Pre-eclampsia and natural birth

EBelle80 · April 2012

I haven't posted very often, but look to this board for inspiration and answers!

This is my third baby, and we were planning a midwife-assisted homebirth until yesterday. I have not had any trouble with my blood pressure until last week when I felt a little strange and decided to check it myself. My readings were very high, and my MW was alarmed enough to send me to a specialist. The specialist's recommendation was to check into the hospital and monitor, and possibly deliver in two weeks or less. So we came back to our local hospital, transferred care, and checked in on Tuesday night.

Needless to say the shock of it all and the derailing of my birth hopes has been hard to deal with but I am trying to get past it and focus on my health now.

I am still waiting for the results of my urine collection, and my bp seems to be responding well to a pill medication. I might get to go home and be monitored, but I'm not sure yet. They also gave me the first of two steroid shots to help baby's lungs develop. My new doctor said I do have pre-eclampsia, and that even though my labs look good now it is just a matter of time before they don't anymore.

So now I am facing a likely induction. I have no idea what my cervix is doing, but the baby is super happy in there, no contractions, and not ready yet! My doctor said he prefers the foley bulb method of induction, which I feel I would be more comfortable with than pitocin, which I really don't want. Is it still realistic to hope I can have a pain-med free birth at this point? (I have already had one natural birth) I guess I also am really hoping just to have a vaginal birth at this point. Has anyone experienced this or have any advice at all?

Celyn · April 2012

My understanding is that pre-e isn't diagnosed until you have both an abnormally high BP and over 300mg of protein in your urine, so wait for the lab to come back

A foley will get you to about 3cm without too much discomfort and then hopefully you'll have your own contractions. Otherwise they'd have to force them to start. Some OBs are willing to let you induce via nipple stim (some want you monitored while you do it), if you're opposed to pitocin. The pre-e would only complicate things if your BP was too high to be active and they wanted you confined to the bed or they needed to give you magnesium sulfate (which slows down contractions, so they have to up the pitocin). I've witnessed lots of moms undergoing inductions or augmentations of labor that managed without ped meds. The fact that you've already had babies and know what to expect from labor will go a long way in helping you cope. It helps quite a bit if your OB is willing to turn down/off the pitocin drip once you've established a labor pattern that fits your stage of labor (as opposed to forcing a transition-like pattern from the get go).

FyreFlyeRush · April 2012

You should be able to have as med-free a birth as possible, tho pitocin is likely, with PreE. In fact, they prefer to do vaginal because it puts less stress on mom. However, I'd make allowances for an epidural and magnesium sulfate. Epidurals lower your blood pressure, and your OB may recommend getting one for that purpose. Just remember, a birth plan can always get tossed out the window.

EBelle80 · April 2012

Well, my urine collection was 391 mg of protein and the cut off is 250. So pre-eclampsia it is! My BP is only well controlled if I am on the medication and laying down so I cannot go home at all. I will get my second steroid shot tonight, then hopefully wait at least 48 hours after that before delivery. I would love to make it to 35 weeks on Tuesday the 1st, but my doc may have other ideas. The baby cannot stay in the same hospital as me if he/she has to go to the NICU. Plus side - baby is great, with my history of fast labors this will hopefully go smoothly even with induction, and the doctor said no one will force me to get an epidural if I don't want to - they can just try to control my bp if it goes up. I just can't believe I have been so healthy this whole pregnancy, planning a homebirth (I even bought all the towels already, ya'll!) and here I sit. I am not sad so much anymore as just worried about my baby now, but I still can't believe it.

Celyn · April 2012

*hugs to you* Your BP must have been off the rails. Glad to hear it's under control.

You'll be meeting your baby soon!

catsinawindow · April 2012

I was planning a natural birth and developed PreE late in pregnancy (BP issues at 37 weeks, PreE at 39 weeks). While PreE itself doesn't preclude you from a natural birth, it may change your birth plan to make a natural birth more difficult.

If you end up with severe enough PreE to induce early, you'll probably be on mag sulfate during labor. When you're on this medication (to lower BP and prevent seizures) you probably can't walk around, will likely need continuous monitering, and may not be allowed to eat or drink. Talk to your care providers about whether you'll need to be on Mag and what restrictions they will have. It also can make you feel awful, but it differs from person to person.

I was induced with pitocin, then AROM when the pit didn't work. If I had to do it over again, I might have asked for foley bulb to see if it put me into labor by itself (I was already 2-3cm when I was induced, so my OB didn't recommend it). Ask your OB what your Bishop's score is. It can tell you more about how likely your induction is to work and how they may induce you.

julyjennifer · April 2012

No specific advice, just wanted to say best wishes to you and your baby!

It's hard having everything change on you, but it sounds like you're handling it as well as you can be.

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