Labor And Delivery

Applicable Questions and Answers Listed Below:

What will my labor and delivery be like with POTS?

Added fear around labor and delivery is completely understandable for women who are pregnant, especially given the added uncertainty and unpredictability. We will do our best here to offer added comfort and helpful information. We hope that your labor and delivery is in line with your expectations and desired birth plan, so we first want to speak to this and make room for what may be coming up for you as you proactively prepare. Added compassion and empathy is so important as you prepare to give birth to your child (or children). Although we can’t fairly predict what your labor and delivery will be like with POTS, there is some research available that we hope helps you and your medical team create a safe labor and birthing plan you feel confident in.

It appears to be very important to manage pain effectively, where considering the benefits of early epidural anesthetic management may be helpful, with adequate IV hydration beforehand given the potential for drops in blood pressure (hypotension) associated with its administration (Morgan et al., 2022). In the event that a vasoconstrictor is needed, researchers do mention the potential use of phenylephrine, as it may “help prevent reactive tachycardia caused by peripheral vasodilation, which may lead to hypotension,” which is an important consideration for your providers to be aware of in the event that it is needed (Morgan et al., 2022).

Although some researchers do appear to caution against home births for individuals with POTS given the potential for vital sign variability, and caution against natural births given how pain can influence autonomic nervous system functioning, it is important to note that data available is quite limited, as we don’t have access to large clinical studies (Morgan et al., 2022). Ultimately, you know your body best, and we recommend having these important discussions with your medical team as you weigh all of your potential options.

Do I need to have a C-section?

Not necessarily, no, but this decision should be made based on a number of factors including various obstetric considerations (Kanjwal et al., 2009). In Kanjwal’s study specifically, 81% of patients had vaginal deliveries and 19% had C-sections with no delivery complications (Kanjwal et al., 2009). Although a great deal of the literature does support vaginal delivery as being preferred and safe for many with POTS, it appears to be recommended to focus on obstetric/surgical considerations when determining what is best for each individual patient, given the lack of large clinical studies available and reliance on smaller studies and case reports (Morgan et al., 2022).

Sources:

Kanjwal, K., Karabin, B., Kanjwal, Y., & Grubb, B. P. (2009). Outcomes of pregnancy in patients with preexisting postural tachycardia syndrome. Pacing and Clinical Electrophysiology, 32(8), 1000–1003. https://doi.org/10.1111/j.1540-8159.2009.02430.x

Morgan, K., Smith, A., & Blitshteyn, S. (2022). Pots and pregnancy: A review of literature and recommendations for evaluation and treatment. International Journal of Women’s Health, Volume 14, 1831–1847. https://doi.org/10.2147/ijwh.s366667

Labor And Delivery

Awareness for POTSies

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Devault, PA 19432

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Awareness for POTSies was founded in 2021. This website was developed with love and a great deal of time and commitment to our community. When sharing any content we developed, we ask that you cite our organization and resources appropriately.