Aspirin and Pregnancy: Reducing the Risk of Preeclampsia

In this episode of the Pulling Curls podcast, Hilary Erickson, RN, delves into the topic of taking aspirin during pregnancy. Featuring insights from her recent campaign with the March of Dimes, Hilary discusses the benefits of low-dose aspirin in reducing the risk of preeclampsia, a condition that can have severe health implications for both moms and babies. She covers what preeclampsia is, who might be at risk, and the importance of consulting with your healthcare provider. Tune in to learn more about this important and evolving aspect of prenatal care.

Find it here on Apple or Spotify Podcasts

Big thanks to our sponsor The Online Prenatal Class for Couples — if you’re looking for the easy way to get prepared for birth, it’s here for you!

Links for you:

My video on Aspirin in pregnancy.

Timestamps:

00:00 Screening for preeclampsia, talking to your provider.
04:14 Consider baby aspirin for preeclampsia; weigh risks.
06:37 Sudden swelling, headaches, and liver pain signs.
10:15 Upcoming episode on motherhood and miscarriage.

Keypoints:

• Hilary Erickson, RN, the host, introduces the topic of aspirin use in pregnancy.
• Preeclampsia is explained as a condition involving the narrowing of small arteries, potentially leading to high blood pressure, organ issues, and severe complications like eclampsia.
• Benefits of aspirin in reducing the risk of preeclampsia are discussed, with an emphasis on starting low-dose aspirin (81 mg) around 12 weeks of pregnancy.
• The host underscores the importance of consulting a healthcare provider before starting aspirin during pregnancy.
• Aspirin’s safety and lack of increased bleeding risks during pregnancy are supported by numerous studies, including some conducted in Europe with higher doses.
• Specific risk factors for preeclampsia are listed, such as hypertension, kidney issues, autoimmune diseases, diabetes, multiple gestations, and more.
• Symptoms of preeclampsia are detailed, including high blood pressure, headache, dizziness, blurry vision, swelling, and right-sided rib pain.
• The ease of diagnosing preeclampsia through urine and blood tests is highlighted, encouraging listeners to consult their providers if they experience symptoms.
• Hilary addresses concerns about aspirin’s historical contraindications during pregnancy and reassures listeners about the new, evidence-based recommendations.
• The episode concludes with a call to normalize discussions about aspirin use in pregnancy among friends, family, and healthcare providers, to disseminate this crucial information.

Producer: Drew Erickson

Transcript

[00:00:00.610] – Hilary Erickson

Hey, guys. Welcome back to the Pulling Curls Podcast. Today on Episode 238, we are talking about Aspirin in pregnancy, so let’s untangle it.

[00:00:08.100] – Hilary Erickson

Hi, I’m Hilary, a serial overcomplicator. I’m also a nurse, mom to three, and the curly head behind Pulling Curls and the pregnancy nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with pregnancy and parenting untangled, The Pulling Curls Podcast.

[00:00:38.340] – Hilary Erickson

This episode of the Pulling Curls podcast is sponsored by the online prenatal class for couples. One of the best things you can do for your pregnancy is to get informed by things like this episode and other things. But it’s really important that you get it prepared from beginning to end. So come join me in the online prenatal class for couples. It truly is the easy way to get prepared for birth. Right before my hiatus, I did a campaign with the March of Dines about aspirin during pregnancy, and I looked up all this information about aspirin pregnancy, why it’s helpful, and I wanted to share that information with you guys today.

[00:01:08.850] – Hilary Erickson

So first off, let’s talk about what preeclampsia is. Aspirin is meant to reduce your risk of preeclampsia. But what is preeclampsia? In case you don’t know, it is a narrowing of the small arteries across the body. A high blood pressure is a symptom of preeclampsia. It happens in about one in 25 pregnancy. It can cause high blood pressure, kidney and other organ issues if it continues. And ultimately, it can progress to eclampsia, which if you’re a down and Abbey fan, you would know about with Lady Sibyl, can cause seizures and ultimately death.

[00:01:39.900] – Hilary Erickson

And it can have other side effects on babies, such as small babies, which we call IUGR, low birth weight on the baby and can cause placental abruption, which is when your placenta detaches from your uterus, which can cause bleeding.

[00:01:53.380] – Hilary Erickson

And it can have long term health issues for both mom and baby. So preventing it or decreasing a risk of it is a huge deal.

[00:02:01.010] – Hilary Erickson

Now, everybody needs to be screened for preeclampsia on aspirin or not on aspirin. At your regular appointments, they likely do a urine dip to check for protein. They check your blood pressure at every appointment. And you can actually self-screen about aspirin prior to your first appointment.

