Dangerous pregnancies - your thoughts (long)

[lil mermaid]

I have a cousin who is pregnant with Baby #2 and due about 3 weeks after I am (I am due April 12.) She has an adorable DD who will be 2 in February.

Both of her children were conceived via IVF. She was very lucky in that both times she got pregnant on the first try.

During her first pregnancy, she developed pre-eclampsia very early in her third trimester. She was put on hospital bedrest and given steroids to help develop the baby's lungs because they thought that they would have to deliver her as soon as possible - her blood pressure was that high (don't remember the exact number, but it was scary.) They got the pre-e somewhat under control and she was sent home, where she was supposed to continue to be on strict bedrest (although, she didn't do what she was supposed to.)

Before that, early on in her pregnancy, it was suspected that she might have lupus. After the onset of the preeclampsia, it was thought that lupus may be it was contributing to/causing the preeclampsia.

They ended up delivering the baby at 35 weeks. She was thankfully born healthy.

She actually had had blood in her urine for about 10 years, on and off previous to getting pregnant and never knew why. She was supposed to have a kidney biopsy but kept putting it off - for years. After her daughter was a few months old she did have the kidney biopsy and was diagnosed with a kidney disease (and told that she did NOT have lupus.) A few months after that, she started having more lupus symptoms - though was not diagnosed. They do believe that there is something else going on, although it has not yet been resolved.

Also, since her last pregnancy, she has gained a lot of weight. She was a bigger girl before, but she now is probably about 100 lbs overweight, at least.

All of this was known to the infertility doctor.

Her perinatologist has told her in no uncertain terms that she should expect a repeat of the last pregnancy, and that she would most likely have another premature baby and be on bedrest for her entire third trimester. He also told her that the pre-e will cause even more damage to her kidneys. Her blood pressure is already elevated and she has swelling in her face, hands and legs. She is about 21 weeks pregnant.

She was diagnosed with gestational diabetes last week.

I am very scared for my cousin and her family - and I am sort of irritated at the same time. She is acting like this is no big deal, when in reality it is something that can kill her! She says that she wants to have five children. She is also unconcerned about the fact that she will likely have a premature baby. After all, her daughter was born healthy, and she believes that any other children will be the same way. I don't know if she is in denial, or just not very smart.

Her mother (my aunt) is beside herself - she is scared that her daughter will die.

Okay, so here is my question. In your opinion, is it ethical for a fertility doctor to even do the procedure on someone with these kinds of issues? And how ethical is it to purposely get pregnant when you have these kinds of issues?

I know that some of you will think that I am being judgemental - and I guess that I am. I am very concerned, especially since she now has a daughter to think about.

 

[mtemm]

(((HUGS))) and prayers for your cousin. I'm not going to go into the ethical question, I just hope she has a healthy remainder of her pregnancy and a healthy baby. How very scary. Is there a reason why her peri told her she would likely have pre-e again? Often it happens in a first pregnancy, but not in subesquent ones (assuming the same father). So perhaps there is still hope.

I'm also not sure that bp that is elevated at 21 weeks is pre-e. Its been a couple of years since I read up on it, but doesn't it have to be a bit later in the pregnancy for it to be pre-e? I had PIH with my first, it didn't end up all the way to pre-e, just elevated pressure. Then I had pre-e with my second pregnancy. (I hadn't expected problems based on my research, but I ended up with twins and multiples increase chances of pre-e).

If she does end up with it, I hope she does adhere to what the doctors tell her to do. I'm sure she is scared, even if she does put on a brave face.

 

[MushyMushy]

Okay, so here is my question. In your opinion, is it ethical for a fertility doctor to even do the procedure on someone with these kinds of issues? And how ethical is it to purposely get pregnant when you have these kinds of issues?

I know that some of you will think that I am being judgemental - and I guess that I am. I am very concerned, especially since she now has a daughter to think about.

You probably opened up a can of worms, but I'm not afraid to bite.

I've known a couple of people who insisted on getting pregnant again and again and again, not considering the risk to themselves at all. I just don't get it. I really don't understand, particularly those who, like your cousin, have a child they might be leaving motherless!

You would think the father would step in and say enough is enough, but the ones I know didn't.

 

[KirstenB]

With these multiple health problems, that can't be a healthy environment for her developing baby either. There are certain people you just can't reason with, and she sounds like one of them. I hope she and her baby come out of this healthy.

