When to TTC after severe pe and a stillbirth

Are you considering having another child after preeclampsia? Trying again after preeclampsia can be an emotional challenge. You can find support with others who share your concerns here.

When to TTC after severe pe and a stillbirth

Postby cgoodi1 » Mon Mar 05, 2012 05:44 pm

I am really disappointed after meeting with my blood pressure doctor this afternoon. Two and a half weeks after delivering my sleeping baby girl at 21 weeks pregnant, my pressures have been normal for a week and I am off medication for a week and a half. I thought he would be more positive, but he told me that he wants us to wait at least a year to try again and my ob/gyn agrees. I have to go back in a month for results and do some more blood work and another urine test to make sure things are looking better. I am so sad that the doctors want us to wait a whole year. He mentioned that I'll have to be on low dose aspirin and heparin the next time. Giving myself a needle all the time will be difficult since I'm terrified of blood work and needles but I think that's not a huge price to pay if it allows me to bring a baby home. I'm meeting with an MFM on the 28th of March and am hoping that he will allow me to try again sooner. I just really would like to try sooner rather than later. I'm only 26, but my husband and I wanted a large family and waiting a year would make me 28 when I'd have my first baby and that's if we get pregnant right away and if all is uneventful.
When were you allowed to try again? Was it a successful pregnancy if you lost a baby before? Were you on heparin and lda?
Stillbirth - 21 weeks gestation due to severe preeclampsia, HELLP and IUGR - 15/02/12
Baby girl Aria - Induced due to high blood pressure at 36 weeks + 2 days - 7lbs 3oz - 05/03/13
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Re: When to TTC after severe pe and a stillbirth

Postby sam10 » Mon Mar 05, 2012 10:09 pm

I am so sorry your visit today did not go as well as you had hoped for.If it were not hard enough to lose a baby due to PE, to hear from the doctors to have to wait to TTC for a year is the ultimate curveball. :(
The important thing to remember and keep in mind is that our doctors usually have our well-being in mind and also their reasons why they have us waiting on the sidelines. Have your doctors explained why they wanted you to wait for one year?
My doctors both OB and MFM asked me to wait for 9-12months before TTC and I was 37 at that time. Not great, but I needed to heal from PE, my c-section and I desperately needed to grasp of what had happened in a very short time (PE, pregnancy cut short, being a NICU mom, a BLM a week later burying my son). All of this happened in a very short time. I truly needed time to 'catch my breath'.

Meeting with your MFM will surely help to put together a TTC plan for you, which will be based on your personal situation and constitution ( your case of PE, underlying disorders, your recovery, and so on). S/he might want to do some more tests if these haven't been done yet, check in on your recovery and so on. If you need help with a list of questions to bring to your appointment with the MFM, let me know, so I can dig up some info for you.

I am so sorry you lost your precious baby. Sending you hugs.
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
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Re: When to TTC after severe pe and a stillbirth

Postby kerisue » Mon Mar 05, 2012 10:45 pm

My doctors asked me to wait 12-18 mos. before trying to conceive again. It was very difficult to hear because of my age and because my arms were so very, very empty after Millie died. Preeclampsia does a huge number on our bodies and loss does a huge number on our hearts. I ended up getting the okay to ttc again after about 10 mos. and in retrospect I needed every minute of that time. (in the end they got their way though bc I'm still ttc). As for aspirin and heparin- I have seen two MFMs and both said NO to lmwh (not enough science showing benefit) and let me make my own decision about lda (I decided to take it).
Mama to Millie
born June 2010 @ 24 wks. gestation due to my severe PE and CHF
lived 25 days, loved and missed
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Re: When to TTC after severe pe and a stillbirth

Postby sam10 » Mon Mar 05, 2012 11:03 pm

My doctor also said no to Heparin for the same reason as Keri has described. LDA I am supposed to take once pregnant.
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
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Re: When to TTC after severe pe and a stillbirth

Postby angieb » Tue Mar 06, 2012 10:10 am

Doctors vary widely on their opinions on this.

My OB said wait 3 months (and that was after a classical c-section, but since it took us a year and a half to get pregnant the first time, I'm guessing she expected it to take awhile.) My MFM said 6 months minimum. I actually stopped using protection at 6 weeks postpartum (kinda idiotic in hindsight but my cycles were nonexistant so there really wasn't much risk of getting pregnant.) I ended up finally getting pregnant at the end of Aug.2010 after delivering our daughter in Sept.2009, so almost a year. In hindsight, I'm glad it took awhile because that gave me time to grieve for my daughter before the stresses of a new pregnancy started too. Subsequent pregnancies are VERY VERY hard and I imagine it would be even more difficult in the first year. During my second c-section, my OB noted that my previous c-section had healed "perfectly".

I was on LDA and lovenox throughout my second pregnancy (which went very well) and would have found an MFM willing to put me on both if mine hadn't suggested it. The needles are NOT fun, but you get used to it. And it was definitely "worth it".
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/
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Re: When to TTC after severe pe and a stillbirth

Postby Maplecat6 » Tue Mar 06, 2012 10:36 am

I'm sorry for your lost. Wanting another baby so badly and having to wait is very difficult.

