Riding the Waves of Resilience: Transforming the Narrative Around Preeclampsia

In the calm, rhythmic expanse of the Pacific Ocean off Cowell Beach in Santa Cruz, a circle of surfers sat silently on their boards. They were not there for sport, nor were they chasing the swell. Instead, these women—many of whom are mothers—held pink flowers in their hands, their presence a poignant testament to survival, grief, and the urgent need for medical advocacy.

This "Paddle Out" event, organized by registered nurse and three-time preeclampsia survivor Chelsea Woody in partnership with the Preeclampsia Foundation, represents a growing movement to bring a life-threatening, often invisible, medical crisis into the light. Preeclampsia, a hypertensive disorder unique to pregnancy and the postpartum period, affects five to eight percent of all pregnancies in the United States. For thousands of families, it is a devastating, life-altering experience; for many, it is a condition they were never warned to look for.

The Silent Crisis: Understanding Preeclampsia

Preeclampsia is a complex, multi-system disorder that typically develops after the 20th week of pregnancy. It is characterized by high blood pressure and signs of damage to another organ system, most often the liver or kidneys. According to data from the Journal of the American Heart Association, the incidence of hypertensive disorders in pregnancy has doubled in the United States between 2007 and 2019. Despite this alarming trend, public awareness remains dangerously low.

The condition is often described by survivors as an "out-of-body" experience. For Jody Wilfong, founder of Surf Therapy Santa Cruz and a mother who battled preeclampsia through three separate pregnancies, the reality was terrifying. During her first experience at age 24, her blood pressure surged to 220/110—a hypertensive emergency that left her blacking out. "I didn’t fully understand the seriousness of what was happening," she recalls. "I was on a magnesium sulfate drip to prevent seizures, but I felt like I was in a fog, disconnected from the reality of how close I was to losing my life."

A Chronology of Advocacy and Healing

The journey to the shoreline in Santa Cruz was not an overnight success, but the culmination of years of individual and collective trauma.

• The Onset: For many, the crisis begins subtly. Symptoms like minor swelling or a lingering headache are often dismissed as "normal" pregnancy discomforts.
• The Turning Point: As medical systems struggled, particularly during the COVID-19 pandemic, many pregnant individuals found themselves isolated. Chelsea Woody, navigating her own pregnancy during the pandemic, experienced the profound gap in care. Despite being a nurse, she found that her own body was betraying her in ways she hadn’t been taught to identify until she was in the thick of a crisis.
• The Loss: The tragedy of preeclampsia is not just in the morbidity of the mother, but in the loss of infants. Woody suffered the loss of her first baby, a trauma that fueled her mission to ensure no other parent would feel as unsupported as she did.
• The Emergence of Community: Events like the Santa Cruz Paddle Out represent a shift from the sterile, fear-based language of clinical settings to a communal, healing approach. By bringing together survivors, OB/GYNs like Dr. Sara Johnson, and birth workers, the movement is reclaiming the narrative of maternal health.

Supporting Data: A Disproportionate Burden

Preeclampsia is a "great equalizer" in that it can affect anyone, regardless of health history or socioeconomic status. However, the data reveals a stark, uncomfortable truth about the role of systemic inequality.

Black women are disproportionately affected by the condition, facing higher rates of morbidity and more severe outcomes compared to their counterparts. While White women experience preeclampsia at a rate of 4.3 percent, the rate for Black women sits at 7 percent. Latinx women face a 4.7 percent incidence rate, while Asian and Pacific Islander women see 2.9 percent.

Experts point to a combination of systemic racism, chronic stress, health care inequities, and a higher prevalence of cardiovascular risk factors as primary drivers of these disparities. Woody, who identifies as Black and Asian, emphasizes that the medical system often fails to account for the "weathering" effect of chronic stress on marginalized bodies. When these factors intersect with a pregnancy complication, the result is a systemic failure that requires more than just clinical intervention—it requires social change.

Official Responses and Medical Guidelines

The medical community is slowly pivoting to prioritize better education and preventative care. Dr. Sara Johnson, an OB/GYN and fellow survivor, is currently working with the March of Dimes on an initiative titled "Low Dose, Big Benefits." The campaign promotes the use of low-dose aspirin for individuals identified as high-risk for preeclampsia.

"Babies are floating in salt water in your belly," Dr. Johnson says, drawing a parallel between the fetal environment and the ocean. "So it’s a beautiful, poetic, and grounding thing to be held by the ocean while we process these medical traumas."

However, medical professionals acknowledge that awareness is the first line of defense. The Preeclampsia Foundation continues to lobby for standardized screening protocols and improved postpartum follow-up. Currently, many patients are discharged after birth without a clear understanding that preeclampsia can persist or even develop for the first time in the weeks following delivery.

The P.U.S.H. Campaign: A Tool for Survival

To bridge the gap between medical knowledge and patient awareness, Chelsea Woody developed the "P.U.S.H." campaign. Modeled after the "B.E. F.A.S.T." stroke recognition acronym, P.U.S.H. provides a simple, actionable guide for expectant parents:

• P – Persistent: A severe, unrelenting headache or right upper stomach pain.
• U – Unusual: Rapid swelling in the face, eyes, or hands, or sudden weight gain (more than 5 pounds in a single week).
• S – Sight: Changes in vision, such as seeing spots, blurriness, or double vision.
• H – High Blood Pressure: Readings consistently over 140/90.

This initiative is designed to empower patients to speak up when they feel that something is wrong, even if their symptoms seem "vague" to providers.

Implications: Moving Beyond the Hospital Walls

The implications of this work reach far beyond the clinical management of pregnancy. The movement advocates for a holistic view of maternal health that acknowledges the long-term impacts of preeclampsia. Even after a successful delivery, survivors face a significantly higher lifetime risk of cardiovascular disease, stroke, and chronic kidney disease.

"I wanted to use surfing to tell a story about maternal health," Woody explains. "I wanted to show that a complicated pregnancy doesn’t need to be a sedentary, fear-filled existence. I wanted to show the importance of connecting to something that brings you joy, even when you are carrying a high-risk diagnosis."

The Paddle Out event was more than a ceremony; it was a reclaiming of space. As the women floated in the Pacific, letting their pink flowers drift away, they were not just remembering those lost or honoring their own battles; they were asserting that maternal health is a community responsibility.

As Woody continues her work on the film High Risk Dreams and looks to expand the Paddle Out events to other coastal cities, the message remains clear: the conversation about maternal health must move out of the sterile, intimidating halls of hospitals and into the public sphere. By fostering connection, providing clear educational tools, and addressing the racial disparities that persist in our healthcare system, the movement is shifting the tide—one wave, and one life, at a time.

For now, the focus is on continuity. Whether through the professional advocacy of organizations like the Preeclampsia Foundation or the personal, grounding acts of surf therapy, the goal is to ensure that "surviving pregnancy" is not just a phrase used by the lucky, but a reality for everyone. As Wilfong noted, "Raising awareness and helping women recognize the signs early could save lives. It is the most important work we can do."