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High Blood Pressure, Midwife wants to induce TONIGHT, need help - UPDATED 5/21 with full birth story

post #1 of 19
Thread Starter 
Long story short. I am currently 41+3 and the pregnancy has been fantastic without a single health issue. For the last two months I have had trace protein in my urine and minimal swelling in my ankles. My BP was always really low (100/60) before pregnancy, but throughout the pregnancy I've hovered around 110/75 or so. Today at the BPP (which was a 10/10 by the way) my BP measured 130/90 three separate times. Two days ago it was 110/75. Baby is doing great, but midwife is very concerned that with my current BP and the fact that I'm well over 40 weeks that I need to be induced tonight.

I am so frightened of the hospital birth scenario and all I want is to go to bed and wake up in labor naturally. I've had some very mild contractions about 15 minutes apart the last couple days, but aside from that, I have had no indication that I am EVER going to go into labor. I have already lost my birth center birth because of the high BP, but I am not emotionally or physically prepared to be induced tonight. I am currently 1.5 cm dilated, about 50% effaced, and baby is at -1 station. Midwife says my cervix is fairly ripe, but I am just totally devastated to be going down this road.

So first off, is the midwife right? Is she overreacting? And assuming it makes sense for me to be induced tonight (which I am leaning towards at this point because I trust my midwife), does anyone have any advice for how to have the best possible birth at a hospital? I was told that I'm now going to have to fight really hard to use the tub during labor (water birth is not permitted) and that I will be mostly confined to the bed because activity could cause my BP to become more elevated. I need some advice and support!
post #2 of 19
DDC crashing! Obviously I can't advise if induction is the best thing for you but high blood pressure was one of the reasons induction was advised in my situation. Like you mine was very low pre-preg (and for most of the pregnancy) and almost doubled towards the end. It wasn't that high for the average person but it was super high for me.

Maybe you should call the midwife and talk it through with her again? Has she suggested which method of induction she recommends? On the plus side it sounds as though your body is about ready to labour so hopefully things will progress easily.

Induction wouldn't have been my first choice but it is possible to have a positive induced labour and birth. Can you have mobile monitoring? Or agree to regular monitoring rather than continuous monitoring so you're not stuck to the bed if moving around helps? I'd talk through your birth preferences with the midwife and see how you can adapt them to the new situation.

Hope it all goes well.
post #3 of 19
I would ask more questions....

First I think sometimes midwives/docs jump to induction with high BP's when Mom's are post dates. Say, if you were 35 weeks right now? Would they at least give it more time? Or put you on bedrest of some sort? I think it is taking the "easy" way for them (in a CYA kind of way) to just suggest induction.

I'm no expert on BP issues but if it were me I might be asking if you could be evaluated for a longer period of time. And whatever that means to you. Some women might be comfortable monitoring things at home and stopping by hospital for visits. Some might ask to be admitted but not induced. Think of a few things that you might be comfortable with and ask her if she will accommodate you. Even waiting one day for induction if that is what will make you more comfy with it...

High BP can be serious especially when protien is present. Did they retest protein? But getting things "confirmed" will be important to you as well.
post #4 of 19
Thread Starter 
So we got to the hospital, and had urine/blood/liver function/ BP tests. Every single one came out totally can completely normal. My MW still thought we should induce as she believed we had caught something early. I had cervadil overnight and woke up to a very slight cervical change - 80% effaced 2cm dilated. I wanted some time to just walk and see if labor would start, and although contractions continued, they didn't really do much and so several hours later, I was still 2cm. The midwife REALLY wanted to start pit and just get things going. I felt backed in a corner like I had no other options so I agreed, and the pit started. I was totally and completely defeated. Everything I did NOT want was happening. Thankfully, DH, seeing how crushed I was, spoke to the nurse and to the midwife, and somehow convinced them that since there was no longer a legitimate medical reason for the induction (and I was not yet at 42weeks) we should really be permitted to just go home and see what happens over the weekend. I'm not sure how he worked that magic, but he did, and so now I'm home, exhausted, and hopeful for a natural birth once again.
post #5 of 19
Your DH deserves an award.
post #6 of 19
Glad to hear your BP is back to normal and fingers crossed for an uneventful birth soon.
post #7 of 19
Quote:
Originally Posted by laohaire View Post
Your DH deserves an award.


