High BP & Induction - BTDT moms, anyone decline?

albolan80 · July 2015

I've been on twice-weekly NSTs & weekly AFIs for the past 5 weeks due to borderline high BP (high 130s-high 80s). Baby has shown to be just fine, and is measuring at 70th percentile (I know those are not always accurate); one of the bigger signs of babybeing negatively impacted by BP is small size/slow growth.

All of my lab work (as recently as yesterday) has shown no signs of pre-e. Yesterday my BP had jumped to 154/84 and today I went in again for a check and it was 152/98. The nurse (that I'd never seen before) went to talk to a doc - whom I'd also never seen/met before - and came back and said I was going to be induced on Monday at 37w0. No discussion, no anything - just, show up at 11:30 for induction.

I asked if I could be re-tested on Monday before induction to make sure it's necessary since my BP hadn't been that high before. I was basically told probably not, but I called back later and went back in to at least MEET the doc that ordered the induction and ask some questions.

She said that because I've had borderline BP for the last 5 weeks they should have told me before now that I would need to be induced at full term (they consider it to be 37 weeks). We talked through a lot of the alternatives and at the end said no one was going to force me to have an induction. I want to keep my little guy in there as long as possible, and I also want my body to be more receptive to delivering to avoid as many interventions as possible - esp. a c-section as we want to attempt getting pregnant again pretty quickly (I'm almost 35 an it took us 2+ years to get pregnant). But more than ANYTHING I just want him to be safe, obviously.

Has anyone else pushed back or refused an induction with higher BP but no pre-e? The doc from today said I could get a second opinion, but my regular doc isn't in the practice again until Thursday. I clearly don't want to ignore what a doc is saying, and whatever is best for my baby is what I'll end up doing...but I partly felt like they were scheduling just to schedule. As of right now, I'm going back on Monday for an NST & BP check at 8:30 am (per my request), and if my BP is high/er I'm going to head over for the induction - she said either Monday or Tuesday (so she changed during the course of our conversation). If it's lower, we'll discuss next steps. They're also going to check my cervix to see if I'm dilated at all - the doc said that while induction blows (exact words

) if I'm at least a little dilated it'll go better. I'm just stressing out over potential interventions and distressing my baby.

Has anyone had something like this happen? I'd at least like to give him a few more days in there - so I'm hoping it's lower on Monday and we can at least push to Thursday or so. Every day counts!

Jenaboo4 · July 2015

I have pre e. Before I was diagnosed with it I had bp of 140/90 or higher and did a 24 hour urine that was over 300 protein. In order to be diagnosed with pre e you have to have both. Before I peed the protein I had the high bp so I was just considered hypertension disorder at that point. But pre e is nothing to play around with. I have had it now 3 times. Luckly 2 prior pregnancies I didn't show (high bp & spilled protein on that little dip stick at Dr office) until I was 37 + weeks. This time totally different and now as of 10 pm last night I'm showing signs of kidney failure due to pre e because I got it early on. Ask for protein test. If you're not spilling protein than your kidneys are fine just you bp needs to be controlled until delivery. My advice. Hope it helps

Jenaboo4 · July 2015

Oh yea,up to this point I have put my foot down & told my doctor several times he wasn't inducing me... he has wanted to a couple of times. But my bp has been controlled on meds (a couple of spikes) and she hasn't never hit distress. Just now my blood work isn't so pretty so Might not have a choice anymore

laurasuzanne2006 · July 2015

I would absolutely refuse an induction without signs of pre e if all else looked good.

EmEeGee · July 2015

I'm in a similar situation. I have high BP when I'm not pregnant so I've been monitored closely throughout this pregnancy. My numbers are typically 130's/80's when I check it at home, but without fail... My first reading in the office is always 140's/100's. I ask them to give me ten min or so and the recheck is always better. My urine has never shown protein and my pre-e labs were perfectly fine. Baby shows no signs of growth restrictions and my NST/AFI checks are normal as well.