My daughter was delivered by classical C-section at 27 weeks. Four months later, the MFM told us we could start trying again anytime. So, it sounds like there is a lot of variation in wait time recommendations. We sat out another cycle so due dates wouldn't accidently line-up. The MFM had me start on LDA before conception. On Thursday, I'll be 30 weeks pregnant. Emotionally, this pregnancy has been rough. Physically, everything looks perfect.
Amy, mom to four
Quinn, 4/28/06, no complications
Lou, 5/8/09, no complications
Rosie, 3/13/11-3/29/11, eclampsia at 27 weeks and then died from NEC
Sara, 5/3/12, no complications other than an obscene amount of monitoring
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Re: When to TTC after severe pe and a stillbirth

Postby amjon » Wed Mar 07, 2012 08:48 am

I was told in the hospital I could wait one cycle and try. My new OB didn't tell me to wait when I met with him either. He's planning on more monitoring than I had the first time though
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Re: When to TTC after severe pe and a stillbirth

Postby cmccaffrey » Thu Mar 08, 2012 02:42 am

Yes, being told to wait seems harsh and unfair. I remember being so upset and all I could think about was trying again to start our family. My OB and MFM told me to wait 7 months to a year just to make sure I had optimal healing from my c-section and so that my body could bounce back to the way it was before I got pregnant. In looking back, I am glad they had me wait. I was able to work on a game plan and get myself in a good place emotionally and physically. Also, I was able to do A LOT of testing to see if I had any kind of disease that might cause PE or worse to happen again. Luckily, I didn't have and definitive issues which gave me hope for a better outcome. We got pregnant the first month trying at 7 months postpartum. My doctors had me on lovenox (injections) and baby aspirin the entire pregnancy and I made it to 38 weeks 2 days with a repeat c-section. I don't think I would have tried again so soon had I not met with several doctors, had all the testing done only and had solid game plan only because I am a very nervous person by nature and I just don't think I would have had the strength. Also, if you feel like your doctors are wrong, look for another specialist and get their opinion. Different doctors might have something different to say. We met with SEVERAL doctors before I decided on the ones that would get me through my pregnancy.

I am so sorry that you have to go through all of this, especially after losing your little one, but I will keep you in my prayers and I wish you luck.

<3
Christa (25) & J (26)
Mommy to:
Mason born 10.11.10 @ 30+3 wks due to Severe Pre-E. Only lived 2.5 days
Noah born 2.1.12 @ 38 weeks thanks to lots of doctors visits, LDA, Lovenox and no preeclampsia!

learn more about our story... http://tinyurl.com/7a979vy
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Re: When to TTC after severe pe and a stillbirth

Postby heather j » Thu Mar 08, 2012 10:44 am

I'm so sorry for your loss. As you can see, we have a such an amazing community of mamas here who understand *exactly* what your frustrations are. What field does the doctor prescribing your bp meds work in (internist, cardiologist, OB)? It's quite possible that your MFM may have an entirely different opinion and perspective - they see the worst of us and are well-adept at rolling with what arises; their experiences, training, and education in complex pregnancy conditions best equip them to oversee these types of pregnancies. When you have your appointment, take along a list of questions you have for your doctor, and be prepared to have an in-depth discussion about what you see a future pregnancy (and conception) looking like and what your doctor sees. Don't be concerned about asking them to explain or justify their recommendations. We spent over two hours in consult with the MFM who oversaw my last two pregnancies; you are, ultimately, placing a great amount of trust and confidence in this person; giving of their time to be a partner is not too much to expect from them (and most doctors realize this). This is your life and the life of your family; a good doctor (and one you want leading your ship) will not balk at explaining and discussing reasons and rationale with his/her patients. Like Sam mentioned, our doctors usually have our very best interest at heart - they want healthy mamas and babies. Finding the right fit for you and your family and becoming a team together will be your best ammunition against this heart-wrenching disease.
Heather (PAI-1 4G/4G) mama to:
Nicolas Edison (6/2004) 36 weeks, PE, HELLP, and placental abruption
Ella Amelia (3/2007) 37 weeks, lovenox, PE-free
Oliver Lyon (1/2011) 37 weeks, lovenox, PE-free
Milo Mason (2/2014) 39 weeks PE-free
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Re: When to TTC after severe pe and a stillbirth

Postby angieb » Thu Mar 08, 2012 03:38 pm

heather j wrote:When you have your appointment, take along a list of questions you have for your doctor, and be prepared to have an in-depth discussion about what you see a future pregnancy (and conception) looking like and what your doctor sees. Don't be concerned about asking them to explain or justify their recommendations. We spent over two hours in consult with the MFM who oversaw my last two pregnancies; you are, ultimately, placing a great amount of trust and confidence in this person; giving of their time to be a partner is not too much to expect from them (and most doctors realize this). This is your life and the life of your family; a good doctor (and one you want leading your ship) will not balk at explaining and discussing reasons and rationale with his/her patients. Like Sam mentioned, our doctors usually have our very best interest at heart - they want healthy mamas and babies. Finding the right fit for you and your family and becoming a team together will be your best ammunition against this heart-wrenching disease.


This is a great point. Ultimately, you want a doctor that is okay with dealing with crazy-stressed-out-hormonal pregnant women... "my first baby died and nothing you can say will convince me that this one won't too even if everything does look great right now" (<--- that was me with my second pregnancy.) My doctors were SAINTS (I think I asked like 8 different people about hiccups because I read some nonsense online about it being a warning sign for stillbirth and no one could convince me otherwise! I religiously charted his hiccups which really didn't mean anything. Junk like that.) Anyway, you definitely want someone who has a lot of patience and who won't totally dismiss you as a "worrywart" when you are concerned about something. Definitely bring in a LONG list of questions and expect them to take their time discussing them with you. My consults both lasted at least an hour as well.
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/
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