Sitting on the sofa on a quiet Sunday morning in April, Becki Barratt felt a deep sense of contentment as she nursed her three-week-old son, Beauden, while her two-year-old daughter, Aréya, played nearby.
In fact Becki, a health and fitness coach, had only just remarked to her partner James, 32, how incredibly well she felt – especially considering she’d recently given birth.
Yet seconds later, everything changed.
‘James went upstairs to go to the loo and a strange, heavy feeling suddenly came over me,’ recalls Becki, 33, who lives in Chester.
‘My left hand began spasming involuntarily. I managed to put Beauden down on the floor, but when I tried to stand up, my left leg collapsed completely underneath and I fell to the floor, unable to move.’
Becki screamed for James, who raced downstairs to find her immobile.
‘I looked at him, my speech slurring, and said: “I feel like I’m having a stroke”,’ she recalls.
‘It felt absurd even saying it. I was 33, ate a great diet, had no high blood pressure, and ran my own fitness business. How could I be having a stroke?’
Three weeks after giving birth, 33-year-old fitness coach Becki Barratt suffered a paralysing stroke while breastfeeding her newborn son, leaving her entire left side unable to move
An MRI confirmed that a clot had cut off oxygen to the right side of Becki’s brain, and she began rehabilitation therapy the very next day. Becki seen with mum Melanie and son Beauden
Yet Becki’s instinct would be proven right – she was having a stroke, caused when the blood supply to part of the brain is cut off.
In the UK, someone has a stroke every five minutes – around 100,000 people every year.
The most common kind is an ischaemic stroke, when a blood clot blocks blood flow and oxygen to the brain, accounting for around 85 per cent of cases.
‘While most strokes happen in people over 65, around one in four strokes occur in people of working age – and this number is steadily increasing,’ says Professor Martin James, a consultant stroke physician at the Royal Devon University Healthcare NHS Foundation Trust.
Indeed, research suggests strokes are rising in people under 55. And experts suggest some may have different causes – as they seem to affect those who, like Becki, have none of the usual risk factors, such as high blood pressure or smoking.
Within 15 minutes, an ambulance arrived and Becki was rushed to hospital.
‘My daughter saw me being wheeled off on a stretcher, screaming that someone was taking her mum away,’ says Becki. ‘It broke my heart.’
The entire left side of her body was paralysed by the time she arrived to hospital.
‘I couldn’t move it at all, my face had no expression and my voice was a flat, slurred monotone,’ she recalls. ‘I thought, “This is it. I’ll never move again”.’
An emergency CT scan showed no visible bleed on the brain to indicate a haemorrhagic stroke, where bleeding in or around the brain causes sudden, severe symptoms such as a violent headache, weakness down one side or loss of consciousness.
As Becki sometimes had migraines, doctors initially thought her paralysis might be a symptom of a hemiplegic migraine – a rare type that can mimic stroke, causing temporary weakness down one side of the body caused by abnormal electrical activity in the brain, rather than a blockage in blood flow.
But to be safe, doctors administered the clot-busting treatment thrombolysis, while waiting for final test results.
Giving this drug within a ‘golden hour’ window gives the best possible chance of survival and reduces long-term disability from an ischaemic stroke.
Two days later, an MRI confirmed that a clot had indeed cut off oxygen to the right side of Becki’s brain. The prompt use of thrombolysis had saved her life, but her brain tissue was damaged, leaving her left side paralysed.
Every stroke is different, so no one could predict how Becki would recover.
‘My whole world spiralled,’ she recalls. ‘We were living in this perfect baby bubble – and in a single second, it had burst.’
She began daily rehabilitation the next day in hospital.
Accustomed to lifting heavy weights in the gym, Becki suddenly found her ‘entire goal’ entailed ‘trying to force a neural signal down to bend my little finger on my left hand’.
Three days after her stroke, she managed her first tiny steps, supported by four physiotherapists: ‘It felt like a humongous leap forward,’ she says.
Becki was in hospital for five days.
Arriving home was an emotional experience – but also ‘a dose of reality,’ she says.
In a wheelchair and unable to use her left side, she had to get used to her ‘new norm’, as she puts it.
Both James’s and Becki’s parents rallied to help look after the children, while Becki had a bed made up in the family sitting room.
‘I’d lie there helpless, hearing my baby crying for me upstairs, unable to reach him,’ she recalls.
‘Every day became about small victories – changing a nappy, holding my children safely, making a cup of tea.’
Since the stroke, Becki has had hour-long rehabilitation therapy at her home three to four times a week.