[00:02:16.920] – Hilary Erickson

You can go through to see if you are at an increased risk for preeclampsia, and then you might be at a benefit for taking aspirin. Now, that is something that you need to talk with your provider about. So I’m not giving you the A Okay to take aspirin. You need to talk with them because there are instances in which you should not take aspirin, and I need you to talk with your provider about that.

[00:02:36.470] – Hilary Erickson

So aspirin, they usually recommend a low dose aspirin. So back in the day, we called that baby aspirin, but it’s an 81 milligram dose of aspirin that you start at about 12 weeks of pregnancy. And the idea is that it is helping your placenta as it grows, just open up and have the best chance at blood supply and things like that as it and the baby is growing. Now, first off, I love Love how cheap this is when they came and asked me to help out with that campaign. Aspirin is extremely cheap. It’s just the one you get at the drug store. Some people’s insurance will pay for it if your doctor writes a prescription. But if you forget it, you can run by the Dollar tree and grab it.

[00:03:14.730] – Hilary Erickson

And This can help you and your baby prevent preeclampsia, which I think is awesome. Now, aspirin use in pregnancy has changed a bunch since I have been a labor nurse and also since your mom had a baby. So your parents, siblings, whoever, might start freaking out when you say that you’re taking aspirin during your pregnancy. It has been a big no-no for a long time during pregnancy until they started studying this. Now, I had my first patient who was on aspirin probably five years ago early on the scene, and they said it was to help prevent preeclampsia, which I thought was super exciting. But of course, I was worried because aspirin often can have the side effect of bleeding.

[00:03:51.010] – Hilary Erickson

I will say that I have combed all the studies that I have found. There have been no increases in bleeding, especially at postpartum, because of course, the nurse in me is worried that you’re going to bleed after baby’s born. Nobody wants that happening. But there has not been an increased incidence of bleeding or hemorrhage when you’re taking aspirin during your pregnancy. And you have to remember that this is a pretty small amount.

[00:04:11.370] – Hilary Erickson

In talking with some of the researchers in Europe, they use a larger amount. In the US, we’re being very conservative with just a baby aspirin.

[00:04:18.740] – Hilary Erickson

Of course, I have to say, not everyone should be taking it, so you need to talk with your provider. As with anything in pregnancy, there are risks and benefits that we need to weigh to make sure if it’s the right thing for you.

[00:04:28.640] – Hilary Erickson

Now, I wanted to talk through some of the risk factors for preeclampsia. They include high blood pressure or hypertension before you got pregnant or at any point in your pregnancy, kidney issues, autoimmune issues like lupus, diabetes. If you’ve had preeclampsia on previous pregnancies, either your direct sibling or your mom having preeclampsia, so not the same as if your grandma had it, you’re looking for a sibling or a mom. If you’re pregnant with twins or twiplets, multiple gestation. If you’re overweight, if you’ve had a previous preterm birth or a low birth weight birth, birth, so a small baby, if you’re African-American or Black, if you’re over 35, if you’ve had IVF, if you’re experiencing financial hardships or stressors, and it’s your first baby.

[00:05:10.890] – Hilary Erickson

So as I read through these, I think people start to get really defensive. I hear people sometimes saying, I shouldn’t have to talk about my weight during my pregnancy. And I’m sure there are people when we ask you if you have financial stressors, are worried that we’re being judgy of you. And that’s not the case at all. We’re really asking these questions to check how much stress is your body in, how much stress are you in? So that we can best help you. So I know that some of those questions can feel offensive, but I don’t want you to feel that way at all. So if you have any of those, they recommend that you start a low dose aspirin starting about 12 weeks of pregnancy. They find that it’s best if you start at least by 20 weeks of pregnancy.

[00:05:48.560] – Hilary Erickson

If you guys are listening into it later in your pregnancy and you have some of those things, please talk with your provider at your next appointment to see if it would be right for you. Again, we’re trying to take it at the time when the placenta is growing the most. So if you were only taking it in your last month of pregnancy, I don’t know that the risks would outweigh the benefits at that point.

[00:06:05.420] – Hilary Erickson

And I do know that some people are on aspirin even earlier due to IVF or other issues. And so those people do those people, right? And I did want to quickly go through the symptoms of preeclampsia, so high blood pressure. And now when we say high blood pressure, that means high blood pressure for you. So if you’re a low blood pressure writer and suddenly one of the numbers has jumped 20, then that’s high blood pressure for you, right? And I think that’s really important to mention. Headache, dizziness, blurry vision. Swelling can be a thing, but a lot of people just have swelling. But when it’s a quick onset of swelling, a lot of times people will notice in their face or their nose, that can be a sign of it, as well as right excited pain right below your ribs or your bra line can be your liver is starting to get enlarged. So that shows that your body is getting over this, right?

