Pregnancy, Labor, and POTS - What should I prepare for?

[MyBabyLove2274]

I am 22 weeks pregnant with my son and I have been diagnosed with POTS/Hypotension for almost 4 years now.  I have been researching POTS and Pregnancy because I want to be prepared for the worst.  Originally my greatest worry was passing out during labor (possibly not waking up), now I realize there are many more complications to pay attention to.  I would greatly appreciate any comments, articles, and experiences with your pregnancy/labor&delivery with the combination of POTS.

1. What are the risks if you pass out during labor or even before the epidural?
2. Which do you find is safer for the mother and baby: vaginal birth or caesarian birth?
3. What is your biggest worry with POTS and Pregnancy?
4. Do you have any other information that could be helpful in my pregnancy?

[MH Community Mgr]

Hi,

As a general reminder, it's always important to speak with your medical provider regarding what is the best treatment plan for you and your baby.

Thanks,
Cheryl

[puregospeltruth]

I see this is an old thread but still wanted to share my story incase it helps anyone searching online about this topic.
I also have Dysautonomia. My first and second pregnancy were very similar. Low blood pressure, passing out, low blood sugar, tachycardias, sensitivity to the sun. For the first two or three months of both pregnancies I was pretty much bed ridden. I felt pretty good after that with occasional symptoms. I am 41 weeks pregnant with my second child so I don't know how this birth will go. But with the first one, I had a wonderful obgyn who works like a midwife. He encouraged me to try a natural birth with no epidural, all natural. Because the epidural lowers your blood pressure and can be deadly for people with POTS. I was in the hospital in labor for 12 hours, it was a wonderful time, yes painful but I had zero symptoms of POTS. My doctor and doula did everything possible to keep me hydrated, cool, well fed during this time. I took lots of hot showers that would help with the pain and it would also cool me down after I got out. Unfortunaltly my baby wouldn't drop even though I dilated the 10cm. Long story short my baby went inside and I needed an emergency C-Section. Because the epidural drops your blood pressure the doctor ordered a very low dose of local anesthesia. So low, I could feel the cutting and cauterizing, it was torture, painful, horrible! The heat of the lights in the operating room were letting heat out, I started to feel really hot and uncomfortable and eventually passed out. I passed out completely two times during the surgery and then went into convulsion. I felt I was dying. Thankfully the baby and I made it out alive. I would choose a natural birth anytime over a c-section. For this birth, I'm taking extra precautions incase I need a c-section again. Essential oils, to calm down and de stress, a hand fan for my doula to fan me, and ice to cool me down if I get to hot. I think and hope with these things I should be able to manage. Hope this was of help!

[MyBabyLove2274]

It is always good to hear a POTS Pregnancy success story, thank you.  I am having symptoms during my pregnancy.  Now I am almost in my third trimester and I am hoping they will not worsen as I get farther a long.  I have done a lot of research, taken classes, and talked to some great doctors.  I am not as scared now and much more prepared.  I am going to try to have a natural birth and I am leaning towards no epidural due to the complications it causes with hypotension and it also slows down the labor process which increases my chances of passing out by Valsalva.  Now I have a great team together and now all we can do is wait and hope for the best.

[Cyn1974]

I had POTS and Dysaughtonomia for 3 years and fell pregnant with my son. I was told not to by the Doc but decided to proceed and found the symptoms were less during the pregnancy.  I also had a C-Section as I went low on fluid and my son was breach.  No other complications, both my children are fine but unfortunately the symptoms will return after the birth or at least this was my experience. I would suggest the stress of labor is not very good for the condition.
Cyn

[MyBabyLove2274]

My biggest worry as well is whether or not my son and I will make it through to the delivery.  I do have a few questions about your responce.

The weekly visits you had after 26 weeks were they ultra sounds to check on your son, doplar, or something else?  
What was the factor that put you on bed rest?  I wonder if I will be bed ridden as well due to my history of passing out so easily.  
Your recover after your C-section is quite amazing.  Did you get put to sleep during the operation or were you able to stay consious without complications?  
Did you have an epidural?  
Did you pass out at all during your delivery?

I have found some women with POTS have mortality risks from blood loss, cardiac arrest, etc...  Some of the stories are quite terrifying.  Then there are others that go by smoothy with the acception that the vaginal births were forceps and vacuum assisted.  I hope that all the information I find will help my delivery go smoothly for me as well as my son.  After my findings and experiences maybe I will be able to help other POTS moms-to-be.

Thanks for your help

[MyBabyLove2274]

Thank you for you help and sending me the articles.  I could only bring up the second.  For some reason the first one wouldn't work.  If you find anything else it would be very appreciated and I will deffinetly post my findings when I have done all my reaserch and I will include my own case as well.

[Asher812]

Hi Again.  I don't know about the epidural and passing out.  My doctor didn't give me the option for natural child birth.  It was c-section only for me.  The concern was that I would get too sick to do what is necessary during natural birth.  In fact, my doc didn't even want me to go into labor.  They scheduled to take my son by c-section at 36 weeks.  Labor itself was going to be too much for me to handle. My biggest worry about POTS was being able to get to the end of the pregnancy.  My doctor had me come in on a weekly basis starting at 26 weeks.  He would always check the baby to make sure he was getting everything he needed and made sure that I was surviving ok.  We just keep saying, "get through one more week". I was put on bed rest at 29/30 weeks.  By 34 weeks I couldn't even get to the bathroom without collapsing.  That day my doc decided to take my son by c-section.  I know they talk about how c-sections can be painful for awhile after.  For me, I had the c-section at 11;48pm on 7-7-07 and by 8am I was up and walking around.  I hadn't felt that good in months!!  My son was pulling all my blood and as soon as he was born, my body recovered quickly.  I was walking around the next day like nothing had occurred.  

I hope that helps a little bit.  Let me know if I can try to help with something else!