any Mamas w/white coat hypertension still out there?

[League_mama]

We talked about this several months ago and I wondered if any of you are still out there. I'm still dealing with this and with my midwives who are in general dealing with it reasonably well, except they won't accept my b/p readings from home and still take it at my prenatals, where it is of course at least ten points higher. I run around 120/75 at home, 130 or 140 / 80-84 at the appointments (although usually they take it again and it's dropped by 10 pts or so). Luckily my baseline was really, really high back when I was 13 weeks (something like 144/80) so I haven't ever approximated the rise they look for to indicate PIH. Don't have any significant swelling or anything else, but really just so stressed about these appointments! And I'm only 37 weeks so this is going to go on a long time. Any tips on how to handle this/them for the next few weeks so I don't 'risk myself' out of a home birth? I've been working on relaxation and stuff but there's only so much time for that w/a 3 year old, the holidays, and DH in grad school and student teaching 6+ days a week.

[JoyofBirth]

I always take deep breaths and close my eyes and imagine ocean waves on the beach I love in San Diego while they take it. That was helping mine. Not anymore though. It doesn't sound like too much of an issue. And if the midwife gets concerned about it, her next step should be to have you watch it in between, which you already are.

[pantufla]

Ugh! I'm right there with you, mama. I don't understand why your m/w's won't accept your readings from home -- well, I mean I do, but with my first baby it was the midwife who suggested I take my own pressures at home and even loaned me a home BP thingy. My BP is significantly better at the m/w's office than at the doc's office, so that's something, right? (Every time I go to the doc it's 140/90. I've gotten to the point where I don't even let them take it. Why let them enter it into my record when it's not even accurate?) Are your midwives doing a home visit? At my home visit last week my m/w took my BP and it was completely normal. :

Oh, and I meant to add... I know someone who does hypnosis (like hypnobabies), and she works with mamas over this sort of thing. Can you find someone in your area?

[League_mama]

I've tried hypnosis...did w/pg w/DD at least but went into labor and delivered her quickly without any bp checks before the next prenatal! I guess I'm stressing out today because I have a prenatal--actually my home visit--on Thurs, and I've been taking my pressure today and can't get the top number under 120, which heretofore I have been able to do easily w/a little deep breathing. Making me wonder if BP is climbing a bit. Glad there are others still out there--Pantufla, don't you have GBS too? That's my other delightful concern at the moment, though honestly I think neither are terribly real problems.

[pantufla]

Yes, I'm highly colonized with GBS. I'm doing the Hibiclens protocol. Although, if labor goes on for awhile with my water broken I'm open to IV antibiotics... Not really excited about that idea though...

Frankly, one of the worst parts of my two labors has been having my BP taken.

The top number of your BP at 120 should be fine.

[phatchristy]

Honestly, if you want to take 15/10 off of it, I'd do that cream of tartar remedy...you mix some with lemon juice and water and do it three days on, two days off, something like that.

I'm pretty much in the same situation. I remember writing to you about it before LOL. I'd up the cal/mag/d and protein. Also, fatty acid supplementation is supposed to help too. Have cucumber, watermelon every day. There's all sorts of things you can do really.

I think (if I'm remembering right) even HOPS/valerian can take it down too. But that may be more short term (as in the context of labor).

Maybe it's because it's my 4th babe with them...I don't know, but since my last one they just said it was getting too stressful for me and that I should just take it at home. Because the same stuff was happening. My bp would be somewhat elevated there (not high, but higher than it should be for me) and then they would wait a little while until after I'd heard the baby, talked to the mw and it would go down. I'm not getting why they're not working with you. Do they know how it makes you feel? Midwifery is all about empowering women, so I'm not getting this one. As long as they have something in their book to protect themselves from liability they should be relaxed you'd think!!!! Have you talked to them about this recently?

Some good reading is the midwifery archives at gentlebirth.org. Come to think of it, I should go there myself to read up!

[phatchristy]

Originally Posted by League_mama

I guess I'm stressing out today because I have a prenatal--actually my home visit--on Thurs, and I've been taking my pressure today and can't get the top number under 120, which heretofore I have been able to do easily w/a little deep breathing. Making me wonder if BP is climbing a bit.

Oh, I forgot to address this one too...definitely it is normal in the third trimester for it to go up a little, going back basically to what it was pre-preg. From what I read with the first trimester it is like pre-pregnancy, then in the second trimester it lowers a bit (to encourage the body to increase blood volume, etc) and then in the third it does go up somewhat again. Mine always does somewhat. I usually start to see it closer to my pre-pregnancy rate around now. Usually returns to around 120/80....in the second trimester I typically see it more around 115/72 or something like that.

And, keep in mind, the top number is NOT as big of a deal as the bottom number. The bottom number is your heart at rest. The top number is more variable, and more likely to be affected by stress, etc.

Anyhow, trying to be reassuring. I go through the same stuff, reading up and being proactive helps!

