Meghan Markle Details Her "Scary" Postpartum Preeclampsia — Here's What That Means

Pregnancy can come with a whole host of side effects — from pregnancy nose to gestational diabetes. It can also be accompanied by certain complications, with some more serious than others. One potentially fatal complication is preeclampsia.

Preeclampsia is a condition that usually develops in the third trimester of pregnancy and is characterized by high blood pressure, says Stephanie Hack, MD, an ob-gyn and the founder of Lady Parts Doctor. "It can affect multiple organs and is a precursor to eclampsia, a condition with high blood pressure and seizures." The condition can also happen after childbirth, known as postpartum preeclampsia, and cause similar symptoms.

The condition has been thrust into the news in recent years as celebrities like Kim Kardashian have opened up about the experience. And in 2023, Olympic champion Tori Bowie passed away from complications related to childbirth and preeclampsia. Most recently, Meghan Markle, opened up about her experience with postpartum preeclampsia on the debut episode of her podcast, "Confessions of a Female Founder."

"It's so rare and so scary," Meghan said during the conversation with Bumble founder Whitney Wolfe, who also experienced the condition. "And you're still trying to juggle all of these things, and the world doesn't know what's happening quietly. And in the quiet, you're still trying to show up for people — mostly for your children — but those things are huge medical scares."

Overall, preeclampsia affects roughly one in 25 pregnancies, per Johns Hopkins Medicine — and while postpartum preeclampsia is more rare (about 6 percent of preeclampsia cases happen postpartum), it's still incredibly important to know your risk. Here's everything you need to know about preeclampsia (during and after childbirth), including the signs and symptoms, how quickly it can develop, and how it's treated.

Alison Cowan, MD, an ob-gyn and the head of medical affairs at Mirvie.

Stephanie Hack, MD, is an ob-gyn and the founder of Lady Parts Doctor.

Preeclampsia is a pregnancy complication that has symptoms that can range from mild to severe. "With preeclampsia, you might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage," Mayo Clinic reports.

Symptoms of preeclampsia "can also be completely silent, which is why it is so important to know your risk of preeclampsia in pregnancy and to have regular care and blood pressure checks," says Alison Cowan, MD, an ob-gyn and the head of medical affairs at Mirvie, a company developing predictive testing for life-threatening pregnancy complications. The condition typically occurs after 20 weeks in pregnancy and becomes more common as pregnancy progresses, she adds.

Postpartum preeclampsia is similar in that it can be difficult to detect, but it shares many of the same symptoms as preeclampsia, per the Mayo Clinic. The primary difference between the two conditions is timing. Postpartum preeclampsia typically develop within 48 hours of childbirth. But in some cases, it can occur up to six weeks after childbirth or later, known as late postpartum preeclampsia.

Unfortunately, the causes of preeclampsia and postpartum preeclampsia are not fully understood, which is one of the reasons it's so challenging to predict and prevent, Dr. Cowan says. "[Preeclampsia] likely has to do with abnormalities in the placenta's implantation that ultimately result in the development of high blood pressure over time," she explains.

To break this down further, the placenta is the organ that nourishes the fetus throughout pregnancy, and in the early stages, new blood vessels develop and evolve to supply oxygen and nutrients to the placenta, per Mayo Clinic. In women with preeclampsia, research suggests these blood vessels do not develop or work properly, which causes irregular regulation of blood pressure in the pregnant person.

There are also certain risk factors for both conditions, including high blood pressure during pregnancy, weight, having multiples, chronic high blood pressure, and diabetes.

Also worth noting: Black pregnant people bear a disproportionate burden of pregnancy risk, including preeclampsia, in the United States, says Dr. Cowan. "Black individuals have approximately a threefold increased risk of dying in pregnancy overall and are five times more likely to die from preeclampsia and eclampsia than white women," she explains. Additionally, Black women are five times more likely to die from postpartum cardiomyopathy (a related condition that is much more common in individuals with preeclampsia) than white women, she adds.

The signs of preeclampsia and postpartum preeclampsia are very similar. The first warning sign for both is high blood pressure, with a reading of 140/90 or higher, says Dr. Cowan. Additional symptoms can include the following:

That said, many cases of preeclampsia and postpartum preeclampsia are silent and asymptomatic, Dr. Cowan says. "This is why it is so important to have regular blood pressure checks, which we recommend more frequently for individuals at higher risk, and at the end of pregnancy for all, when preeclampsia is more common."

It's often said the "cure" for preeclampsia is delivering the baby, which is largely true, Dr. Cowan says. "When preeclampsia develops earlier in pregnancy, we try to do everything we can to manage it, sometimes with medications and close monitoring to prolong the pregnancy a bit longer," she explains. However, any time preeclampsia develops at 37 weeks or beyond, the recommendation is to proceed with delivery (usually an induction of labor or C-section), she adds.

If extreme features of preeclampsia such as lab abnormalities or severely elevated blood pressure develop, then preeclampsia is often treated with magnesium sulfate, Dr. Cowan explains. "This is given through the IV and has been shown to significantly decrease the chances of eclampsia, which are seizures in the setting of preeclampsia."

Magnesium sulfate is also used to treat postpartum preeclampsia and help reduce the risk of seizures, per the Mayo Clinic. You doctor may also provide high blood pressure medication.

If preeclampsia (during or after childbirth) with severe features goes unrecognized, eclampsia, a life-threatening condition characterized by seizures can develop, Dr. Cowan says.

The first step to preeclampsia prevention is knowing your risk, Dr. Cowan says. Women with certain major risk factors such as chronic high blood pressure, type 1 or type 2 diabetes, or a history of prior preeclampsia are known to be at high risk, she explains. The challenge today is that many individuals with no apparent risk factors go on to develop preeclampsia, so it makes prevention more difficult, she adds.

Right now, there is currently no reliable way to predict preeclampsia before symptoms occur, but there are several strategies to prevent preeclampsia (both during and after childbirth) from occurring or to at least recognize when it happens, Dr. Cowan says.

Research out of Mayo Clinic found that the best clinical evidence for prevention is using low-dose aspirin. The exact mechanism for how baby aspirin staves off preeclampsia isn't known, but studies suggest that aspirin helps at-risk patients to have more normal placental development. Baby aspirin is also recommended for postpartum preeclampsia. That being said, it's important to talk with your doctor before regularly starting any medications, vitamins, or supplements.

Additionally, the American Pregnancy Association recommends using little or no added salt in your meals, drinking six to eight glasses of water a day, exercising regularly, avoiding alcohol and caffeine, and getting adequate rest.

Another helpful resource is this Mirvie checklist for patients and guidelines for providers, which is a great tool to assess your risk of preeclampsia, Dr. Cowan says. "This care plan brings together all of the evidence-based interventions that women can act on when they know their risk, which includes strategies as simple as regular home blood pressure monitoring, taking a baby aspirin every day, and getting targeted lab work done at your doctor's office."

When it comes to both preeclampsia and postpartum preeclampsia, it's also useful to be proactive during doctor's appointment. Have a conversation with your provider about both conditions, potential risk factors, and signs to look out for. It's also helpful to keep track of any new or unusual symptoms during or after childbirth so that you remember to flag it. You know your body best and if something feels off, it's never a bad idea to bring it up.

Andi Breitowich is a Chicago-based freelance writer and graduate from Emory University and Northwestern University's Medill School of Journalism. Her work has appeared in PS, Women's Health, Cosmopolitan, and elsewhere.