My pregnancy was healthy and even with low blood pressure until 34 wk. I stared getting increasingly more swollen about a month prior but nothing alarming until one day I developed severe ankle swelling at work. I checked my blood pressure which was 140/90. I called my OB to report these symptoms and was referred to the antenatal unit for preeclampsia work up. Blood labs, urine, and NST were normal and my BP came back down. I was sent home with instructions to monitor my blood pressure and call again if elevated. The following week I went in for my OB visit and my blood pressure was 150/95 and the swelling continued. I was placed on immediate medical leave from work and referred back to the antenatal unit for another work up, again normal and blood pressure came back down. The following week I was told I would be induced at 37 weeks due to gestational hypertension. 2 days before the induction date I developed severe mid back pain that progressively worsened over 2-3 hours. I called my OB and the on call told me it sounded like musculoskeletal back pain. I knew in my gut this was not the case and after giving it another hour I could not ignore the voice in my head saying something was wrong. Being a PA, I was well versed on the symptoms of preeclampsia and how to advocate for myself. Upon presenting to the hospital my blood pressure was 170/103. My back pain was radiating to my upper abdomen and if I moved at all I had severe pain causing nausea. I was told I now had preeclampsia and needed to be induced. We started with cervical ripening and my blood pressure came down on its own before medication was needed. My labs showed my platelets were barely low and everything else normal but compared to labs earlier that week they were starting to move in the wrong direction. Within 6 hours my abdominal pain worsened to vomiting due to pain with any movement. My blood pressure continued to spike then drop. My labs showed my platelets dropping, liver function tests elevating, and hemoglobin dropping. I was started on magnesium drip. A balloon catheter was placed and pitocin started to speed up induction due to my decline. An epidural was placed because if my platelets dropped any lower they would not be able to do so due to the bleeding risk. 6 hours from the last blood labs, I decompensated further with my labs looking much worse. I was told I had HELLP syndrome and needed to deliver immediately via c section. Within 45 minutes of that conversation with my OB, my daughter, Mackenzie, was delivered now at 36 wks + 6 days. She required supplemental oxygen for the first few minutes of life but otherwise required no additional intervention or NICU care. I also required supplemental oxygen during the delivery and had low blood pressure needing medication. Within an hour after delivery my severe abdominal pain had resolved and my health fully stabilized. 2 days after delivery my blood pressure started to elevate to 140/90 and I was started on medication. Within 2 weeks postpartum my blood pressure normalized and I have been off medication since. Next month we will celebrate my daughter’s 1st birthday. Thankfully both she and I are completely healthy without any residual complications for a very scary experience. I was told had I not advocated for myself and came in when I did, I could have had a very different outcome. For this reason I find it even more important to share my story and education others to trust their intuition!