Greatly Multiply thy Sorrow

So, the class has been very interesting yet solemn this past week. There are a host of normal pregnancy discomforts that happens during pregnancy because of the physiological changes that take place in the woman's body. However, we have been learning about the complications that can occur during pregnancy and that's where things get solemn.

Hypertension in pregnancy represents the most significant complication of pregnancy and is one of the top causes in maternal/fetal/neonatal morbidity and mortality. There are different types, yet if not identified and properly managed things can go south very quickly.

As a Midwife, a woman with hypertension is a high-risk woman and her care is outside of my scope of practice. However, a woman can develop hypertension while in my care and therefore having thorough knowledge in assessment and diagnosis will aid in a timely transfer for treatment.

Hypertension can turn into a severe condition called preeclampsia and that can become eclampsia, which has a multi-organ effect specifically on the placenta, kidneys, liver, brain, heart and hematological changes in the mother, which can result in the death of mother and baby.

Signs of eclampsia are hypertension, protein in the urine, lack of urine output, headache, visual disturbance, and seizures. The goal of treatment is to prevent the complications which can lead to eclampsia. This may mean terminating the pregnancy through delivery which has a host of risk factors.

My take away, interestingly enough because of the stress on the mother's body with preeclampsia there is the presence of cortisol. Cortisol helps to mature the fetal lungs thus increasing the chance of survival when premature delivery is necessary. Now that is divine design! When God said to Eve "in sorrow thou shalt bring forth children" {Gen 3:17} I always referred that to the pain in childbirth, now as I study midwifery I am beginning to realize there are other sorrows that women can have during childbirth and I could see that as their midwife I would be affected as well. Oh, I wish there could have been one record of childbearing before sin!