Mild pre-e and natural birth - Help!

Mrs.vtjaime · July 2012

Hi there. I'm 38 weeks, and have planned and prepared to have an intervention-free childbirth. My pregnancy has been totally textbook. Until Monday, when I was sent into L&D for high BP. I went to my follow up appointment today, and my BP is still high, though not terrible (134/90). I don't have any other pre-e symptoms except for a "trace" amount of protein in my urine. I had some more labs drawn today, and will be doing a 24-hour urine catch this weekend.

My doc is talking induction at 39 weeks. I'm not dilated at all, so she mentioned starting with miso and goin from there. I voiced my hesitancy at using miso, and she basically brushed me off, and told me that it will give me a better chance at avoiding a c-section than will inducing without it. I plan todo some research over the weekend and discuss it with her more at my appointment Tuesday.

I don't really know why I'm posting. I guess I'm wondering if anyone else had pre-e and still attempted natural childbirth. Also, any tips on inductions being as med-free as possible would be helpful. I'm starting evening primrose oil vaginally, having sex, eating all the usual suspects, and starting nipple stimulation with my pump. Anything I'm missing on the natural induction front? I'm not allowed to walk, because I'm on bedrest. Oh, and I also have an acupuncture appointment for Monday.

MommaA117 · July 2012

Lurking. I was never going to attempt a natural birth because I have other complications that make me high risk as well but I also developed very high blood pressure and needed an induction three weeks early. I ended up not needing the pitocin and labor progressed on its own with the cervical softener (cervadil). I also had an incompetent cervix though so that may have helped with getting things going. My water broke on its own literally not even two hours after getting the softener.

If you're pre-e starts to progress they will do whatever they need to do to get your baby out safely even if it does involve interventions that you originally did not want. Pre-eclampsia is nothing to mess with which I am sure you already know.

I know of many inductions that progress very well and still allow a vaginal birth as mine did. I was scared too because you usually hear all of the horror stories and chain of interventions leading up to a c-section but that was not the case with me.

Hopefully that gives you a little bit of encouragement if you do end up having to take the road that you originally wanted to avoid. Then again, maybe your blood pressure will stay the same and you won't spill anymore protein and Still have your natural birth Either way, best of luck

stepht514 · July 2012

I didnt have a natural birth but I did end up with pre-e. Mine started about 35 weeks and they kept a close eye on it. About 37 weeks they had started talking induction or csection. For unrelated reasons I ended up with a csection. What I was trying to say originaly was it started about 35 weeks and I made it to 37 probably could have made it to 38/39 if it wasnt for the csection (my OB thought my pelvis to be too narrow). So you are already 38 weeks and it is mild. I would say that you could probably make it on your own as long as the pre-e doesnt all of a sudden get dramatically worse. All the research you can do is a really good thing. I wish I would have done more research before my csection. I would have found that the chance of a too narrow pelvis was super small and the reality of a csection instead of my OBs words "a csection is easy all the work is on me as the doctor". I really hope you get the birth you want. At least the Pre-e is mild and you have some time to decide what you want to do.

perplexed59 · July 2012

This is probably nosy but why are you on bedrest still if you are trying to get the baby to come early? I think that there are those who have still had a natural birth with mild pre-e but sometimes in this case is better for you and the baby to take offered interventions to have a safe delivery for your baby and you. Epidurals can make your blood pressure drop which if your bp is up will make it safer for you and the baby. Sometimes our best efforts to have the birth we want conflicts what is really best for you and the baby. With my daughter I took the attitude that there was a way I would like things to go but in the end I would do whatever it took to make sure my baby arrived as safely as possible. Good luck to you!

judahsmommy1 · July 2012

perplexed59:
This is probably nosy but why are you on bedrest still if you are trying to get the baby to come early? I think that there are those who have still had a natural birth with mild pre-e but sometimes in this case is better for you and the baby to take offered interventions to have a safe delivery for your baby and you. Epidurals can make your blood pressure drop which if your bp is up will make it safer for you and the baby. Sometimes our best efforts to have the birth we want conflicts what is really best for you and the baby. With my daughter I took the attitude that there was a way I would like things to go but in the end I would do whatever it took to make sure my baby arrived as safely as possible. Good luck to you!

The bed rest is probably to help with the Pre-e at this point. OP... At this point without blood work I honestly don't know that you can say that you even have pre-e . You have border line blood pressure with a trace of protein in your urine. I would encourage you to ask for more testing if a med-free birth is important to you. Ask for tests to find out how the blood pressure is effecting you and the baby. Is your placenta still functioning as expected? Ask for a non-stress test to figure out how the baby is doing. To me it seems like your doctor is choosing to induce because it's easier at this point to decide to induce than to pursue an actual diagnosis and figure out what's going on. If you truly do have pre-e, then yes, it's worth it to get the baby out. If you have border line blood pressure with a trace of protein and nothing else, waiting is best for both you and baby.