[phatchristy]

Originally Posted by phatchristy

Honestly, if you want to take 15/10 off of it, I'd do that cream of tartar remedy...you mix some with lemon juice and water and do it three days on, two days off, something like that.

I looked it up in the midwifery archives, and it's even more cream of tartar than I remembered! (DOH) Here's what one of the mws wrote:

I use 2 t cream of tartar with the juice of half a lemon taken 3 days skip a day repeat to treat high blood pressure. It will drop the pressure about 20/10 right away.

This is what I do at the end of each pregnancy. It works! I'm actually starting today as I realize I'm now 37 weeks and I expect it to creep up a little now. Though I did feel like crap last Wednesday night (cooked the whole day, really overdid it). I woke up early and took my bp and it was 118/76 or something.

I'm definitely going to be trying to keep myself low stress.

[League_mama]

I'm doing the cream of tartar thing tonight. Also upped my protein to about 150 today AND drank a gallon of water and feel like that's made a difference (got lower numbers taking it today). Wow, 118/76 and you felt stressed? That's great, if I could only post those numbers sometimes for the midwives! Actually I think my BP is higher in the am because I haven't had protein for so long, that's a real relationship for me.
My m/ws, well, I haven't had a great time with them. They really seem to be looking for something wrong. In fact at one point one of them suggested I didn't have the commitment to have an out of hospital birth--THE ONE I DELIVERED MY DAUGHTER AT HOME WITH. So I think they just desperately need to record a 'good' BP number on my chart every time I see them and are flustered when I don't produce. I'm in Missouri where there are BIG issues w/midwifery and I guess they don't want to have me stroke out on them or something. They have a pretty high rate of transfer too. I'm really hoping to just go into labor in the next couple of weeks and call them in time to help w/ the actual delivery and hopefully maybe even avoid my BP being taking during labor (didn't happen last time, DD came too fast!).
Well mamas, thanks for the positive thoughts! Here comes my prenatal and second GBS test tomorrow, wish me luck!

[terrainthailand]

I've been dealing with this too and don't have any advice other than what has already been said. Even though I was checking at home and getting great numbers, my doctor has been concerned about the high numbers I was posting at her office since very early on, and didn't really care what I was getting at home. I ended up visiting the cardiologist 4 or 5 times before she finally dropped it - he made it very clear that I do not have hypertension, I have white coat hypertension. When she has brought it up in passing (like suggesting I cut back on salt to address the high blood pressure), I gently remind her, "okay, I can do that, but I don't actually have high blood pressure so is it really necessary that I change my diet?" The fact that I haven't had any protein spills has helped her calm down a bit I think.

Still, even though she has dropped it, even though I know there is nothing wrong with me, and even though I practice meditation and deep breathing before they take my blood pressure - it is still high. No matter how relaxed I get myself, as soon as the nurse comes over to me for the "walk" over the blood pressure machine all my work is undone. It is actually kind of funny.

My doc was out for my last appointment so I had to see someone new. He, of course, wanted to go over the whole thing again. This time I just stayed calm and submitted to yet ANOTHER blood test... and AGAIN... nothing is wrong with me. Sorry, no solutions... just wanted to let you know you aren't alone.

Also, I do worry about how this is going to play out when I am in labor. What if it is high then too? How will I know whether it is my "nerves" or whether there really is a problem?

[phatchristy]

Originally Posted by League_mama

I'm doing the cream of tartar thing tonight. Also upped my protein to about 150 today AND drank a gallon of water and feel like that's made a difference (got lower numbers taking it today). Wow, 118/76 and you felt stressed? That's great, if I could only post those numbers sometimes for the midwives! Actually I think my BP is higher in the am because I haven't had protein for so long, that's a real relationship for me.

I think for me it's psychology mainly. If I'm upset the systolic does go up...sometimes to 135 or so, diastolic pretty much stays the same, might go up to 80 or so. But, at home, on my turf it seems to be good. Even like I said when I felt so awful after being up all day (early) the day before thanksgiving I think I was so tired then though I was stressed that the bp ws good LOL. Though even *thinking* about bp issues apparently makes me upset. I took mine last night, it was fine (116/78) and then again this morning and the diastolic was even lower. Its lower when I don't have kids demanding stuff out of me.

My m/ws, well, I haven't had a great time with them. They really seem to be looking for something wrong. In fact at one point one of them suggested I didn't have the commitment to have an out of hospital birth--THE ONE I DELIVERED MY DAUGHTER AT HOME WITH. So I think they just desperately need to record a 'good' BP number on my chart every time I see them and are flustered when I don't produce. I'm in Missouri where there are BIG issues w/midwifery and I guess they don't want to have me stroke out on them or something. They have a pretty high rate of transfer too. I'm really hoping to just go into labor in the next couple of weeks and call them in time to help w/ the actual delivery and hopefully maybe even avoid my BP being taking during labor (didn't happen last time, DD came too fast!).
Well mamas, thanks for the positive thoughts! Here comes my prenatal and second GBS test tomorrow, wish me luck!

