Pregnancy W/ Pots

[Fallon2120]

My husband and I want to start trying to get pregnant at the end of the summer. I was wondering for those of you that had POTS before you got pregnant how your pregnancy went? Did you have hyperemisis graviderum? Did you have a c-section? At any point did you have to go on bedrest? I'm just curious b/c right now my EP isn't quite sure what to do with me when I get pregnant. Right now he has told me I will probably have to have a scheduled c-section at 30 weeks and that they will have to watch me really closely. My obgyn said I can stay on a beta blocker they will just do more ultrasounds. Oh yeah, did you take any meds while pregnant? What were your md's suggestions?

[Rachel]

I had POTS before I got pregnant. I was very disabled from POTS at the time I got pregnant (and still am disabled). Dr. Grubb said that my POTS is a severe case. Despite the severity of my POTS symptoms, I did very well while pregnant. I felt better than normal with pregnancy. I didn't have much trouble at all with morning sickness, and definitely didn't have hyperemisis graviderum. I was able to make it through labor, and didn't need a c-section. I was never on bedrest, even at the end of pregnancy. I delivered at 41 weeks.

There hasn't been much research on POTS and pregnancy, but from what I've read and heard from physicians, doctors say that pregnancy with POTS is very safe. Many physicians have even indicated that their POTS patients do better while pregnant, largely due to the increase in blood volume.

I didn't take any meds during pregnancy. I know there are others here, though, who have had midodrine and other meds during pregnancy. If you speak with a high risk obgyn he/she will be able to help you decide what meds are safe/okay to be on during pregnancy.

I don't know your symptoms/severity of dysautonomia, but it seems like your EP is overly concerned. I would be very concerned about having a C-section at 30 weeks. I've never heard of that being necessary with a POTS patient.

There have been many discussions about POTS and pregnancy in the past; you can do a search to find more information. Most of us have had successful pregnancies and healthy babies. There have been some sad stories as well. Personally, I've had several miscarriages, and the doctors don't know why. Everything went perfectly with my 5th pregnancy, though. The only thing that went "wrong" was I needed some pitocin toward the end of labor because my uterus wasn't contracting properly.

If you have any more questions, ask away!

Rachel

[EarthMother]

I have three children, my eldest is 21 and no one new about POTS back then. We called it idiopathic orthostatic intolerance. It put me in the "high risk" category for my first delivery, mainly because no one knew what to expect. I was out on short term disability with my first born ... looking back I think the severe morning sickness that lasted almost five months had probably dehydrated me and tripped a POTS flaire. But I was feeling pretty good in my third trimester and delivery was normal.

My other two pregnancies were no longer even treated as high risk. My Doctors felt comfortable with how my body responded and I had no problems related to POTS.

Good luck finding what works for you.

~EM

[Fallon2120]

I'm sorry, I didn't mean 30 weeks. I meant to type 37. My OB and EP said they would probably go ahead and schedule the c-section for 37 weeks, but if things were going well then they would probably let me go to 39. Thanks for the replies. That is very encouraging!

[Rachel]

Oh, okay! 37 makes a whole lot more sense! That's a whole lot safer for your baby!

If your body heals well, then a C-section may be easier on you. Labor is difficult. For me, I knew that I needed to avoid a C-section if in any way possible. My body doesn't heal well, and certainly does not heal quickly. Recovering from an incision, even a small one, would have been very difficult for me. Recovering from labor and delivery was a long, hard process. But for me it was easier than recovering from an incision would have been.

I wish you the best.

Rachel

[MomtoGiuliana]

I think not enough is known and some doctors like to err on the side of caution and "c-section at 37 weeks" often seems to be the stock approach. There are risks with early delivery and risks with c-section (of course) and risks if you don't take this route--problem is, with our condition it is hard to impossible to evaluate what these are.

I had undiagnosed, fairly severe POTS and had a c-section at 40 weeks. after 3 hrs of labor I had placental abruption. Of course, looking back, a c-section without going into labor would have been best, but no way to have known in advance.

C-section is hard on your body. It is surgery and it takes time to heal. It sent my POTS into a tailspin. I was very sick following c-section (lost blood and had to have transfusion--so low blood volume didn't help).

I think you will find that many women on this site had normal pregnancies and vaginal deliveries even with POTS diagnosed.

[Fallon2120]

Thanks ladies! It is so nice to know I am not alone and there are women out there who have had healthy babies We want to start trying towards the end of summer, beginning of fall. Right now my EP is doing some research and has been in contact with an md at the mayo clinic. I have an appt in June to kind of get a game plan set, as far as whether or not he wants to change my meds before pregnancy, how often he will want to see me when I become pregnant, and how he and my OB can work together to hopefully have a good outcome. There is still so much that is not known about POTS, so there really isn't much known about what do do with us when were pregnant. Thanks again!