Wednesday will mark the third year since May 22, was declared World Preeclampsia Day. The purpose is to raise awareness about the on-set hypertension also known as preeclampsia but known by very few women of child bearing age and expectant mothers. The month of May is also a preeclampsia awareness month
The World Preeclampsia Day marked every May 22, evokes memories of sadness in Kevin Ssebaggala as she recalls losing five of her babies to the fatal health condition. Preeclampsia is an onset of high blood pressure during pregnancy.
The 39-year-old’s terrible experience started in 2007 when she and her husband decided to start a family shortly after their wedding. Their dream to have children turned into misery when it became routine for them to lose the babies prematurely until they decided to stop trying two years ago.
Ssebaggala has had to fruitlessly brave labour pains and caesarean sections twice because the babies died during delivery as the doctors fought to save their lives.
“If my babies had survived, I would be a mother of seven. It is by the grace of God that two are surviving,” says Kevin Ssebaggala, a businesswoman at St Balikuddembe Market, commonly known as Owino.
Memories of the first experience when she lost the baby to preeclampsia at eight months of pregnancy are still fresh. “I remember going to bed with a severe headache. The next day, I went to hospital and a scan indicated that the baby had moved near my heart which made it beat so fast,” she narrates. Ssebaggala did not know anything about preeclampsia and when the doctors said she had high blood pressure, she thought it was the usual hypertension. She collapsed and hit her head on the floor even before buying the prescribed medicine from Mulago National Referral Hospital where she received antenatal care.
“The doctors rushed, induced and I was able to deliver the baby but unfortunately, it was already dead,” says Ssebaggala.
The second time the businesswoman lost her baby was a year after. Again, it was at seven months of pregnancy shortly after she had returned home following her discharge from hospital where she had been monitored for one month. The blood pressure had also remained stable throughout the seven months but rose again four days after her discharge.
She says she felt paralysed in addition to general body weakness. “That night when I lost the second baby, I first got a discharge which the doctors had warned was a bad sign. Then I had to travel all the way from Kasangati to Mulago National Referral Hospital at 1am but the baby was delivered on the way. It was too late for me to get help from a nearby health facility,” she narrates.
However, Ssebaggala was for the first time lucky to have her baby boy alive in 2009 after she had a ceasarean section at seven months of pregnancy, when after several tries by the doctors, her pressure failed to stabilise. Unfortunately in 2012, she lost another baby girl at eight months of pregnancy. In 2014 she lost a set of twins at six months of pregnancy after experiencing severe chest pain.
“The fourth time, I was pregnant with twins but my blood pressure failed to stabilise when I six months pregnant even after staying in hospital for three weeks as doctors did all they could to save the babies. The twins, boys, also passed on bringing the number to five,” she says.
But Ssebaggala would not give up her dream of having more children. She conceived again in 2016 and this time the doctors managed to save her baby girl who is now two and a half years old.
“One time, my brother said I had started gaining too much weight when I was around seven months pregnant. I had also feared to go for antenatal care this time for fear of losing another baby. However, when I finally gathered the courage to go, I was immediately admitted and after a C-section, I was able to deliver a baby girl,” says Ssebaggala.
Losing five children would break any woman and the mother of two says she always felt worthless and tried to escape from her husband for fear of condemnation. “It affected me because even those who heard about my predicament would go around saying I had wronged my family, friends and neighbours who had bewitched me. They did not know that this is a serious condition that every pregnant woman should watch out for,” she says. She adds that at the [preeclampsia] ward, other mothers with the same condition would give her moral support and this made her accept what was happening and the strength to carry on.
Problems in marriage
Luckily, Ssebaggala says her husband is very supportive and has been there to grieve and celebrate with her.
“My husband gave me support though I could see that he was tired. He had children elsewhere. It was painful when I got to know but I understood that he needed to have children. The most important thing is that he would always be there for me,” she says.
In order to save the lives of other women, Ssebaggala has since developed the passion to create awareness and sensitise fellow women about the condition. She works with several non-governmental organisations to sensitise the public through media.
Dr Vincent Karuhanga, a general practitioner at Friends Polyclinic in Kampala, explains that preeclampsia occurs when vessels of the placenta are abnormal and do not give the child enough blood and oxygen.
As a result, the condition weakens the immune system and causes high blood pressure of the mother.
“The child may be born dead or too small while the mother may suffer high blood pressure for the rest of her life, as well as heart issues,” Dr Karuhanga says.
At worst, preeclampsia damages other major organs of the body such as the kidney, brain and liver which makes it irreversible causing death in most cases.
About the condition
According to the World Health Organisation (WHO), pre-eclampsia usually begins after 20 weeks of pregnancy in a woman whose blood pressure had been normal. It can lead to serious, even fatal complications for both mother and baby.
However, although there may be no symptoms, high blood pressure and protein in the urine are key features. There may also be swelling in the legs and water retention, but this can be hard to distinguish from normal pregnancy.
Pre-eclampsia can often be managed with oral or IV medication until the baby is sufficiently mature to be delivered. This often requires weighing the risks of early delivery versus the risks of continued pre-eclampsia symptoms.
Statistics from Mulago National Referral Hospital’s Gynaecology and Obstetrics Department indicate that at least 26 out of the 136 maternal deaths registered annually result from preeclampsia.