What is vasovagal syncope?
According to my OB, Amy Stoddard, vasovagal syncope is not very common during pregnancy but is still considered a normal symptom. It is something that is easily managed and the phase should pass unless you have experienced episodes before pregnancy. Episodes can occur when you need to use the restroom, cough, or experience stress. Your vasovagal nerve becomes stimulated, causing your blood pressure to drop and you to feel faint.
The Pregnancy Corner website states:
Vasovagal syncope: A common cause of fainting episodes, vasovagal syncope is caused by a chemical imbalance. The vagus nerve is a cranial nerve that runs from the brain to the abdomen. Stimulating the vagus nerve releases a chemical that slows the heartbeat and dilates the blood vessels. When this happens the brain does not receive enough blood, and this can cause a pregnant woman to faint. Vasovagal syncope can be brought on by pain, stress, straining during urination or bowel movement, , dehydration or anemia. Symptoms of vasovagal syncope include nausea; feeling warm or lightheaded; sweating; become pale; and hyperventilating. This condition is more common in pregnant women. Sitting down and putting the head between the knees can help prevent fainting when the symptoms of vasovagal syncope begin. (Lee, 2015).
How to take care of yourself during an episode
Soon after I reached the halfway point in my pregnancy, I began to experience vasovagal episodes. Thinking about it, this makes sense because your blood pressure is lowest during mid-pregnancy due to the increase in blood volume in your body. Therefore, episodes are more likely. For me, they usually occurred within an hour or so of eating breakfast (maybe 2-3 hours after waking up). I would suddenly get hot and sweaty, very uncomfortable in my chest and abdomen area, lightheaded, and have tunnel vision. The frequency of my episodes peaked around the 5th month of pregnancy. I had about 3 per week.
The most important thing you can do is listen to your body, especially during pregnancy. As soon as you begin to feel faint, hot, tired, etc. do something that will make you feel better, and do it immediately. Now is not the time to push yourself or to keep up with other people. During my episodes, all I could think about was lying down, so that’s what I did. I had to take care of myself in that moment before I could ask my doctor about it or try to find an explanation elsewhere. Lying down on your left side is the best position to maximize blood flow to your brain and to your baby, the same position you should try to sleep in as pregnancy progresses! You want to try to prevent falling down and potentially injuring yourself or your baby. If you can’t lie down, sit with your head between your knees or ask for help.
Next, there is a good chance that after a few episodes, you will get nervous and want to ask your doctor. Do it. That’s what they are there for. It can be very helpful to think about your episodes and see if you can identify a pattern. Are you always doing the same activity when the episodes begin? Is it a particular time of day? For me, my episodes happened around the same time of day, particularly when I was about to have a bowel movement. (TMI? Maybe. But if you’re pregnant or know a pregnant person, then things such as passing gas, belching, stretch marks, and bad body odor become commonplace. You’re growing another person, so cut yourself some slack!) Anyway, although my OB couldn’t give me medicine or an exact date when my episodes would pass, her reassurance that everything was ok made me feel loads better. I wasn’t crazy, I just needed to identify my trigger and be prepared to lie down at the onset of an episode.
My craziest episodes…
Most of my episodes happened while I was still at home, so they never amounted to much. However, the few episodes that did occur when I was out were definitely more severe. I think in these situations I was more anxious because I wasn’t at home, so the intensity and duration was greater than my usual experiences.
- Tommy and I were in the car (thankfully he was driving), when I started to get uncomfortable. At first I thought it was the car seat, but then I quickly experienced light sensitivity, tunnel vision, and of course I felt hot and sweaty. This episode made me panic because it came on so quickly. It probably lasted for 5-10 minutes until I was able to get home and lie down. At the time it felt like much longer. The anxiety definitely made things worse, but Tommy was extremely calm and supportive of me. He immediately took me home, helped me up the stairs, and called my sister to “babysit” me just in case when he had to leave for work. After lying down I felt fine, just very tired. I probably stayed in bed for the next few hours. I was physically and emotionally drained.
- I had just dropped Tommy off at work and was driving home alone when I became uncomfortable again, as I had in the previous episode. I knew I wouldn’t be able to make it home unless I addressed the situation first, so I pulled into a Rite Aid parking lot, blasted the AC, reclined my seat, and lied down on my left side. I stayed there for about five minutes when I realized I had to make it to the restroom or go in my pants. As I was hurrying out of the car to the store I had to stop and sit briefly with my head between my legs. At this time I felt embarrassed in case anyone was watching my sweaty, smelly self. This embarrassment actually made me feel better. I realized that if I could feel embarrassed in this moment instead of asking for help, then I was able to take care of myself. It kept me calm. I then went to the restroom and felt much better. I sat in there for another 10 minutes until I felt safe enough to drive home.
- At 24 weeks I had to go in for my glucose screen, which tests for gestational diabetes. Basically, you fast for 2 hours, drink this really sugary drink, wait and hour, and then have your blood drawn. My drink tasted like flat orange soda mixed with mouthwash. My tummy wasn’t happy, but at least it tasted like familiar stuff that you would normally put in your mouth! Anyway, as I was waiting to have my blood drawn, I of course had to have an episode. Luckily, it was fairly empty in there and I was quiet so no one really paid attention went I put my hair up and my head down. Luckily I had a thin tank top on under my sweater so I didn’t have to be too exposed to cool myself off! Although it lasted for about 10-15 minutes, I again felt that sense of embarrassment so I was able to stay calm. Also, I was surrounded by medical professionals anyway. If I had to faint, this would be the safest place to do it.
I’m now 6 months pregnant and the episodes have waned. I did experience a mild one yesterday, but that was the first one in almost 2 weeks! At this point, my blood pressure should be on the rise again, so hopefully the worst of these episodes is behind me.
Lee, D. (2015). Dizziness During Pregnancy. Pregnancy Corner: Your Complete Pregnancy Guide. Retrieved from http://www.pregnancycorner.com/pregnant/pregnancy-symptoms/dizziness.html