Preeclampsia: Deadly price of motherhood

It had been more than six years since Fridah had her last baby. Having put the chapter of childbearing behind her, she was enjoying nurturing her own little ones and those of the church community. Fridah and her husband were part of the leadership that started our little community church, the New Valley Sabbath School. With a congregation of approximately 60, including children, the little church became a fortress for many, despite being a simple temporary mabati structure. While Fridah’s husband, the senior elder of the church, worked tirelessly with fellow elders to ensure the church thrived, Fridah found her mission in the children’s ministry. It was amazing how she dealt with the most difficult age-group, the pre-teens and early teens, with such grace and humility. Though she was soft-spoken by nature, she was amazingly firm and this trait served to shape the lives of the young ones she dealt with in a positive way.
I recall her husband regaling me with stories of how their little one came into the world on his own terms. Fridah was just 32 weeks pregnant when she woke up in the middle of the night in pain. There was no time to get her to the hospital where she had planned to deliver. They barely made it to the delivery room as her waters broke and the little one made a grand entrance at barely a kilogramme. While he battled for his tiny life in the newborn unit, Fridah battled preeclampsia. Despite the blood pressure swinging up and down, it was reassuring to know that the baby had been delivered and that her body could begin the healing process. Everyone was so focused on the baby that the mother missed out on getting adequate information concerning the preeclampsia.

INADEQUATE CARE
As the laboratory tests confirmed that there was no residual damage to her liver and kidneys, Fridah took her anti-hypertensive medication and channelled her energies to ensuring her little gift survived. She assumed things would settle down on their own. The little one thrived and went home, much to everyone’s delight. They handled the challenges of prematurity as they came and with time, he went on to prove his mettle by catching up with his peers by his first birthday. However, this was at a price. Fridah forgot about her own blood pressure issues.
Her post-partum follow-up and care was inadequate and since she did not feel unwell, she assumed her complications had resolved. What she did not know was that despite being “well”, her blood pressure remained consistently high, well after the post-partum period. It took nearly two years for this to be picked up during hospitalisation for a minor procedure.
The preeclampsia had long turned into chronic hypertension which had quietly but progressively damaged her kidneys. Though she took medication faithfully to manage the hypertension, it was too late. Her kidneys had failed irreparably. Her saving grace would be a kidney transplant.
Fridah had to start dialysis to cleanse her body of waste, excess fluid and salts. Twice a week, she made a date with the dialysis machine. For those two days, she could do nothing other than get to the hospital, do the preliminary tests and get hooked onto the machine for hours.
She would get home exhausted but she never complained. She had bad days when all she could do was sleep and she had better days which she did what she loved best. On a good day, she would still wake up early on Sunday morning to make it to choir practice at church. She would still hold her Sabbath school classes on Sabbath morning seated on a plastic chair, surrounded by her beloved charges.

MASKED PAIN
The grace with which she carried herself masked the inner pain. She would lie in her bed quietly without complaining but her husband knew the struggles within. Being a chronically ill patient drained all of the family's resources but they never gave up. Her husband’s dedication and commitment to her care extended her life beyond measure. She would never lack her drugs, even when he did not have a penny in his pocket.
Last week, we bid farewell to Fridah, who succumbed to the long arm of preeclampsia, a dramatic condition that only comes second to post-partum haemorrhage in the list of top causes of maternal death. It causes a rise in blood pressure in the pregnant woman, with damage to major body organs, while putting the baby at risk of death. The ultimate treatment of the condition is to deliver the baby to allow the mother’s body to heal. This means that in the face of extreme prematurity, the life of the baby may be sacrificed in order for the mother to live.
Though majority of mothers fully recover within the post-partum period, for a few of them, the high blood pressure may persist beyond this time. For these few, they will have become chronically hypertensive, and in need of life-long treatment.
Unfortunately, for mums like Fridah, when we drop the ball by not insisting on the importance of continued care until the blood pressure is confirmed to have settled, long-term complications set in. The cost of these complications is unfortunate. As we bid farewell to our sister, my prayer is that her death shall not be in vain. With preeclampsia, it is not over till it’s over.