As a successful health and fitness coach in her 30s, Becki had none of the usual risk factors for strokes, such as high blood pressure, smoking, obesity or being over the age of 55
The risk of a stroke is nine times higher in the days around childbirth and three times higher in the six weeks afterwards, compared with a woman’s normal risk outside pregnancy
Five months on, she can walk and even run short intervals. Her left side remains weaker – she can only hold her children on that side for a minute or so, for example.
She still doesn’t know exactly what caused the stroke – something experts say is not unusual in younger patients.
‘Even after extensive tests, sometimes we simply cannot say for certain why a stroke happened,’ says Professor James.
Becki was checked for a patent foramen ovale (PFO) – a flap-like opening between the two top chambers of the heart, and a common cause of ischaemic strokes in otherwise healthy people – but this came back clear. As did blood tests for different blood-clotting disorders.
She’s now awaiting a transoesophageal echocardiogram – a more detailed ultrasound scan of the heart taken from inside the oesophagus, which could still find a PFO.
Up to one in four people have a PFO (which normally close up shortly after birth). They usually don’t cause problems, but sometimes a blood clot from a vein can escape through the hole to the brain.
If a PFO proves to be the cause of Becki’s stroke, it could be treated with surgery to close up the opening.
But Becki says: ‘I’m aware I may never get the answers I want, as around 50 per cent of strokes are left unexplained.’
Although she’s aware another future stroke is possible, for now she says: ‘All I can do is focus on what is in my control.’
The fact Becki had recently given birth could offer a possible explanation. Pregnancy and the period immediately following childbirth are recognised times when stroke risk is higher, if uncommon, says Professor Deb Lowe, a consultant stroke physician at Wirral University Teaching Hospital NHS Foundation Trust.
‘Pregnancy can bring an increased risk of high blood pressure and blood clots due to the demands on the mother’s body at the time.
‘This is why blood pressure is monitored regularly throughout pregnancy.’
The risk of a stroke is nine times higher in the days immediately around childbirth and three times higher in the six weeks afterwards, according to a major study involving two million women in England, published in the Journal of the American Heart Association in 2017. This is compared with a woman’s normal risk outside pregnancy. Overall, the risk is estimated to be around 30 strokes for every 100,000 pregnancies.
Women who develop pre-eclampsia – high blood pressure during pregnancy – are at much greater risk, with strokes occurring in as many as one in 500 births among this group.
But other potential causes are still emerging, according to Dr Linxin Li, an associate professor at Wolfson Centre for the Prevention of Stroke and Dementia at the University of Oxford.
A study she co-authored, published in JAMA Neurology in 2022, found that stroke incidence in under-55s rose by 67 per cent between 2002-2010 and 2010-2018, even as rates fell among older adults.
The research was based on GP data from 94,567 people in Oxfordshire.
Crucially, a similar pattern wasn’t seen for other cardiovascular problems such as heart attacks, suggesting this reflects factors that are specific to stroke and cannot be entirely attributed to traditional risk factors for clots such as blood pressure, being overweight and smoking.
In fact Dr Li’s research has found the sharpest increases occur among younger patients with none of those risk factors – suggesting other causes such as long working hours, stress and air pollution.
The study also found a significant rise in the proportion of young stroke patients in more skilled, professional or managerial occupations – potentially supporting the ‘long working hours’ theory.
Previous research has also found that working more than 55 hours a week is a risk factor for stroke, as well as atrial fibrillation (an irregular heart rhythm that itself raises stroke risk).
‘This suggests a plausible biological pathway from overwork to stroke via heart rhythm disruption,’ says Dr Li.
Meanwhile, it’s thought air pollution could lead to strokes by increasing inflammation that then increases the risk of clots.
A major 2023 review in the journal Stroke found that air pollution can trigger strokes in susceptible people on days when pollution is particularly bad.
But while these short-term pollution spikes were found to trigger strokes in older people, the study also found that long-term exposure to air pollution raised the risk for younger, healthier people.
‘The strongest evidence for a youth-specific air pollution link is more about cumulative long-term exposure than sudden pollution spikes,’ says Dr Li.
One important preventative measure is regularly checking blood pressure.
Experts agree that high blood pressure, dubbed a silent killer as it’s symptomless, is a major modifiable risk factor for stroke – which is why everyone should have their blood pressure regularly checked, says Professor James.
Becki is now training to run the London Marathon next April for the charity Stroke Association.
The race date coincides with the anniversary of her stroke – it’s to fulfil a promise she made to herself watching the race on TV while lying in hospital.
‘I can’t run for more than three minutes right now, so 26.2 miles feels a long way off,’ she smiles, ‘But I will get there.’
To support Becki’s fundraising for the Stroke Association, or to learn the signs of stroke using FAST (Face, Arms, Speech, Time), visit stroke.org.uk
