Pregnancies from hell: Hypertension, hydramnios and more

Katherine Keeling is your typical Type A personality: a determined, no-nonsense workaholic who thrived in her fast-paced job as a property manager for a large Toronto corporation. But last year, a positive pregnancy test brought her life to a screeching halt.

It wasn’t the first time she had seen that little pink plus sign. Even though Katherine was only 33, she and her husband, David, had been struggling to become parents for years. They had already endured four miscarriages (one with twins), three rounds of in vitro fertilization and four frozen embryo transfers over seven years. But finally, a pregnancy stuck—they had a baby on the way. Because her body had previously rejected the growing embryos, Katherine had to take intralipids through an IV for three hours each month at a clinic, which depressed her immune system so it wouldn’t reject the growing fetus. That was inconvenient, but they had no idea it was just the beginning of one crazy roller coaster ride of a pregnancy.

First up, at seven weeks, was the discovery of a small subchorionic hemorrhage (SCH), which is a bleed or a clot that can cause the placenta to tear away from the uterine wall if it gets too large. When she started bleeding, Katherine assumed she was having another miscarriage. So, while many women would panic at the discovery of a SCH, she was actually relieved she hadn’t lost the baby. The solution? Slow down. For Katherine, that was easier said than done. “My job is a high-stress position and I’d been there less than a year. So there I was, only in my first trimester and I had to go to HR to work something out.”

Luckily, regular monitoring of the SCH showed it was resolving on its own. But then Katherine’s blood pressure started to rise. In her second trimester, she was diagnosed with hypertension and had to do blood pressure checks every night, and keep a journal of her activities. It quickly became clear that her job wasn’t conducive to staying relaxed. The doctor gave her a choice: Go on medication to bring her blood pressure down, or go on bed rest.

“I had concerns about the meds,” Katherine says. “With how much we went through to get pregnant, I didn’t want to do something that might jeopardize it when I knew that just being at home could solve the issue. Of course, the baby was always my top priority, but I also really wanted to find a way to ease out of my job instead of just dropping everything. I felt like I was abandoning them. But when I was 23 weeks along, the doctor said, ‘You’re done.’”

She took a medical leave, but didn’t truly start the “rest” part until her husband threatened to take away her phone to stop the steady stream of calls from colleagues. “I was insanely bored,” says Katherine. “To go from being busy all the time to being forced to sit on my butt all day was like torture. I watched more shows on Netflix than I can count.” She’d get an early start to the long days, too, waking up with her husband at five so he could set her up on the couch and make her breakfast and lunch so she wouldn’t have to do much.

Bedrest helped to ease Katherine’s hypertension, but not her pregnancy drama. Around the 25-week mark, she failed her first glucose screening test. And then her second. She was diagnosed with gestational diabetes and tried to control her insulin levels through diet, but it didn’t work. “I would eat one fried egg and a slice of toast and my blood sugar would skyrocket,” she explains. So she had to start injecting herself with insulin every day, keeping a food journal on top of her blood pressure diary, and meeting with a diabetes specialist every two weeks.

Throughout her pregnancy, Katherine says she saw a doctor and had an ultrasound practically every week. “I was a nervous wreck the entire time—I’m prone to panicking about everything. My doctor warned me that the hypertension could cause my baby to be small, and the gestational diabetes could cause him to be large, so we needed to monitor his growth closely.”

These weren’t the only new concerns. Katherine’s fluid levels had been rising because of a condition called hydramnios, which is when your body produces an abundance of amniotic fluid. In some cases, it’s just a small amount of extra fluid and doesn’t pose great risk. But when it’s severe, which, as luck would have it, was the case with Katherine, there are many potential issues, including that the baby may not be ingesting enough, or that there’s too much room in the womb and the cord could wrap around the baby. It also meant her water might break and the cord might come out first, causing the baby to lose oxygen. Hydramnios also makes you look way more pregnant than you actually are. “I just kept getting bigger and bigger,” she says. “There’s only one picture of me during my entire pregnancy at about 27 weeks, and I looked like I was about to give birth.”

