Non medical comfort measures

[expert@preeclampsia.org]

I currently have a client who has been diagnosed with pre-eclampsia and wishes to walk, rock and treat her labor symptoms without medical interventions. She has been put on modified bedrest. I generally tell my clients that to keep labor moving you have to keep moving, with walking, baths, hands and knees etc. Too many positions on which to elaborate, but I was wondering if typically their labor can be treated like their non pre-elcampsia counterparts.

[expert@preeclampsia.org]

This depends on the severity of the preeclampsia. Women with mild preeclampsia can usually move about in labor. If she is on MgSO4 to prevent seizures (eclampsia) she may not feel like being up and about. Similarly, if she has severe preeclampsia, she may not feel like it. If her BP is seriously elevated, activity may make it worse; labor pains may make it worse. She may medically benefit from an epidural.

Preeclampsia can sometimes get worse rapidly - particularly in labor. It can affect the placenta such that the baby may not tolerate labor. For these reasons her chance of needing a cesarean (while by no means certain) is elevated. She may require induction of labor before her cervix is favorable. If her labor lasts for 48 or 72 hours, the chances of needing pain control will of course increase.

She will need a fluid approach to her support depending on the circumstances.