Question for Homebirth Midwives...

[Gretaoh]

I have chronic high blood pressure. Because of this, my first pregnancy was treated as high risk. Despite the fact that I never had any symptoms of pre-eclampsia (other than my elevated blood pressure), I was subjected to weekly testing that caused me a great deal of stress (not that great for the blood pressure!). I ended up having an unplanned home birth. We waited too long before deciding it was time to go to the hospital, and ended up calling an ambulance, instead. Other than dealing with the paramedics, my birth experience ended up being really wonderful and intervention-free!

So, my question is this.... do traditional midwives ever agree to take on a patient with blood pressure issues?! The nurse-midwives at the hospital wouldn't think of it, during my last pregnancy. I'm TTC, and just trying to get my ducks in a row! : ) Thanks for any help that can be given.

[Zangua]

If the high blood pressure is your only symptom, and you have it chronically (as in, not during your pregnancy), then I see no reason why you couldn't have a home birth. I would call homebirth midwives in your area to discuss your options.

[Zangua]

Additionally, I would get on a raw garlic regiment.

[MsBlack]

I agree--controlled chronic/essential hypertension would not automatically rule you out of homebirth in my opinion. And whether garlic or other, I would hope you would investigate natural ways to help your b/p moderate and stay moderated--although really that would be up to you. As long as your b/p was not interfering with normal processes of pregnancy/labor, I don't see why you couldn't have a homebirth....and of course, the fact that you already HAVE had a successful homebirth makes it clear that you are able to birth normally, high b/p or not!

Congrats on that, by the way~

[mwherbs]

first off since you are considering getting pregnant start supplementing with high doses of folic acid- it can lower bp, and has been shown to have a protective effect against PE
secondly I would say try to do something to reduce your chronic hypertension status now before pregnancy- diet and exercise - look into supplemental helps- or see an alternative provider who can help with this- things like hibuscus flower and dark berries as well as garlic and folic acid, probably an increase in green veggies are some of the things that come to mind not to mention something like a swim or walk 3 days a week...
I know so little about the meds used to control hypertension- I just know general ideas, and so it would not be an automatic yes to someone with controlled chronic hypertension- some of the meds cause changes in fetal growth the potential for placental insufficency come from not only the hypertension but the drugs that control it too --- probably the best I could offer would be parallel care and if everything was fine throughout then assist at home

[Gretaoh]

Thank you!

Thanks, everyone, for the helpful and encouraging advice. I have always suspected that what I actually have is "white coat" hypertension. The first time I ever showed any evidence of elevated blood pressure, I was running late for a doc appt and was stressed about not making it in time. The doc (who was filling in for my regular doc) kinda freaked out on me-- your blood pressure is too high! You need tests! Basically, stressing me out further with her tone. Anytime after that, when I'd have my blood pressure taken, I'd immediately be stressed that it was going to by high-- and of course it would be. But, if the nurse took it a couple more times, it would be a bit lower everytime she took it. My ob doctors never took this seriously. I now monitor my blood pressure at home (just took it and it was completely normal).

Regardless, I will look into the supplementation recommended. Now, I just need to find me a midwife who will take my anxiety seriously, and not stress me out further with the "you and your baby are gonna die!" kinda talk I experienced last time (One doc told me I would need to be "strapped to a table" during labor). Frustrating.

[ACsMom]

I'm not a midwife but I thought I'd share that I had "essential" high bp for a while, which started during the birth of my first child (pretty much as soon as I checked into the hospital for the induction, which we were talked into and felt deep down was the wrong thing to do....we were right, ended up with a section). After that experience, we had a stressful first year with our new baby (because of the c-section) so I had mild high bp on and off during that time. I took a diuretic once for a period of about a month. When I started getting myself back together, exercising a bit, eating healthy (I second the raw garlic treatment - I consume 1-2 cloves/day, usually minced finely into a salad or a rice dish or stew). My bp has been awesome - usually floats around 100/60. Now that I'm almost 8 months preg, it's more like 120/60 most of the time. It might go up a little more - that's okay. I STILL get white coat syndrome, even if it's just my midwife who's taking my bp!! Weird, but it's something I'm paranoid about, so it makes sense. I have a wrist thing at home I use to take my own bp - it's always fine at home.

Bottom line - when you do get pregnant, you won't want to be on any meds, but you can definitely control it through diet. If you're paranoid about pre-eclampsia, do the Brewer diet faithfully and you'll be fine. Right now I'm doing Brewer, with lots of fresh greens and veggies, including the raw garlic regimen, and I also take extra calcium and magnesium (in addition to my prenatal vitamin). I'm not a doc or a midwife so I can't sit here and advise you to do that, but I can say that the whole program is working beautifully for me. You can also use relaxation techniques, as well as acupressure points, to help keep you relaxed and pressure low during pregnancy (and all the time!)

Finally, my midwife has been very reassuring to me on this issue, which helps. She keeps reminding me that somewhat elevated blood pressure during pregnancy, especially late pregnancy, is normal.

Good luck and kudos on doing your homework early!

[nashvillemidwife]

I would accept her as a client if it were controlled, but there would be close monitoring and consultation with a physician with a solid plan for transfer if needed. Even well-controlled hypertension can become unstable in pregnancy, and can happen very suddenly. I speak from personal experience, I wish I had not waited until it shot up at 39 weeks and had to scramble to get proper OB care. Mt BP was perfect for the entire pregnancy until I had to suddenly be put on bedrest for the last week. If there is a next time I will still plan to birth at home if all remains well, but will have co-care from the beginning.

[KaiNtheSky]

Happy to have found this question. . .

SO and I are (unofficially) ttc #2. I am 29 and have suffered with essential hypertension since I was a little over 14 years-old--and no one has been able to determine why (great diet and BMI). I've been on medicine for years to control my blood pressure. In the beginning, my treatments did not work long term but during my pregnancy with my son (about 4 years ago), I was taken off my original medicine which was Toprol and placed on Aldomet (low dose). Since then I've not had any issues with my blood pressure. Initially, my OB thought that my hypertension was going to be an problem because of how unstable it seemed but later was amazed because it got progressively better with my pregnancy. He would constantly joke with me about needing to have more children to sustain my blood pressure.

I enjoyed my OB but the hospital experience left a bad taste in my mouth . I was lucky to have had a nurse who was a devoted follower of Ina May and able to get me through the unmedicated birth with very little pain--despite 2 failed attempts of induction and a high dose of pitocin . Going into the hospital, I had no idea what to expect because my perinatologist requested a short-notice induction (@39 weeks due to low amniotic fluid). . .but my nurse was awesome and made sure I stuck with my birth plan. I would not have made it without her. . . and she is part of my inspiration for wanting to have my next birthing experience with a midwife. . .AND at home if possible.

Your question is just what I have been looking for and has given me some hope. I thought that I was alone and crazy for wanting a home birth, even though my hypertension has been under control for quite a while.

So please continue to post about how things are going for you during this journey.