Postural orthostatic tachycardia syndrome (POTS) & pregnancy


Postural orthostatic tachycardia syndrome or simply ‘POTS’, is a condition in which the autonomic nervous system and sympathetic nervous system affecting the bodies circulation. This means that someone with POTS can’t coordinate the blood vessel squeeze and heart rate response, therefore the blood pressure can’t be kept steady and stable.

Women with POTS quite often have a fast labour, this is what we call a precipitate labour. Which is great for some women as it means it will be over quicker but this can sometimes come with complications also, such as an increased risk of Postpartum haemorrhage (PPH – heavy bleeding post delivery) as the uterus can sometimes not contract down well.

Therefore midwives would encourage women with POTS to have active management of the third stage of labour, this may involve having an injection to deliver the placenta aiding contractions while minimises bleeding. Women are also at increases risk of having fainting episodes while in labour or having an uncontrollable high or low blood pressure. This is likely to be tachycardic ( a fast heart rate), therefore often women would be encouraged by their healthcare professional to have an epidural if their blood pressures and heart rate are outside normal levels. An epidural is sometimes good for controlling these as women are not in pain and can relax.

With all this being said, most women with POTS cope fine with labour and can labour normally, but they would need to be on a labour ward for increased monitoring.

Please chat to your midwife for more details and your obstetrician for any personal advice for you as they will understand the severity of your POTS.