However, I was also told that I would not be allowed to go past my due date and would be induced no later than my EDD. I wasn't happy about it, but like you said, if it's the safest option for me and baby then it is what it is. To avoid induction, my dr wants to start doing cervical checks and membrane sweeps in my 37-38th weeks to encourage my body to do this on its own. Obviously if the baby isn't ready, it probably won't work and in any other situation Id refuse both services, but in the face of an induction I'm going to let her in hopes that it riles things up just enough to go into labor on my own (hopefully in my 39th week). I appreciate that she understand my strong desire to not be induced and is giving me a chance. But the induction will still be on the table.

Just wanted to offer you a different take on it between my dr and I. Perhaps it's something you could discuss as an option so long as your health is still good and baby's is too. Good luck.

Saratiff · July 2015

So I'm not a BTDT mom but I do work in cardiology. Your blood pressure is high and has been for over a month. It also sounds like you didn't have high blood pressure before getting pregnant so this is not a baseline for you either. I totally get wanting to cook baby as long as possible. I just also know the strain that that puts on your heart. Maybe run it by a cardiologist and see what they think?

Kimk1616 · July 2015

I was in a similar situation last week. My BP was in the 140+/80 range and I ended up being scheduled for an induction. I never made it to the induction stage because after 36 hours of cervix ripening meds, I was still only dilated to maybe 1 or 2. I will agree, that sucked terribly. Eventually my baby girl was showing to be too stressed and doctors were very concerned about continuing and how she would do during labor. I ended up with what I absolutely didn't want, tons of interventions and ultimately a csection. The cord was wrapped around her neck twice which is why she was showing so many signs of stress by I do wonder if this happened because of the contractions I was having during the cervix ripening. I have a happy and healthy baby girl born at 37w 2d and I don't regret it. But I do wonder why the induction was pushed so suddenly even though my BP wasn't crazy high and I did not have pre e. Ultimately, I was too scared to ask questions and get a second opinion, I just wanted my baby to be okay. But those 36 hours were painful and miserable and I will think twice about rushing in to it should this happen again in the future.

I hope everything turns out well for you. I know that your baby is your first priority but it doesn't hurt to ask questions and be informed before making such a big decision.

jesselayne8 · July 2015

As much as I am all for going into labor naturally. I would not refuse an induction Monday if your pressure is still high. It's not just a matter of your baby's health but also your own. Stroke is a big concern. I would go into Monday prepared for an induction and hope that your pressure is better so baby can cook a few more days.

lelesmom · July 2015

I just got induced Monday and what is going on with you sounds like what happened with my first. High BP (150s/90s) and no pre-e until I was 39 it jumped up and I was put on bedrest. I was only induced at 40 weeks because my BP was getting up to 170s/110. Now this pregnancy I had protein in my urine since week 28 but was only diagnosed with pre-e Monday after monitoring my BP, blood work, and urine. They weren't able to get my BP under control so I was admitted that day and induced Monday. Your BP doesn't seem to be at a dangerous number so I do not believe it is necessary, however I'm not a doctor and I would talk about it with your SO and if you truly feel it is needed then hopefully the doctors are thinking about you and baby's health not about their weekend schedules. Best of luck. T&P

albolan80 · July 2015

Thanks, everyone... Great ideas and info. So far my labs (blood & urine) have showed no signs of pre-e at all, which is great... I'm just afraid I'm making the wrong decision because I'm, well, afraid! Of delivering, of inducing, etc. It's very helpful to have other perspectives, thank you!

On a lighter note... My SO said 'honey, he has a face now, he doesn't look like a lizard anymore, so he's probably ready.' Yep. Gotta love him!

He says that because t my AFI they flipped on the 3d so we got to see his amazing little face

Bailey1823A · July 2015

I agree with @Saratiff. As an L&D RN 150s/upper 90s is concerning without pre-eclampsia. While is does seem like baby is growing well I would be more worried about stroke or seizure for you. Also preeclampsia can sneak up in the end of pregnancy and everything can be normal one day and you can be very sick the next. But with having high bps two days in a row, I would trust your doctors for sure. Good luck and hope your follow up is better.

dkizz82 · July 2015

I would at least want to discuss it with MY doctor.

