Hypertension & VBAC? (Kind of long)

ashie0610

I don't think I've formally intro'ed here but I watch the board a lot whenever baby fever strikes.  I'm mostly a bump lurker in general though.  

The back-story is that I had my son via c-section at 37 1/2 weeks due to hypertension and breech presentation.  There was never any protein in my urine or other signs of pre-e, and I was scheduled for a c-section anyway. I think probably could have been monitored a little longer but since I was considered full-term they did the surgery right then.  I was completed terrified and my BP skyrocketed during the surgery, so I ended up on magnesium.  Bottom line: the whole experience was very traumatic for me and trying for a VBAC with #2 is very important to me.

DH and I are thinking about when we'd like to start TTC #2, so I've been trying to get more info on VBACs in my area so that we make sure we put enough time between deliveries and find a supportive practice near our hospital.  I really loved my OB because she did a great job on my surgery, but I'm not sure how accommodating she will be with a VBAC (although she was the one who pointed out that I'd be a great candidate).  I'm a little nervous she might push for another c-section if my BP problems resurface.

I started calling local midwife practices in the area to ask about their VBAC practices and one of them mentioned that while they don't induce VBACs as a general rule, their patients don't have much hypertension anyway.  I thought that was kind of an odd claim and am curious what this group thinks...

So two questions:  1. Do you think seeing a midwife vs. an OB could actually affect your BP?   and 2. Anyone tips/success stories for those who've had successful VBACs with high BP?

 Thanks! 

gardengirl3

ashie0610:

I started calling local midwife practices in the area to ask about their VBAC practices and one of them mentioned that while they don't induce VBACs as a general rule, their patients don't have much hypertension anyway.  I thought that was kind of an odd claim and am curious what this group thinks...

So two questions:  1. Do you think seeing a midwife vs. an OB could actually affect your BP?   and 2. Anyone tips/success stories for those who've had successful VBACs with high BP?

 Thanks! 

 

My guess would be that they mean....they won't take high risk patients at the midwife practice and would refer you to a doctor instead.  (high risk= high BP, diabetes, etc).  That's how the midwife practice I went to was.  Midwives specialize in normal pregnancy and delivery, not high risk situations.

I'm not saying you couldn't do a VBAC with high BP, only that you might have to see a doctor to do so.

ETA: grammar/spelling

ashie0610

Thanks for your response.  That makes sense to me.  That particular comment was via email so I didn't know how to interpret it at first.  Their big thing is creating as safe and comfortable environment so I thought that was what she was getting at.

She also mentioned that they partner with a local OB in the event that a c-section does end up being needed (i.e. another breech or other complications) so I guess I'll just need to go in for a consultation once I am pregnant again!

LLB430

I had a c-section for breech position with dd and was hypertensive as well.  My pregnancy with ds, I did not present as hypertensive until post partum.  I had a great vbac experience.  I thought for sure I would have had hbp with my second pregnancy but sailed through it with awesome bp.  Just prior to being discharged from the hospital it started to rise. 

I went into my second pregnancy really wanting a vbac but after my first pregnancy realized I really had to go with the flow because everthing with regards to my bp was out of my control. I just prepared for every possibility and put complete trust into my AMAZING OB. She was awesome in my vbac, which involved an induction. 

Good Luck to you!

DiveFrog

I haven't had a VBAC yet, but I did have high BP with my first and was using a midwife practice. What worked so well was that the midwives and OB's are all part of the same practice and work closely with each other. The midwives were with me the entire time at the hospital and continued my care through the birth (she was in the OR with me) and coordinated care with the OB for my care after delivery.

It is a fantastic practice that allows normal pregnancies be treated by an awesome group of midwives and let's the OB's handle the more complicated cases. Since you don't know exactly where you are going to end up during a pregnancy it is a very reassuring feeling to have both available at the same place.

BlinkingLight1

I had a successful (induced) VBAC @ 42w5d with gestational hypertension. I also tested negative for pre-e. Honestly, it was a fight to keep them from inducing me at 40 weeks. I had to get a weekly u/s starting @ 36 weeks and the high risk OB told me he recommended getting induced at 39 weeks, which I declined.

So,

1) yes, I think having a provider your uncomfortable with versus one you're comfortable with (OB or midwife) can affect your BP. My BP was always high (130s/90ish) when I went to the hospital (I saw a hospital mw) and it was lower when I tested it myself (high120s/80s).

I was told to drink distilled water, take a Vitamin D supplement and eat over 100g of protein a day. The protein did help. I think making sure you're eating well (lots of meat and veggies, no processed food, low sugar) and exercising will help your BP a lot too.

Good luck!

ashie0610

Just saw these other responses now.  Thank you for the encouragement!  I think the point about being able to go with the flow (or not) had a TON to do with my high BP last time so I need to chill with the next one.