Scary Shit Series – Preeclampsia

Last Updated: December 2025

Preeclampsia affects about 5–8% of pregnancies and can escalate quickly from mild symptoms to a life‑threatening emergency. The good news is that when it is caught early and monitored closely, many women and babies do very well.

If preeclampsia were a person, it would be that unassuming guy at a party who farts then walks away from a conversation to go piss in the punch when no one is looking. It seems quiet and harmless, but it’s sneaky and mean.

What is preeclampsia?

Preeclampsia is a pregnancy complication involving new‑onset high blood pressure and signs of organ stress, usually after 20 weeks of pregnancy. It happens when the blood vessels that supply the placenta and your organs do not function normally, which can raise blood pressure and damage organs like the kidneys, liver, and brain. Fun, right?

It typically develops after 20 weeks of pregnancy and can also appear after birth, up to six weeks postpartum. The highest postpartum risk is in the first week after delivery, especially in the first 48 hours.

Why it’s dangerous:

It can restrict blood flow to your placenta, increasing the risk of premature birth or a smaller baby.
It can injure your kidneys, liver, and brain and may progress to eclampsia (seizures) or stroke if not treated promptly.

The catch: Symptoms can mimic normal pregnancy discomforts, and some women have no noticeable symptoms at all. This is why your healthcare provider checks your blood pressure and urine at every prenatal and often postpartum visit.

5 critical warning signs

If you notice any of the following, contact your healthcare provider or go to labor and delivery right away. This is not a “wait and see” situation.

1. Sudden facial and hand swelling

While some swelling in the feet and ankles is common in pregnancy, sudden or severe puffiness in your face, hands, or around your eyes is a red flag.
Pay attention to swelling that appears quickly, feels different from your usual pregnancy swelling, or is getting rapidly worse, and seek evaluation promptly.

Now, let’s be honest, I got ‘puffy’ all over when I was pregnant and could have been cast as Violet Beauregarde in Charlie and the Chocolate Factory, so I’m not sure I would have noticed this one. Still, it’s a good symptom to watch for.

2. Sudden weight gain from fluid

Rapid, unexplained weight gain over a few days can be a sign that your body is retaining excess fluid, especially if it comes with swelling in your face or hands.
Rather than focusing on a specific number, watch for sudden changes that feel out of the ordinary for your pregnancy and report them to your provider.

Again, this is from the woman who gained 5 pounds in a week, although I think I was retaining Dairy Queen and not fluid.

3. Nausea or vomiting after the first trimester

You *should* be over any morning sickness at this point so nausea and vomiting that kinda comes out of left field should be brought to your doctor or midwife’s attention.
When these symptoms show up suddenly in the third trimester – especially together with headaches, vision changes, or pain under your ribs – they need urgent medical evaluation.

4. Sharp pain below right ribs or in shoulder

Pain under your right ribs, in your upper abdomen, or that feels like deep pinching along your bra strap or right shoulder/neck can signal liver involvement or a related condition called HELLP syndrome.
This pain may worsen when you lie on your right side or take deep breaths and should be treated as an emergency. (I guess it’s sound advice not to ignore any kind of severe pain).

5. Persistent headaches or vision changes

Severe headaches that do not improve with usual measures, or that feel different from normal tension or sinus headaches, can be a sign of severe preeclampsia.
Seeing spots or flashing lights, having blurry vision, light sensitivity, or temporary loss of vision suggests serious brain involvement and requires urgent care.

Yes, I know

“Why, thank you! I’m pregnant, so I’m completely unfamiliar with swelling and weight gain,” you say sarcastically. This is one of the many reasons preeclampsia is such a dick.

Not only does it often present similar symptoms to a normal pregnancy, but you may also have no symptoms at all and be completely floored by the news that you have this potentially dangerous condition. This is why it’s important to pee in a cup all the time and it’s why your blood pressure is seemingly taken every ten seconds after you’ve had a baby.