 

[DisDaydreamer]

WOW... a real problem. I guess if the doctor is giving all the right information to your cousin then it is her decision and not the doctor's. A doctor can only advise. I pray all will be well with this next birth and your cousin will be satisfied with her family makings. I don't know what else to say.

 

[lil mermaid]

(((HUGS))) and prayers for your cousin. I'm not going to go into the ethical question, I just hope she has a healthy remainder of her pregnancy and a healthy baby. How very scary. Is there a reason why her peri told her she would likely have pre-e again? Often it happens in a first pregnancy, but not in subesquent ones (assuming the same father). So perhaps there is still hope.

I'm also not sure that bp that is elevated at 21 weeks is pre-e. Its been a couple of years since I read up on it, but doesn't it have to be a bit later in the pregnancy for it to be pre-e? I had PIH with my first, it didn't end up all the way to pre-e, just elevated pressure. Then I had pre-e with my second pregnancy. (I hadn't expected problems based on my research, but I ended up with twins and multiples increase chances of pre-e).

If she does end up with it, I hope she does adhere to what the doctors tell her to do. I'm sure she is scared, even if she does put on a brave face.

I don't know why he told her that exactly - I believe that it is because it is very common in patients with the type of kidney disease she has. She does already have high blood pressure and swelling, although I don't believe she has the protein in her urine (you need all 3 to have pre-e, right?) I thought from reading up on it that pre-e can be any time after 20 or so weeks, though I certainly could be wrong there. Anyhow, she hasn't been diagnosed with it yet.

Thanks for the good thoughts.

 

[Beth76]

I know that some of you will think that I am being judgemental - and I guess that I am.

Of course it's none of your business, but that doesn't mean you can't talk about it. I totally get what you're saying. I do agree that it seems she's being completely irresponsible about that. I certainly hope that she and her baby make it through this pregnancy just fine and that she decides not to try to have any more babies.

 

[Acklander]

I've been on the other side of it, so I guess I can see it from your cousin's point of view. I had very high risk pregnancies, personal health issues, etc... and went through IVF with my second child. I went over all the issues with my fertility Dr. and once pregnant I transfered to an OB who only dealt with high risk pregnancies. I don't think it was unethical of my Dr to do the IVF procedure, he informed me of all the challenges, I did my research and then my husband and I made the decision. I would only consider it unethical if the Dr. had withheld or made unrealistic promises, other than that - it's a personal decision. I had a fantastic OB, who worked with me and I had a strong support system with family to help me through the challenges when I had surgery to have a cerclage put in (to help prevent premature birth) and once I was on bedrest.

 

[The Mystery Machine]

I also had 2 high risk pregnancies delivering at 35 weeks. Now I did not go to a fertility doctor, not sure what I think about that.

I have talked to people that have had bad and then good, good and then bad. So you never know, I guess.

In your cousin's case she sounds like she wants kids at the expense of her own self.
Heck, maybe she is in denial or blind to her own needs.

 

[babynurse1]

I think that her fertility doctor is so in the wrong. (S)he knows the risks, yet continues to aid her in what could be a disatrous ending.

I have had patients that have done the same thing. My last one did not have a positive ending. The mom was sooo in denial! It was her 4th high risk pregnancy, and after the baby was born she kept saying "I'm so glad she's healthy" I was like "Lady, you just don't get it do you?" But of course I had to keep my mouth shut.

A few days later the baby took a turn for the worse, and I hate to say what happened. Many people think if they have one 34 or 35 week baby and everything was ok, then the next one will too. Sadly, this is not always the case.

I wish she could see how important it is to be alive and well for the babies she does have, and not try to obtain her idealistic family, which could have a very sad result.

 

[MareQ]

Anyhow, she hasn't been diagnosed with it yet.

Thanks for the good thoughts.

Doesn't mean she will be either. I had VERY mild Pre-E with my first. With my second I had SEVERE pre-e - never progressed to out and out eclampsia but I had to be hospitalized, full bedt rest on mag sulphate and was induced as soon as I hit 37 weeks. I had blood pressure issues for months after that too. Then - Low an behold WHOOPS here comes our unplanned baby # 3 - at my all time heaviest weight to boot. I was frightened - however it was by all means a picture perfect pregnancy (except for the fact that he kept flipping breech on me during my 9th month but that was just his own little comical personality coming through )

Be concerned for her but try not to judge her. Common sense would tell her to not do this again but we all know that sometimes the ache to have a baby throws all common sense out the window.

