Natural Birth

Early pregnancy and high blood pressure-midwife care out of the question?

Hi, I'm a first time mom, only about 8 weeks pregnant. Just had my first intake appt and was surprised that I have high BP. This has never been a problem for me. The intake nurse then informed me that I was too high risk for midwifery care and has told me I need to see a dr. I was mortified and I am beside myself. I've been dreaming of a natural birth with a midwife since before I even got pregnant. The last few weeks my diet hasn't been quite right w/ severe nausea, fatigue and some vomiting. So I admit I haven't been the picture of health as I'm just trying to adjust to being pregnant. Does this really mean I am that high risk? Are my hopes of a lovely natural birth really crushed? I am working now on increasing my activity and adjusting my diet as my nausea allows. Any words of wisdom would be greatly appreciated!

Re: Early pregnancy and high blood pressure-midwife care out of the question?

  • mb314mb314 member
    I had a med free birth with a midwife and I had pre existing high blood pressure. I took labetalol to control the blood pressure during pregnancy. I was watched more carefully and had to do some extra urine tests. Around 39 weeks, my midwife did start talking induction bc my blood pressure was creeping up and bc of my blood pressure history. They wanted me to be induced at 40 weeks. We did some tests including a non stress test and a sonogram and it did seem like DS was stressed so I agreed to schedule an induction at 40 weeks. Luckily my labor started on its own at 39 w 5 days and I avoided pitocin.

    Long story short high blood pressure doesn't necessarily mean you can't work with a midwife but likely they will monitor you more carefully and there is a greater risk that you will need to be induced. Good luck!

    Question - was this the only time you've been told your blood pressure was high? It could have been a fluke, and I would see if you can talk to a midwife about the situation.
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  • Hi! Thank you for the response! I have NEVER had a BP issue. He was just an intake nurse and he was using those automatic BP things. I told him that manual ones worked better for me, and he just didn't listen. He said bc he got 2 high readings I was no longer "low risk" so I couldn't receive midwife care. I haven't even been able to see a midwife, he told me I needed to see doctors bc of the BP and is sending me to an OB on Monday. My hope is that she will give me a manual BP reading, and it will be normal and I can then try to get a midwife again. There aren't any actual birthing centers close by, so I'm having to get the midwife care at a hospital, which I think is part of the issue.
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  • I'm not seeing a midwife, but my BP was up a bit at the beginning of pregnancy and has come back down to perfect. I would try to do your best to get it down with lots of water and excercise, and then see what it's like at your next appointment and ask again about midwife care. Good luck! Evenif you do risk out of midwife care, there are OBs that are supportive of natural birth and there's no reason why your natural birth dreams need to be washed aside. =)
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  • Thank you!!!
  • mb314mb314 member
    Do you know if your blood pressure is high typically?  Can you monitor it at home with a home machine?  Typically a high blood pressure diagnosis isn't made by a nurse and is done after getting several high readings.  I am still surprised that you would be labeled "high risk" so easily by the midwife's office without ever even seeing a midwife. 

    Good luck!  AS pp said, many OBs are natural birth friendly so if you can't go with a midwife, I hope you find a great OB that will support your birth choices.
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  • Hi! I have never had a BP issue, in fact just a week and a half ago I had it checked when I was verifying my pregnancy and it was normal, that nurse did so manually not with that machine the intake nurse used at the midwives clinic. I also felt like I was categorized and dismissed quickly, especially so early on in my pregnancy. He checked my BP two times w/ the machine, disregarding my request about doing so manually. I'm seeing the OB on Monday and will ask that she does a manual BP reading and see what happens. I'm making dietary adjustments and getting more active just in case there is a real problem. I just find it hard to believe my BP went up in a week and a half! I am now wondering if a hospital birth is in alignment with what I want especially after being out in the "high risk" category so quickly by them. We shall see how the OB goes, who knows she may be great! Thank you everyone for the advice, validation and support. It is disheartening to be so early on in my first trimester and to already feel completely disempowered about the birth. Thanks all!
  • Hi there.  For the midwives at my freestanding birth center HBP prior to 37 weeks of PG will label you too "high risk" for their care and you would be transferred to an OB or hospital-based MW group.  HOWEVER, what you describe would not be considered an official diagnosis of HBP.

    According to my MWs, HBP is pressures above 140/90 that do not drop below that number with a short resting period and the HBP needs to be recorded twice at least 6 hours apart.  I also hear you on the automatic blood pressure cuff, I tend to read higher on those than a manual one.  Also, are you sure that they were using the right size cuff?  That can make a difference, too.  Finally, were you sitting with your feet on the floor?  I haven't noticed that this makes a difference for me, but for others I have heard it does.

    Good luck, and I would definately talk with the doctor about what happened last time.  Try taking your pressures at home or at the drug store and see what they are running ususally.


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    BFP#2:  EDD 2/11/14, MMC confirmed 7/15/13 (growth stopped at 6 weeks), D&C @ 12 weeks 7/25/13

  • Thank you so much for all of the tips and information. I will be monitoring my BP on my own and taking precautions just in case.
    The point is that that intake nurse over stepped his scope and handled the situation all wrong, and got me all worked up without cause. When he re-checked my BP it was withing 1 minute of the first time, obviously not an appropriate resting period. I will file a complaint, that whole experience was very traumatic.
    To be sure I'm keeping an appt with an OB who knows maybe I'll love her and maybe she is pro-natural birth. If my BP is good, I'll discuss transferring to a midwife, if I'm not in love with the OB.
    Again, I appreciate all the tips and information from everyone! You've been a great help!
  • Can you find a different practice? Even if you had ACTUAL high BP it does not preclude you from seeing a MW since it doesn't automatically make you high risk (and, FWIW, I was high risk due to PTL/shortened cervix issues - I saw MWs and MFMs concurrently through a hospital and they all were in total support of this arrangement and use it with many patients so even if you were high risk I don't think all situations would risk you out of MW care).

    The nurse who did your intake should also know how inaccurate those stupid machines are AND the protocol for retest so the whole situation just has warning bells going off in my head that the practice doesn't follow ACOG standards of care.

    Sorry, I'm sort of rambling but I hope you can find a different practice. It's far too early in your pregnancy for these shenanigans.


    Six years of infertility and loss, four IUIs, one IVF and one very awesome little boy born via med-free birth 10.24.13.
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  • Hi everyone, I just want to thank you for all the knowledge and support! I saw an OB today and a) my BP was 118/76, totally normal! B)I loved the OB and she is pro-natural birth. I am still going to file a complaint on that intake nurse. I don't see how I went from 146 to 118 in one week. That's pretty extreme. I'm certain it was the automatic BP device misreading. He caused me way more stress than necessary. But now all is well, me and baby are both healthy so far! So thanks again for all of your guidance!
  • mb314mb314 member

    I’m glad you like the OB, and more importantly that your blood pressure registered as normal.  A lot of things can cause a temporary spike in blood pressure (particularly stress) so it could have been the machine or it could have been a natural temporary spike.  In any case, good luck and I hope your blood pressure remains normal and you continue to love your OB

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