[00:06:54.480] – Hilary Erickson

One of the things with headache, I’ve heard several times that if you feel like you have the worst headache of your life and you’re pregnant or postpartum, because remember, the preeclampsia can show up any time in that first year, although usually it’s within the first six weeks after a baby is born.

[00:07:09.070] – Hilary Erickson

If you have the worst headache of your life, I totally recommend that you go call your provider, something along those lines. Now, a lot of people get worried with this. So it must be a very complicated disease. Us checking for preeclampsia is pretty easy. It doesn’t involve usually a urine and a blood draw, but it is very easy for us to tell if you either don’t have anything at all, if you just have high blood pressure, or if you have preeclampsia.

[00:07:32.380] – Hilary Erickson

So don’t worry that it’s a big, huge deal to be diagnosed as this. It’s not. It’s very easy to do through lab work. So if you have any concern at all and you’re later in pregnancy, talk with your provider, even if you’re on aspirin. So aspirin is going to lower your chance of getting preeclampsia. It could also lower the severity of getting preeclampsia, or it may even change like you get it later in pregnancy than you would have otherwise. Those are the three things that they’re seeing in the studies. So the three things I want you to take away from this episode is no matter how far along you are, I would ask your provider about aspirin at your next appointment.

[00:08:06.560] – Hilary Erickson

I am seeing a lot of providers who are really hesitant to recommend this, which is a red flag for me. The studies and across the board, generally in OB care, most providers are recommending it if you have the risk factor. So talk with your provider about it at your next appointment just to see what they say, unless you’re in your last month. And I probably wouldn’t. I would save that precious prenatal appointment time for other things.

[00:08:29.800] – Hilary Erickson

Second thing is if your friends or family are like, oh, my gosh, you’re on aspirin. That’s not good for you, to reassure them that this is new research, new and exciting research that’s coming out. And tell them to take a listen to this episode because it really is exciting that we’re even studying medications that you can take in pregnancy for so long. We’ve just been like, Well, we’ll just treat it when it happens, and I’m excited that we’re doing something to prevent it.

[00:08:53.070] – Hilary Erickson

And third, I would encourage you guys to mention this to pregnant friends, pregnant neighbors, people in groups, so that it starts to become the norm. When we started laying babies on their back instead of their belly to sleep, that was a big change.

[00:09:06.060] – Hilary Erickson

And I know when I had babies, my mom was like, Oh, now that baby needs to go on her belly. And that is not the case. We now know that there is a decreased chance of Sids if we put baby on their back. Same thing for this. This is a big change. And the more we talk about it, the more we normalize it with our pregnant friends, a baby showers, and all those different kinds of things, the more likely people are going to be to take it.

[00:09:27.220] – Hilary Erickson

Because I do see in my groups every now and then people saying, My provider recommended that I take aspirin, and I can’t believe they did that. They’re trying to poison me, which that has so many issues in and of itself. But if you think your doctor is poisoning you, please find a new doctor. And also, if your doctor recommend something, I always encourage you to go home and do your own research if you have any questions or concerns, or talk with pregnant friends to see if it’s the norm, which this is the norm.

[00:09:54.060] – Hilary Erickson

So exciting that we are studying things in pregnancy. So exciting that this is a cheap and effective way to reduce your risk of preeclampsia because we are seeing more and more preeclampsia the further we get into life right now. So let’s try and reduce it as much as we can. Hope you guys enjoyed this episode.

[00:10:11.020] – Hilary Erickson

Stay tuned next week. We are talking about having fun at home, which sounds silly, but join me. It’s going to be a fun episode. And then the next time we’re talking about motherhood and miscarriage and how that can affect your motherhood journey. So stay tuned.

[00:10:24.580] – Hilary Erickson

Thanks for joining us on the Pulling Curls podcast today. If you like today’s episode, please consider reviewing, sharing, It really helps our podcast grow. Thank you.

Keywords:

aspirin in pregnancy, preeclampsia, eclampsia, high blood pressure during pregnancy, prenatal care, pregnancy complications, low dose aspirin, aspirin benefits, aspirin risks, preeclampsia symptoms, pregnancy health, pregnancy screening, urine dip test, blood pressure monitoring, placental abruption, pregnancy medication, preeclampsia prevention, pregnancy risk factors, high blood pressure issues, IUGR, low birth weight, pregnant with twins, multiple gestation, pregnancy stress, pregnancy weight, IVF and preeclampsia, financial stressors in pregnancy, aspirin dosage, labor nurse insights, pregnancy studies