Mrs.vtjaime · July 2012

Thanks for the responses so far. And yes, I'm on bedrest to keep my BP lower.

I wanted to avoid writing a novel (so much for that!), but I spent Monday night in triage and had an initial round of bloodwork done, wherein they found that my Utica acid levels are also high, so my doc is fairly certain. I had an NST yesterday and baby was great. My fluid was at at 16.3, which is also normal.

So you think that if my BP stays as is and the tests all come back about the same, I should try to wait? Again, I'm doing research and just gathering as much info as possible. Thanks!

katiej23 · July 2012

I had some high BP at week 39, and did bedrest and the 24 hour urine collection plus bloodwork for PreE - and still had my natural homebirth as we had planned. It never made it to PreE status (always borderline) and my midwife said that it wasn't all that uncommon for your body to just get a littler higher BP when you are so close to delivery. The bedrest was successful in keeping my BP in normal range. If I were in your shoes, I'd keep doing the testing but wait until it's for sure an issue before you agree to an induction (rather than jumping the gun 'just in case').

Best of luck to you!

MommaA117 · July 2012

perplexed59:
This is probably nosy but why are you on bedrest still if you are trying to get the baby to come early? I think that there are those who have still had a natural birth with mild pre-e but sometimes in this case is better for you and the baby to take offered interventions to have a safe delivery for your baby and you. Epidurals can make your blood pressure drop which if your bp is up will make it safer for you and the baby. Sometimes our best efforts to have the birth we want conflicts what is really best for you and the baby. With my daughter I took the attitude that there was a way I would like things to go but in the end I would do whatever it took to make sure my baby arrived as safely as possible. Good luck to you!

Like pp said, the BP goes way up usually when you are up and moving.

MommaA117 · July 2012

Like pp also said, 134/90 isnt all that crazy as long as you monitor it. I got to like 160/120 or something like that. I know the bottom number was 120. I might be shooting a little low on the top number. Yes, it was high...

catsinawindow · July 2012

You recieved some good advice, here, but I thought I'd chip in with my 2 cents.

I was induced at 39 weeks due to PreE. BP issues started at 37 weeks, but I didn't develop PreE until week 39. My OBs were comfortable waiting to see if LO would come on his own until PreE developed, but once it developed, it was agreed that we would induce immediately.

I attempted a natural childbirth with my PreE induction, but was not successfull. There were a lot of factors that played in to this, however, some of which you probably won't encounter (ie. I developed a PreE complication that made getting the epidural a good decision, medically). Other than this complication, the things I thought made going natural hard were the Mag Sulfate, being confined to bed, and continuous monitering (both because of the Mag). I did have a vaginal delivery though. PreE is actually a positive factor on some versions of the Bishop's score!

It IS possible to go natural with a PreE induction, people do it. I do think it's harder, though, especially if you're on Mag Sulfate. But, hey, maybe you won't end up developing PreE. You are very close to your due date already! Best of luck!

judahsmommy1 · July 2012

Mrs.vtjaime:
Thanks for the responses so far. And yes, I'm on bedrest to keep my BP lower.

I wanted to avoid writing a novel (so much for that!), but I spent Monday night in triage and had an initial round of bloodwork done, wherein they found that my Utica acid levels are also high, so my doc is fairly certain. I had an NST yesterday and baby was great. My fluid was at at 16.3, which is also normal.
So you think that if my BP stays as is and the tests all come back about the same, I should try to wait? Again, I'm doing research and just gathering as much info as possible. Thanks!

So it sounds like they did the tests that they needed to do. I'm not completely familiar with what the results of the tests should look like (as in how to read them) as I do tend to rely on my doctor to interpret the results. (These are good results, borderline, bad, very serious....) If your blood work is coming back with good results then I would consider talking to your doctor about staying on bed rest, monitoring closely, and taking action to try to "induce" naturally. (sex, nipple stimulation etc...) Even a week can make a difference in how ripe your cervix is and therefore, how likely an induction is to be successful.

If your results are borderline or worse, then I would talk to the doctor about the risk/benefit analysis of inducing considering the higher risk of needing to move to a C-section. Pre-e can move VERY quickly and become serious very very fast. I know of two women who lost babies because of fast moving pre-e. Both after 38 weeks. It's not something to mess around with.

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