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Pregnant...delivery Room/anesthesia Questions


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Hi everyone, I am currently pregnant at 28 weeks. I have been managing pretty well despite POTS. In fact, POTS has not flared up that much. The biggest hurdles were nausea and migraines in the first trimester and I wasn’t sure if I was going to make it. I did have some hypotension and a handful of tachycardia episodes. I stopped midodrine within the first trimester. As I enter the third, I feel really good over all.

I am hoping to have a productive conversation with the anesthesiologist in a few weeks. I find myself in the position of trying to describe POTS in the context of delivery to someone who likely does not know anything about POTS. I have read the studies and this forum’s experience about pregnancy, POTS and anesthesia. I read a post that mentioned the epidural helping with adrenaline surges due to contractions which I will share with the anesthesiologist, and I will ask them not to use epinephrine. I’d like to know what other experiences can I share about the POTS birth (delivery) experience to help them understand what could happen? I’d also like to know how pushing affects BP and how was it handled? Also, does pitocin affect POTS patients any differently? Scheduled induction vs. using pitocin to augment delivery? Thanks in advance!

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I was considered to have hyper-POTS. I had two healthy, term deliveries. Both were induced, but by different methods. The first was with pitocin without epidural, which sent my BP skyrocketing and made labor and delivery very fast (3 hours total.) The second induction was by "stripping my membranes,"plus an epidural. My labor progressed well until I got the epidural and my BP bottomed out, my son was born quite blue, but pinked up once delivered. Every person is different, but my BP was very sensitive to both pain and epidural. Good luck!

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