Who is at higher risk?

Preeclampsia can happen to anyone, even without risk factors, but some women are more likely to develop it.

Common risk factors include:

First pregnancy (first‑time mothers)
Previous preeclampsia in an earlier pregnancy
Family history of preeclampsia (mother or sister)
Age under 20 or over 40
BMI of 30 or higher before pregnancy (pre‑pregnancy obesity)
Carrying multiples (twins, triplets, etc.)
Pre‑existing conditions such as chronic high blood pressure, kidney disease, or diabetes

So, basically everyone at some point. Good times.

Treatment and monitoring options

The only true cure for preeclampsia is delivery of the baby and placenta, but careful management can often give your baby more time to bake while keeping you as safe as possible. Treatment depends on gestational age and the severity of your symptoms.

Before about 34 weeks of pregnancy

Close monitoring of your blood pressure, lab tests (kidney, liver, platelets), and your baby’s growth and well‑being, often with more frequent visits or a hospital stay.
Blood pressure medications to keep your readings in a safer range if they are high.
IV magnesium sulfate to prevent seizures if you have preeclampsia with severe features or eclampsia risk.
Your provider may recommend modifying your activity level and possibly staying off work, but routine strict bed rest is no longer recommended for everyone because it does not clearly improve outcomes and can carry its own risks.

After about 34–37 weeks (depending on severity and guidelines)

Delivery is usually recommended once risks of continuing pregnancy outweigh the benefits, especially if there are severe features.
Labor is often induced so you can aim for a vaginal birth, with C‑section reserved for standard obstetric reasons or if you or your baby cannot safely tolerate labor.

Postpartum period (up to 6 weeks after birth)

Preeclampsia can first appear or worsen after delivery, so blood pressure and symptoms should be monitored closely, especially in the first week.
You may need blood pressure medicine, magnesium sulfate, or even hospital readmission if you develop warning signs such as severe headache, vision changes, shortness of breath, or right‑upper‑abdominal pain.

There’s a fine line here. I don’t want to scare you because even if this develops, it usually doesn’t escalate into anything severe, but I do want to emphasize the importance of keeping an eye out for these things and taking this condition seriously.

A Real Story: Why You Shouldn't Downplay Symptoms

My friend developed preeclampsia with her first baby. When her doctor suggested bed rest and testing, she went home but didn't mention her blurry vision and swollen legs because she didn't want to seem like she was complaining.

The next day, she packed in activities: IKEA shopping, the driving range, dinner, and late-night dessert. When her doctor finally reached her, she was immediately hospitalized, given magnesium sulfate in a darkened room, and induced.

Both she and her daughter came through safely, but it taught us an important lesson: you don't have to feel severely ill to be seriously sick. Speak up if something new is happening.

Your Action Plan

Don't skip prenatal appointments - routine blood pressure and urine checks catch preeclampsia early
Track your symptoms - note any sudden changes, even if they seem minor
Know your risk factors - discuss them with your healthcare provider
Monitor yourself postpartum - risk continues for 6 weeks after delivery

So keep your prenatal appointments and stay alert for any sneaky symptoms and don’t let that party farter piss in your punch.

Here are some other helpful resources:

Preeclampsia Foundation - Excellent symptom checklists, stories, and printable resources for patients and families.
NHS - Clear overview of symptoms, diagnosis, treatment, and when to seek urgent care.
Mayo Clinic - Easy‑to‑understand summary of risk factors, complications, and treatment options.

About the Author
Amy Morrison is the founder of Pregnant Chicken, where she's been writing about pregnancy and parenthood with humor and honesty since 2010. As a mom of two boys, Amy combines real-life experience with thoroughly researched information to help parents navigate the messy, wonderful, and sometimes scary parts of pregnancy. Her straight-talking approach has made Pregnant Chicken a trusted resource for hundreds of thousands of parents who appreciate advice that's both practical and refreshingly real.