mom and she should be allowed to choose.

You may also need to make sure that the women has all her questions answered before any medical intervention is done.   For example, if it looks like the doctor is going to break her water, make sure you point that out they are doing that and ask her if she has any questions.

A more complicated labor can still be satisfying and rewarding for a mom.  It can be a difficult challenge for a doula, but a well trained one can make all the difference.



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Rachel has worked as a register nurse (BSN from University of Utah) since 2004 with a work history in Labor and Delivery, NICU and Postpartum Care. She is also the founder of New Beginnings Doula Training which she organized in 2011. When she's not busy being a mother and grandmother, she can be found reading research papers related to some aspect of childbirth.

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