Then, they realized the baby was measuring big. He had been tracking on schedule for a while, but by 30 weeks, he was measuring almost a month ahead of schedule—and was already an estimated 8 pounds, 9 ounces and a foot long. At her checkups, her doctors started hooking Katherine up to monitors regularly to monitor his heart, since his size could cause strain. She was warned that if her waters or blood pressure got to a certain level, or if there were any issues with her son’s heart rate, they’d have to perform a Caesarian section immediately.

In the meantime, Katherine tried to manage the stress of it all, including the physical limitations.

“My tummy would touch my steering wheel, and getting in and out of the car was like trying to squeeze out the toothpaste at the bottom of the tube,” she says. “Dropping anything would nearly make me cry because I knew there was no hope that I would be able to pick it up—my cats ate like royalty with all the stuff I dropped and left! I insisted on doing a lot of things on my own and not getting help, which was probably the worst thing ever.”

Katherine tried to keep her mind on the end goal. “I was in a weird disconnect. Part of me was just happy to be pregnant. I told myself: I never thought this was actually going to happen—this is freaking awesome! Throw what you want at me, I can deal with it,” she says. “But another part of me was a little detached. You see the moms rubbing their stomachs and glowing, and that wasn’t me. In the back of my mind I was setting myself up to expect the worst. I warned myself not to get too attached until the baby was actually out.”

Then, the notorious December 21, 2013 ice storm hit Toronto with a wallop, leaving thousands without power—including Katherine and David, whose first thoughts were about what would happen if she went into labour. “I remember us sitting on the couch, discussing by candlelight what would happen if my water broke, or what we’d do if the blackout was still happening and I needed a C-section. The city was in chaos. Who would we call? When would we go? I started freaking out. I said, ‘It would be the worst thing ever if I went into labour right now.’”

And then, she did.

At least, she thought she did. Katherine started having contractions on Christmas Eve. They were a new sensation to her and she wasn’t sure what was going on, but eventually they dissipated and she realized they must have been Braxton Hicks contractions. They stumbled through what Katherine calls a strange “Charlie Brown Christmas”—no decorations, David working lots of hours, Katherine so uncomfortable—but still hosting family since they were the only ones whose power had returned.

At the end of the first week of January, at 32 weeks pregnant, Katherine went into preterm labour. Her contractions were hard and quick and she knew they had to get to the hospital—it was too risky for her water to break at home. “I was excited. And terrified. You really couldn’t surprise me with anything by this point. My attitude was sort of ‘Let’s do this!’ because by this time, we didn’t really have a good handle on the baby’s state. There was so much fluid that he could swim away from the sensor during ultrasounds.”

But her labour didn’t progress, and the couple was sent home to wait a little longer to meet their boy—but not much longer. With growing concern about stress on the baby and his size, doctors scheduled a C-section for January 23. But baby boy Keeling decided to kick-start things. Contractions started again the night before, and Katherine waddled into the hospital again, only be sent home again once the contractions let up. “We did all our paperwork, though,” Katherine laughs. “We left and said we’d see them in a few hours.”

The next morning, Katherine and David welcomed their healthy baby boy, Bruce, at 34 weeks’ gestation. He was eight pounds, nine ounces and 21 inches long. “There were tubs to catch all the fluid and they overflowed,” Katherine remembers of her delivery. “I don’t think they were prepared for the amount. I remember someone saying, ‘Oh my God, my shoes are soaked!’ I lost 60 pounds immediately after having my son.”

Today, Bruce is a bustling one-year-old who his mom says is way ahead of the curve, despite his early arrival. “He’s an easygoing kid and loves to laugh. He’s our joy.”

A version of this article appeared in the May 2015 issue with the headline "Pregnancies from hell," pp. 84-88

Want to read about more pregnancies from hell? Pregnancies from hell: an incompetent cervix Pregnancies from hell: Twin-to-Twin Transfusion Syndrome