 

[golfgal]

I think SHE is in the wrong, I don't know about the dr. There was also the chance that this pregnancy would be ok too. I know a lot of people that had pre-e with their first and had perfectly normal pregnancies with their second.

I had a friend that was in a drug induced coma because she had such major issues being pregnant with her first, almost died several times with her second and STILL went on to had a third. She had major issues with the pregnancy and thankfully everything turned out ok but what if it hadn't, those other two kids would be without a mother.

 

[rie'smom]

I think it's nice that you're concerned but it's your cousin's decision. She's taking a risk but there are many pregnancies that are 'normal' and end up being catastrophic. As long as your cousin is informed about the risks and is not mentally incompetent, the choice is hers.

 

[Pigeon]

If it were me, I'd never have gone for the second baby and put the mother of my child at risk.

However, as someone who is ardently pro-choice, I believe 100% that it's her body and her decision.

So, I think you should send positive thoughts her way but keep your opinions to yourself.

 

[honeymom]

Pre-e is more common in first pregnancies and often not a problem in the second. I don't know if her perinotologist told her that she would definitely have a problem before she chose to get pregnant or after she was already pregnant.

I have a sister in law who had serious medical issues with the last 2-3 of her 5 pregnancies. On her last one, she fainted from high blood pressure and one of her sons (about 10 at the time) had to run and get a neighbor who then called emergency services (they live in France) who got her to a hospital and delivered the baby. Thankfully she has stopped having children and all of the children were healthy.

 

[*Fantasia*]

She is being selfish if you ask me. She didn't even consider that this pregnancy might hurt the baby and herself and it might even be life threatening and she is not even thinking that she might leave her daughter behind. She is being careless.

I am sorry for her and for her unborn child, and especially for her daughter who might be left without a mother.

My hugs to you... I just hope that at the end that everything is going to be fine.

 

[lil mermaid]

Thanks ya'll for your thoughts. I think I was really alarmed when I saw her a couple of days ago - she really looks ill. Swollen and red and really unhealthy and very different from the way she looked just a few weeks before. Something just really looked "wrong." I know it is her decision - I just can't believe that she made it. I wouldn't say anything to her - that is why I am writing this here. None of you know me personally.

I know that pre-eclampsia doesn't necessarily occur in subsequent pregnancies. I believe that the doctor told her that because it is very common with the type of kidney disease she has - there is a correlation. Also because her blood pressure is already elevated.

They are not only concerned about the pre-e - There is also concern about the damage an additional pregnancy will do to her already damaged kidneys. She had the disease for a number of years before she ever had any treatment for it. There is also the fact that she may have lupus or some other autoimmune disease - they don't know what.

 

[lil mermaid]

My hugs to you... I just hope that at the end that everything is going to be fine.

Thank you - so do I.

 

[MsLeFever]

I had 2 preemie babies (that luckily are very healthy children now). Having had preecclampsia twice - I wouldn't have a third pregnancy. I wouldn't take the risk of another preemie and I wouldn't take the risk of leaving the precious children that I have now!

 

[barkley]

i can only speak for myself. i was diagnosed with severe scoliosis at around age 12. i underwent years of physical thearpy and close to 4 years in a full body (milwaki) brace. my parents and i were warned that a pregnancy could result in major detrimental adverse to my back (including permanant disability).

when i considered pregnancy 20 odd years later i consulted physical therapists as well as orthopedists who offered suggestions on how i could best prepare my body should i choose to become pregnant. the ob/gyn i consulted with was direct with his concerns about the toll a pregnancy would take on my body-and the best and worst case scenarios. he was also honest on what his opinion was about a woman endangering her life or her ability to care for a newborn should she become totaly disabled.

i balanced my options, opted to go 'full bore' with pt to put my body in optimal shape, have an evaluation at that point and then decide if preganacy was a viable/reasonable choice for me (and dh-afterall, he would be the one who would have to care for me and our child should i become totaly disabled).

i would neve encourage someone to endanger their life to have a child-it's unfair to the surviving spouse as well as the child to know that the child's birth was the absolute reason you were not around to parent.