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Natural Birth
May be moved from my Midwife Practice-sorry, long!
I am new here, about 15 weeks along. I have been with a local midwife practice throughout my pregnancy, and hope to have a natural birth free of interventions. Up to this point,I have had a relatively easy pregnancy-no morning sickness, etc. and my baby is growing right on target with a strong heartbeat.
However, I am under a fair amount of stress right now. Nothing terrible, but I am student teaching while completing my masters degree, so I work a full day, then have a few hours of HW each night. As well, my 18-year old sister lives with DH and me (she had problems at home, it was not a safe environment for her) and we have some extra responsibilities with her. My DH does all the cooking and we share cleaning responsibilities.
At my previous appts., I had relatively high blood pressure, but was feeling great. Yesterday, however, I had just come off a week that was physically exhausting, and I had taken a sick day (my first) on Friday. My blood pressure was much higher- 156/90, and my midwife said I need to get in touch with Maternal Fetal Medicine and see what they say. She said they may classify the pregnancy as high-risk, and if so, I would be transferred out of their practice to a specialist (I am delivering at a large university hospital in our area, they are equipped for all situations)
My midwife mentioned that as the pregnancy progresses, if we don't get this under control, I will be at risk for pre-eclampsia and/or losing the placenta. I am beyond worried right now. I don't particularly want to go on bedrest, because I want to finish out this semester, but I know my university will work with me as needed.
My question is-has anyone else dealt with a similar situation? I really want a natural birth, but my midwife cautioned me that if the BP is not lowered/ resolved, it is likely lots of interventions will come into play. I am just going to do whatever they tell me to. Should I just prepare myself for the possibility of induction or C-section?
I contacted both my professors and they got back to me right away saying if my midwife/ doctor says to finish student teaching in the fall, I can take INCs. However, that would be far from ideal.
TIA for your stories/ advice.
This discussion has been closed.
Re: May be moved from my Midwife Practice-sorry, long!
I think you need to take some things off of your plate, I don't know what that might mean for you but stress isn't good for you OR the baby.
How much protein have you been eating? (gms per day) start figuring it out and make sure you are getting at least 80.
Are you working out?
Walking? Yoga? Lifting? Anything?
You have to find a stress reliever and I would be willing to bet you probably aren't sleeping enough (and I'm not being mean, just honest)
If you want to avoid interventions then you need to keep your stress down and keep your BP down, I wouldn't avoid it but I'd make sure to calm down, try to go to a relaxed place before you get your BP taken so that you aren't stressed and it isn't as high. Take deep breaths etc
in some cases this is a condition that you can correct. i would act quickly and do everything in my power to do so.
did your mw give you any suggestions to bring your bp down?
do you have a history of high bp (even before pg) or is this new for you?
what is your diet like? what did you eat yesterday?
do you do acupuncture/acupressure to reduce stress? or any other technique like meditation, yoga, exercise...etc.
there are supplements that can help this such as hawthorn berries. have you heard of them?
i would not just give up and roll over and accept it. you are still early enough in your pg that there are things that you can do now.
I see you are from Long Island. I am also and I am pretty sure we see the same midwives and are delivering at the same hospital.
When I was seeing my RE and doing fertility treatments, my BP was running a little high, but after I got pregnant, it lowered back down to normal. The only explanation the Dr. had for the high BP was the stress of doing the fertility treatments however, he suggested I see a high risk OBGYN.
I started seeing the high risk OBGYN associated with the midwife practice you are talking about. I was with him from weeks 10-20 and he was pretty great. He was very supportive of me switching to the midwives at 20 weeks if everything was looking low-risk with my pregnancy and the great part about seeing the midwives is that if anything ever goes wrong you can go right to the OB's in the same office as them where they share files, information and work together on a lot of cases.
That can also work in the opposite manner. I was just at a hospital tour with the midwives a few days ago and there was a woman there who was their patient but was then diagnosed with IC and had to have an emergency cervical stitch so she was switched to the high-risk OB however, the midwife that gave us the tour said that if everything is looking good at the end of the pregnancy she can see if she can switch back to the midwives for delivery.
All that being said, I agree with PP that I would not just let this happen. Things I have read that you can do to lower your blood pressure are:
1) Rest. Get on a good sleep routine and make sure you are getting enough sleep every night.
2) Eat a well balanced diet with lots of protein, fruit and vegetables but limit salt/sodium
3) Walk for 1/2 hour every single day. Walking can lower your blood pressure but also will help you in so many other ways, including your labor.
Also maybe a prenatal yoga dvd might help you with your stress??
