“Patient care should never be a ‘tick-box’ exercise when it comes to being pregnant in your 40s.” Those were my words because that’s exactly how the journey began for me.
At first I was annoyed and, frankly, frightened when a hospital midwife advised that I should consider taking aspirin from Week 14 until the end of my pregnancy. It alarmed me because she had come to this conclusion after seemingly ticking just a few boxes in my notes.
I felt like she had hurried through the human side of my consultation because she was short on time. She had simply ticked one box because I was of ‘advanced maternal age’ at 40 and the second box because I had a BMI of 31. Combined this meant I was at increased risk of preeclampsia.
I knew I was perfectly healthy despite being classed as ‘high-risk’ because of my age. My blood pressure was low and I was already taking vitamins, including folic acid. So why did I need to take aspirin? I was really alarmed it might harm my baby.
The midwife calmly explained to me that taking a daily dose of 75mg – a quarter of a regular strength aspirin – had been proven to help lower the risk of certain complications, such as early onset preeclampsia. A complex condition that occurs in pregnant women and involves an increase in blood pressure and excess protein in the urine after 20 weeks of pregnancy.
A study had shown that women at high risk for preeclampsia who took low-dose aspirin every day after their first trimester lowered their risk of the high blood pressure complication by 24 per cent. Plus, their risk for preterm birth dropped 14 per cent, and their risk for intrauterine growth restriction dropped 20 per cent. Aspirin appeared to improve the blood flow to the placenta, reducing the strain on the circulatory system caused by the growing fetus.
I knew preeclampsia was not to be taken lightly in pregnancy as the condition, combined with high blood pressure, could lead to seizures, stroke, organ failure and even death for mother and baby. It could also rob fetuses of oxygen and nutrients and lead to low birth weight, preterm birth and stillbirth. Yet everything I’d read online about taking aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen during pregnancy filled me with fear.
I’d read online that taking aspirin around the time of conception and in early pregnancy was associated with an increased risk of miscarriage. And some researchers believed that taking aspirin at adult doses during pregnancy might affect the baby’s growth and may slightly increase the risk of a placental abruption.
When I got home from the hospital that day, it sparked real debate in our household on whether I should or shouldn’t take it, despite the midwife’s reassuring words.
Now at the time of my appointment I was suffering from slight heart palpitations and getting up and down the stairs was leaving me a little breathless at times due to increased blood flow. With my symptoms not getting any better, I wondered if the aspirin might ease them.
So I decided to go with the experts. After all, when deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause.
I decided it was better to pop a pill daily than worry about or suffer the devastating consequences of preeclampsia.
I knew after seeking more reassurance from my midwife that there was NO evidence that taking low dose aspirin in pregnancy would cause a problem to me or my baby. I was healthy and I wasn’t taking other medicines affected by aspirin.
I can’t say for certain whether it was the aspirin or not, but shortly after taking it my heart palpitations stopped and I wasn’t breathless any more. I certainly didn’t develop preeclampsia at any stage of my pregnancy, I didn’t develop swollen ankles and I worked right up until a few weeks before I gave birth.
For that reason alone, I would recommend anyone (of any age/BMI) uncertain about taking aspirin in pregnancy to talk it through with their midwife. I do believe it helped me a great deal, although I had no underlying problems.
It has proved to me that the right boxes were ticked at the start which led to excellent care and interactions with midwives. However in my opinion any initial hospital appointment with the midwife should not just be seen as a simple ‘tick-box’ exercise. Human interaction is vital to allay fears.
If I’d been 39 and my BMI had been 30, I would have most certainly slipped through the net. This alarms me greatly as I know younger people, including my best friend, who have endured preeclampsia and if a daily dose of aspirin saved me, then perhaps it could have saved them too?
Preeclampsia symptoms to look out for:
- Rapid weight gain caused by a significant increase in bodily fluid
- Abdominal pain
- Severe headaches
- Change in reflexes
- Reduced urine or no urine output
- Excessive vomiting and nausea
- Vision changes.