Facing possible medical induction due to high BP and possible pre-e

whitney4126

Up until last week, I have been blessed with a very healthy pregnancy.  I am due Tuesday (9/9).  DH and I have prepared for the last 6 months for a natural childbirth experience (by that, I mean avoiding epidural or pain meds).  When I went for my appointment Thursday, my blood pressure was high for the first time.  My midwife had me admitted for monitoring.  I was monitored for several hours and couldn't get my blood pressure down, but baby was doing well.  The midwife indicated that they were wanting me to get induced that night because I couldn't get my blood pressure down.  She could tell this was not what I wanted, so she offered to let me see if I could get it down by laying flat on my left side for a while.  This worked somewhat, so she let me go home and do a 24 hour urine collection, under the condition that I stay laying on my left side as much as possible over the weekend.  I go back tomorrow (Monday) to follow up and get the urine test results.  The midwife indicated that if my blood pressure was still high or my urine test showed preeclampsia, then I would likely be induced that day.  Well I've monitored my bp over the weekend, and it has remained fairly high, so I am fearing induction is in my future.

I read the tips in the recent post on facing induction, and found them very helpful.  I reviewed Ina May's section on induction.  I plan to discuss the possibility of a stripping membranes and waiting, foley bulb, and/or starting with low levels of pitocin.  Any other tips from mom's who have faced similar dilemmas?

I am quite nervous about attempting natural birth with a medical induction, and my confidence is waning.  I was just wondering about experiences going med-free, despite pitocin.  It seems like I saw a thread on here about this several months ago, but I have been unable to find it.  Also, if I do have preeclampsia, I understand that I will have to have an IV of magnesium sulfate.  I have heard this is uncomfortable.  Has anyone been through this and been able to go without an epidural?  If so, any tips?

Thanks in advance for any help.  I am just suddenly getting very nervous.

emp06c

First, let me say, it is really unfortunate that you are facing induction, if that is not what you want. I'm sorry things have taken this turn for you. Unfortunately, I've had pre-e patients that were in pretty rough shape, so as long as your baby is doing fine and the induction is what's medically indicated to keep you and your little one safe, then know that you are doing the right thing. Especially since BPs can sky rocket (even in women with normal BP) during ctx, transition, and pushing.

Mag is uncomfortable. It basically makes you feel feverish, but it is a muscle relaxer used to help prevent seizures in pre-e pts. Pitocin works on make ctx stronger, so your pit and your mag are going to be battling it out, if they put you on mag. That being said, I have seen women go through inductions without epidurals, but they usually take the IV pain meds, which we administer up until 7 cm dilation (given later than that, or if the baby is born within 2-3 hours of IV meds, we have to have the neonatal nurse practitioner there because they baby may still have the pain meds in its system. The babies have always been fine from my experience, but they have to be monitored for respiratory depression as a precaution from pain meds). Pain meds take the edge off, but they don't completely knock it out. They also usually make our pts feel stoned, so many women usually opt for the epidurals because it takes away the pain and does not effect baby.

I guess, at the end of the day, if you are facing an induction, know that it can be done pain med free, but you ultimately know your body and pain tolerance the best. Just keep an open line of communication with your providers, and ask them a ton of questions about the medications, side effects, risk to baby, etc. If the Pitocin hurts you too badly, and you do decide to have pain intervention, don't feel like you've "caved" or have somehow failed yourself or your baby. Child birth should be as positive an experience as possible, and if the Pitocin and the mag are preventing you from having that, then there's no shame in taking the steps so that you do enjoy it as much as you can. That's just my two-cents.

iris427

I was induced with Pit for my first child. I went in knowing that Pit might be a different story than a spontaneous labor, so I accepted that I might need the epidural. And I did. I made it to 4 cm and I was in so much pain that I found myself not caring what happened to me or my baby. That wasn't a healthy mindset to be in or make medical decisions, so I got the epidural and I don't regret it. I went on to have two unmedicated births with my other children.

I agree with PP, do what you need to do in order to have a healthy and positive delivery. Sometimes you can do that unmedicated. Sometimes pain meds are the best choice and there is no shame in that. Epidurals are very safe and they do not increase the risk of cesarean. I've even heard them be recommended for moms with high BP, because lowering BP is a side effect of epidurals.

When you get thrown a curve ball like this, sometimes you have to just play it by ear and do your best. It's definitely possible to have an induction and no pain meds, but either way, you will do great. GL!

catsinawindow

I was induced due to severe PreE at 39 weeks with my son.  I don't have a positive birth story to share from this, but I did want to share some things I learned through the experience that maybe can help you.

Regarding mag sulfate, it's no fun at all.  For me, it was worse than feeling feverish, I felt woozy, like I couldn't focus my eyes.  As another PP mentioned, it works against Pitocin, such that pitocin wasn't able to put me into active labor.  My labor started once my water was broken by the OB.  You also won't be able to get out of bed while on mag and won't be able to eat or drink.  (Of course, they can't MAKE you do anything, but they will very strongly recommend this).  Mag is given to prevent seizures.  For severe PreE it prevents about 1/50 women from having a seizure, for mild PreE it prevents 1/500 women from having a seizure (per a MFM doc who I saw for a consult when I was PG with DD).  For this reason, some women/docs don't treat mild PreE with mag routinely.  It's something to think about/talk about with your MW. 

As others have said, PreE is not something to mess around with.  PreE at term is ABSOLUTELY a medically indicated reason to induce.  As others have said, don't beat yourself up if you do decide to opt for pain medication.  You simply can't compare the experience of an induced labor with mag to a natural, uncomplicated labor (I know, I've had both .)  Basically, my advice would be that you CAN have a pain-med-free induced labor with PreE, but don't feel like you failed if you decide not to.  I wrestled with a lot of negative emotions after my birth with DS, but ultimately, I am SO proud of myself for getting through such a difficult situation.  Then, 3 months ago, I went on to have a beautiful natural birth with my daughter (no PreE with her!)

MsMacual

I don't have experience with an induction, but I just wanted to say fx that your labs show that you don't have pre-e! 

whitney4126

Thank you ladies for the input. I needed to hear those things. After my appointment today, they don't think I have preeclampsia, but definitely gestational hypertension. So I am being induced tonight. Luckily I get to avoid the magnesium as long as my blood pressure doesn't get out of control during labor. They are getting ready to put in a foley bulb, and then will likely break my water in the morning. Midwife is willing to try to see if these methods will jumpstart my labor before starting pitocin. Either way baby girl will be here soon.

canadianttc1st

I went through the exact same thing I was induced with the pill they put inside you (can't remember what it was called) I ended up being in labour for 36 hours. I didn't want the epidural but by the 32nd hour I was so exhausted I asked for it. They gave it to me right as I was about to push they checked me right after they have it to me and I was fully dilated and ready to push. I ended up pushing for 4 hours I think this is because of the epidural so this time around I'm going to stick to me guns. But at the time I just couldn't do it anymore. Just play it by year and see how it goes but remember it is possible to be induced without if I hadn't have gotten the epidural I probably would have pushed the baby out in the next few minutes who knows.

catsinawindow

Glad to hear that you'll likely be able to avoid mag.  Good luck with your birth, let us know how it goes!

littlepawsbigears

Could you give us an update?