PM me if you want to talk further about the practice
Thanks for all the encouragement and advice:)
Yes, BabyMimi, I have a feeling we are at the same practice. I am relieved to hear that it's possible to switch between the midwives and the high-risk OB... my impression was that once I was switched, it was a permanent thing.
My DH went out and bought me a home cuff this morning, and my readings at home were significantly lower, more like 120/65. I didn't feel particularly nervous at the practice, but I am going to continue to take readings at home and see if they stay lower.
I did ask my midwife if I could make lifestyle changes to improve things, and she said it was unlikely-I am not overweight, eat an overall healthy diet (we don't eat prepared salty foods or add salt to our cooking, we eat out maybe 1-2 times per week) and exercise 3-4 times a week as much as possible (it has been slightly less since beginning student teaching, although I am on my feet constantly throughout the day, too). I will have to look up supplements, I don't take anything but my pre-natals now.
it's good that you got a bp cuff, i did forget to mention that. another thing i forgot that is on my high bp protocol are the risk factors, which overweight is not one of, and things to do to prevent.
Who is at risk for developing a hypertensive disorder?
~ women under 20 or over 35
~ women with diabetes, kidney disease, excessive amniotic fluid, multiple pregnancy (twins), high blood pressure before pg, family history, abnormalities in the baby
~ first time mothers
How can I avoid high blood pressure during my pregnancy?
? 20 mins of brisk exercise daily
? Drink plenty of water, 10-12 glasses per day
? Eat a sufficient amount of protein daily 60-80 grams, more if necessary.
? Rest at least two hours daily, twice daily if you can.
? Relax, find what works the best; (yoga, Tai Chi, meditation)
? Take calcium 1500mg and magnesium 500mg daily
also, Hawthorn Berries, 2 pills three times a day.
Texas, a couple of questions- I took a look at your blog and see you are a midwife:)
My midwife at home said being overweight/ obese was a risk factor for developing hypertension or high BP. Not true?
On the list of risk factors you posted, the only one that's true of me is being a first time Mom. As far as the preventative measures, I do most of these already (must look into the Hawthorne berries), just as part of my regular lifestyle...up to this point, I have had a healthy, relatively easy pregnancy. When you write rest 2 hours daily, do you suggest right after work? I know I don't have time right now for twice daily, I work from 7:15-3:45 most days, and then have HW, classes and/or exercise at night. I am trying to get my university to allow me to take more sick days from teaching if I need them, we only get 2 per semester.
Have you known women who were otherwise healthy, and this problem was controlled with medication, and didn't develop into serious complications.
oh geez, my blog, i haven't updated it in forever!
sure, generally speaking, being overweight can be a risk factor for high bp, but it is not a specific risk factor.
resting during pg is very important, i would suggest that you get it in whenever you can. i realize you have a busy schedule and this will be more challenging for you. you might need to cut back on the extras in order to give all your energy to this pregnancy.
are you doing the calcium and magnesium supplements in the quantaties that i mentioned? if not, you might discuss that with your mw and see what she thinks. are you seeing a CNM or CPM/LM/DEM?
i haven't had too many women with me that developed this condition. however i did have two last year that were close together and fwiw they were both normal weight first time moms. they did not do the bed rest as they were instructed and i'm suspicious as to whether or not they did the rest of the protocol and both risked out of home birth care and required hosp births. they did wonderfully and both had normal vaginal births.
given that you are less than 20 weeks and you mentioned that you've had high bp before at other appts, i would say that you have chronic hypertension (i say that as an internet stranger, not as your mw) and does change things a bit. i would do whatever you can to correct this before it gets out of hand.
what have your readings been the last day or so? how many times a day are you checking it?
I admit to not reading all of the responses since I'm kind of in a hurry, but definitely try to relax and be calm before you go in to your appointments. Also, ask your MWs to give you more time before risking you out to the OB or MFM specialists. Here is my experience...
I switched from a traditional OB in a large hospital at 9 weeks to a family practitioner who is known for being a natural birth proponent. She delivers in a very small, rural hospital. My BP was high or borderline all throughout my first and most of my second trimester. I honestly just think I was nervous--about the pregnancy in general, about staying healthy, about the appointments, etc. I also bought a BP cuff for at home, and every time I checked it there, it was within normal range. So, my doctor just told me at every appointment -- if my BP continues to stay high or get higher, I will risk out of delivering at their small hospital, and unfortunately, I'd have to go back to the larger one in our town. Well, I don't know what happened with my body or if I just finally quit being nervous about the pregnancy, but my BP has been awesome ever since just before Christmas. So, give it time, try to relax, and see if they MWs would be willing to treat you with baby-safe meds for your BP instead of risking you out right away. That was another option my doctor discussed - if she felt I was truly into the hypertensive range, she would be willing to try meds to see if that would control things before sending me away.