Saratiff · July 2015

Hehe @Bailey1823A I was totally going to go the stroke and seizure route but then thought I might be to harsh. I didn't want to be responsible for making her BP higher. X_X

taylorharber1108 · July 2015

I think hypertension is just something most doctors do not want to mess with. Over the last two weeks my bp has jumped into the 140/110s range. There was protein in my urine dip but my levels leveled out in he 24 hour urine catch. At our last ultrasound our baby was measuring in the 29th percentile. My doctor didn't seemed to concerned about his growth but she said it does trigger alarms. My doctor plans on a medical induction this next week (37 weeks) or the next (38 weeks). I plan on asking if I stayed on best rest would she let me go until my 38th week but I am pretty sure she will say no. Hypertension and preeclampsia can lead to seizures which is nothing to play around with. I do not plan to refuse a medical induction and if it results in a c-section I will cross that bridge when I get there.

I hope your doctor will let that baby cook a little longer! Good luck with your decision regarding your induction.

albolan80 · July 2015

Saratiff said:

Hehe @Bailey1823A I was totally going to go the stroke and seizure route but then thought I might be to harsh. I didn't want to be responsible for making her BP higher. X_X

Too late- Dr. Google already told me

Saratiff · July 2015

@albolan80 I should have guessed that. I mean it's a tricky situation but trust your doctors. I mean at least we are talking 37-38 weeks and not like 35. Advocate for yourself but also trust your medical team. A well baked baby also needs their mom in good condition to take care of them. Good luck momma and absolutely keep us posted. Thoughts and prayers for you and little one.

brittiniew · July 2015

Are you on any blood pressure medication? I have had pregnancy induced hypertension with both pregnancies. Last one from 24 weeks and this time from about 32. My BP is well controlled on a very low dose of Methyldopa. Unfortunately I have developed mild preeclampsia this time with some protein in my urine. They are "limping" me along as far as they can haha as I will be 37 weeks on Thursday next week. Maybe you could have a conversation about controlling it with medication for another couple of weeks, as long as you don't have protein in your urine or other complications. I agree with the other mamas that it's definitely nothing to mess around with, but you should have some other options as well! Just weigh out your options, but my blood pressure has been perfect since going on the meds this time! Good luck!!

Bailey1823A · July 2015

Saratiff said:
Hehe @Bailey1823A I was totally going to go the stroke and seizure route but then thought I might be to harsh. I didn't want to be responsible for making her BP higher. X_X

While I wouldn't want to be responsible either, just wanted people to realize this could be a big deal. It's not like the dr wants to induce early for suspected big baby or some non medical reason for an induction.

Shine2015 · July 2015

I know you said your doctor won't be back at the practice until Thursday, but is there anyway she can be contacted before then just so you can discuss it with her since you seem to trust her so much?

EmEeGee · July 2015

To add to my post - I re read it and felt like my advice wasn't how I wanted it to come off. Delaying induction in my case is a little different because my numbers (while slightly elevated) are my baseline and are staying in that range, which is why my dr is willing to let me try a few different things first. Your numbers do appear to have jumped in a shorter period of time and are not your norm which makes total sense for your dr's sudden concern. I was caught up in giving you my experience (honestly I had just rolled over and woken up

) and agree with pp's that high BP, especially new or sudden onset, shouldn't be taken lightly which it doesn't sound like you're doing. I would trust your medical team. Baby needs a healthy momma.

LittleLeahBee · July 2015

I had a very similar situation with my first born son. I was tested multiple times for pre-e, but always passed...right up until his delivery, when I erupted as we were in natural labor anyway. Pre-e is REALLY serious and REALLY dangerous. I would absolutely trust what the doctor is saying, and not let too much more time pass. We had a very scary emergency delivery because of the fact that mine erupted at the last minute. Of course my situation isn't like all of them, but I would certainly be nervous to put it off, having been what I've been through, if it were to happen the same way again. Sending thoughts and prayers, and hoping for the best! Good luck!