Beyoncé Knowles gave birth to twins Rumi and Sir over a year ago, but she didn't reveal very much about her experience until now. In the new issue of Vogue, the notoriously private singer spoke about going through harrowing pregnancy complications, which led to an emergency C-section.
In an essay she wrote for the September issue, Knowles said she was diagnosed with “toxemia” during her pregnancy. "I was 218 pounds the day I gave birth to Rumi and Sir," she said. "I was swollen from toxemia and had been on bed rest for over a month. My health and my babies’ health were in danger, so I had an emergency C-section."
Toxemia—more commonly referred to these days as preeclampsia—is a condition in which you have high blood pressure during pregnancy, the Mayo Clinic explains.
It can cause damage to your organs, most often the liver and kidneys. If left untreated, it can cause serious (possibly fatal) complications for you and your baby, including issues with the placenta, seizures, and heart disease.
Preeclampsia stems from the interaction between your placenta and your body, board-certified ob/gyn Shannon M. Clark, M.D., an associate professor of maternal-fetal medicine at the University of Texas Medical Branch, tells SELF. Early in pregnancy, new blood vessels develop and evolve to send blood to the placenta, the Mayo Clinic explains. But in people with preeclampsia, the blood vessels don’t seem to develop or work the way they should—they’re narrower than normal blood vessels and respond differently to hormonal signaling, which limits the amount of blood that can flow through them.
It's not totally understood why some people develop preeclampsia while others don't, but having an insufficient blood flow to the uterus, damage to the blood vessels, a problem with your immune system, or certain genes that predispose you to having preeclampsia can all play a role.
Other factors that increase the chances you’ll develop preeclampsia include a personal or family history of the condition, having multiples (e.g. twins or triplets), already having chronic high blood pressure, your age (the risk is higher for very young pregnant people and those over the age of 40), and having babies less than two years apart or more than 10 years apart, according to the Mayo Clinic.
Preeclampsia may not cause any symptoms for some people, or it may cause severe issues.
People can have preeclampsia with no symptoms, while others have the condition along with symptoms such as headaches, changes in vision, swelling, and abdominal pain, Dr. Clark says. Preeclampsia can also come with complications like a pre-term birth, placental abruption (a serious condition where the placenta separates from the inner wall of your uterus before delivery), HELLP syndrome (which causes nausea and vomiting, headache, and upper right abdominal pain and signals damage to several organ systems), and eclampsia (which is preeclampsia with seizures), the Mayo Clinic says.
“All physicians know that preeclampsia can go from mild to severe in a matter of days,” Dr. Clark says. “That’s why anyone that’s diagnosed with preeclampsia is monitored very closely.”
Treatment for preeclampsia depends on the severity of it and how far along you are in your pregnancy.
In severe cases of preeclampsia, doctors will either deliver you early or admit you to the hospital where you can be closely monitored, Jessica Shepherd, M.D., a minimally invasive gynecologist at Baylor University Medical Center at Dallas, tells SELF. But if your condition is less severe, or it's too early for you to deliver, your doctor will likely recommend that you are closely managed in an outpatient setting, she says.
That might mean taking antihypertensive medications to lower your blood pressure, corticosteroids to temporarily improve your liver and platelet function, or anticonvulsant medication to try to help prevent a seizure, the Mayo Clinic says.
In the past, bed rest was a common recommendation for people with preeclampsia, but it can actually increase your risk for blood clots and hasn’t been shown to be beneficial, Kara Rood, M.D., a maternal-fetal medicine specialist at The Ohio State University Wexner Medical Center, tells SELF. However, if you (like Bey) tend to be on your feet a lot for work, your doctor may recommend that you take a leave of absence and dial your activity level down until you deliver, Dr. Clark says. Again, this hasn’t been proven to help with preeclampsia, but it may help you monitor your health a little better, she says.
Luckily, having preeclampsia does not mean you're destined to have an emergency C-section, Dr. Rood says. But it may be required if your lab results are “severely abnormal,” or if you're experiencing severe symptoms, Dr. Clark says. Still, “the ideal way to deliver is vaginally, even if the patient has had a seizure and is stable,” Dr. Clark says.
Again, it's possible to have preeclampsia without any symptoms (which is why doctors are on the lookout for it). But if you're pregnant and have any new headaches, vision changes, or swelling in the lower body, hand, or face, it's time to talk to a doctor.