The mws here have a rather low transfer rate actually, around 7%...but I believe that also includes moms that transfer out during the end of pregnancy too I think. Of course, I was feeling good that there weren't like ANY moms due around my dates (within a couple weeks either way) and today I found out they added three new moms just around me who transfered from OBs who pulled a bait and switch on them, etc. But these midwives seem to REALLY be into doing whatever they can NOT to transfer a mom. They're really proactive about stuff.

If you're worried about your bp during labor, you can have hops/valerian on hand. There are other herbs that will work short term too that I know some people use. With my last birth nobody took my bp until after the babe was born...I took it with my machine while I was in labor. She got there and recorded it. Then, after the babe was born she did it, and it was just fine too. I did request though that if they were going to take it, it would be the mw who would take it, not the birth assistant. The birth assistant there couldn't get the equipment to work right once...and pumped my arm up four times before writing out any number. She didn't have the valve tightened.... Of course, by then I was upset.

I hope that your prenatal went OK. I had the GBS test done today. I've always tested negative, but I know I'm a bit yeasty this time and I didn't treat the yeast until today....she said if I wound up with a positive (which I still doubt) I could retake it next week anyhow. I was glad that she said that!

It can get so frustrating feeling like we have to jump through all these hoops to get the birth we want. My last pregnancy at the end was really like that...stressful as far as the mws went, and it wound up being an absolutely wonderful birth. MUCH better than I could have ever imagined. DS having such a great birth and gentle welcome into the world really made everything worth it! I wish the same thing for you! Let me know how your prenatal went!

Do you have a birthing script/relaxation script you use at the end? I have one that I use. I find that also helps me prepare emotionally for the birth. Some friends have had a lot of luck doing the tapping techniques...they call them emotional freedom techniques. You tap certain acupressure spots on your body, face and neck and it apparently relaxes you immensely. I haven't used it for this regularly, but it does appear to work and is so easy to learn. That might be something you want to look into. I know there are some threads here on it on MDC.

I know I wrote a novel, but since I'm working through some of the same issues in my brain, I think writing everything out helps me too. I feel good when I'm being proactive. Just knowing that I'm prepared helps so much!

[League_mama]

Well, I really appreciate all your thoughts, PhatChristy! So thanks for the ideas, etc. And I posted impressively high systolic numbers today (for the m/w, my at-home numbers were like 121/73) and she actually didn't even bat an eye. She said, keep taking it once a day at home and if YOU see a rise that alarms YOU, call me. And eat cucumbers. :-). I have actually thought about a) asking if I can do the bp during labor; and b) what do you think, would valerian work before a prenatal appt? Would that be cheating :-) because MY BP is NOT high, not according to measurements I've been taking.
Oh, thanks for all your support, ladies. Terri, I wouldn't worry about your BP in labor--anecdotally, women w/ white coat hypertension tend to post high numbers when they are thinking about the BP machine, and you so WILL NOT be thinking about that when you are in labor! GL everyone!
L

[pantufla]

LM, I'm glad your appt went well! And they're finally going to take your word for your own BP.

[phatchristy]

Originally Posted by League_mama

I have actually thought about a) asking if I can do the bp during labor; and b) what do you think, would valerian work before a prenatal appt? Would that be cheating :-) because MY BP is NOT high, not according to measurements I've been taking.
Oh, thanks for all your support, ladies. Terri, I wouldn't worry about your BP in labor--anecdotally, women w/ white coat hypertension tend to post high numbers when they are thinking about the BP machine, and you so WILL NOT be thinking about that when you are in labor! GL everyone!
L

I do think during labor you're thinking about other stuff. Even then before my mw left and she took it (this was after the birth) I honestly wasn't even thinking about it at all at that point and it was just fine.

What I did, I just took it myself a couple times when I was in labor, and left it on the counter in a notebook. When the mw asked about it I showed her. That was enough, then she took is after the birth. And, it was just fine there too!

Valerian can make you sleepy...don't know if I'd take that before a prenatal. Maybe I'd do some HOPS tea though if I was concerned and wanted to relax. HOPS tea is SUPER relaxing. I've made it a few times when I was feeling stressed. Works better than rescue remedy for me. It really mellows me out when I've had it. Though I haven't had any in years (I bought it for breastfeeding) and you do have to avoid it in early pregnancy because of hormonal precursors.

[phatchristy]

I'm really glad too that your MWs seem to be changing their attitude...perhaps they're finally realizing that you're stressing about their apparent fixation on it!

Honestly this is definitely something that they've seen before. God knows the mws here have seen it, this is not super uncommon.

My mom actually has the same thing LOL. The good thing is, they at least were listening to her. They say 15-20% of the population does this naturally!