i'm so happy for you and since nothing happened on cervidil and a bit of pit i'm 100% certain that your baby isn't ready yet and you are making a great decision.
post #8 of 19
Yeah for you! I was induced on 12/27 and my girl's b-day is 1/10!
post #9 of 19
Aw, so glad you are home now! "Second" time around will surely be better!
post #10 of 19
Thread Starter 
Quote:
Originally Posted by laohaire View Post
Your DH deserves an award.
He is seriously my hero. He supported and believed in me in a way that no one in my life ever has. Oh yeah - not only did we get to have a few days reprieve, but somehow, we are now allowed to use the free standing birth center again until Sunday! We weren't even asking for that and the MW just volunteered it after hearing what DH had to say.
post #11 of 19
Wow! You have an AWESOME DH. Wishing good things for you by Sunday
post #12 of 19
What a great advocate you have!! AND what a strong mama you are!! It is sooo easy to just go along with what is recommended and not easy to walk away from...Kudos to both of you!!! I hope that you get to have the natural birth you are hoping for.
post #13 of 19
post #14 of 19
Just bumping this to say I hope all went well. I expect you're too busy enjoying your new babe to post.
post #15 of 19
just saw your thread for the first time, and i hope things are still going well for you.

i had a similar situation, rising blood pressure right at the end of pregnancy (though for me that was 35/36 weeks). i DID end up w/ protein in my urine and much higher BP numbers, so pre-e. i realize pre-e is NOT what you have, and that you may not experience further rising BP, but i do see that you are already under pressure and looking to labor in the hospital, so that makes your situation still similar to mine...

i was planning a home birth and ended up laboring, induced, in the hospital.

having been through that and managed the hospital system laboring w/ high bp, i'd be happy to share my experience with you. please do pm me if you'd like to discuss.

otherwise, i'd recommend you talk w/ your MW and/or L&D - whoever it is that will actually be there when you are laboring - about specific blood pressure limits/protocols of your hospital. we had numbers we had to stay under, and for me that DID mean restricted movement. i was able to think creatively with the support of my HBMWs and husband to find ways to cope with the pain other than water and movement.

i never would have believed i could have a successful vaginal delivery under the conditions i had, but i did!!! there was so much beauty in the process, i have no trauma after the fact.

sss and i hope you never need my advice!
post #16 of 19
Thread Starter 
Thanks for the replies! So here's the rest of the story since I never posted the actual birth story:

My MW wanted me induced on Wednesday 4/14. We stayed overnight and went home on 4/15 after we backed out of the induction. MW wanted us to return on 4/16 for another blood test, and also to do a 24hr urine collection, which we gladly agreed to, after all, if there was any legitimate health concern, I certainly was not going to fight being in the hospital. So we went back on 4/16 and the blood test and urine sample were both totally normal. My BP was still a bit high, but lower than it was on 4/14, so MW told us to go home and that if I was not in "booming labor" by 7PM Sunday (which was 42 weeks) she wanted me back at the hospital to follow through with the induction. I agreed, knowing that I would not be showing up for that and hoping that I would be in labor by then.

That night, on Saturday 4/17 at 2:30AM, I woke up to very powerful contractions every 7 minutes. I tried to sleep through them but couldn't because they were just too intense and I had to get on my hands and knees to work through them. I figured that they would speed up soon and I would be on my way to the Birth Center by early afternoon. Nope. The contractions didn't get closer together than 7 minutes for more than 16 hours. At 6:30PM, my water broke and my contractions FINALLY started coming every 3.5 minutes. We left for the birth center at about 7:30 since it was an hour away.

When we got to the birth center it was about 8:30PM on Saturday 4/17 and I was a stretchy 5cm, which was pretty disappointing since I had been 3cm the day before, so after 18 hours of slamming labor, I had only dilated 2cm. When we arrived at the birth center our MW wanted me to walk around a bit before admitting me, so DH and I first went to get coffee for him, our MW, and the student MW. Dunkin Donuts was a 3 minute drive from the Birth Center, but I screamed at DH to pull over since I was contracting at least 2 times. When we got back to the Birth Center, I didn't really feel capable of walking around outside, and just wanted to get into the tub, so our MW admitted me. It was somewhere around 10PM when I was finally admitted, and our MW was estimating a birth within the next six hours. Luckily, my blood pressure was still in the high normal range and so the Birth Center birth was still on.

I labored in the tub, in the shower, on the birth stool, on the toilet, on the birth ball, and on the bed over the next six hours. In that time, I made it to 8cm, but by 4AM Sunday 4/18, I had only had 2 hours of sleep in over two days, and I had been under fairly intense stress for the last five days. I was totally out of energy. At 4AM, I decided to give it one last shot to get to 10cm - I ate a bowl of the birth soup (super high protein and carb) that DH made for me, and I labored silently on the toilet while directing all of my energy inward. After close to an hour, I was still 8cm, and hadn't made any further progress at all. At that point, I was so physically and emotionally exhausted that I pretty much lost it. I could no longer cope with the pain, which had turned into excruciating back labor that only felt manageable with intense counter pressure (which was strange because the baby had not been posterior and I'm still not sure she ever was since she wasn't born sunny side up). I knew that my body couldn't take any more since I still had 2cm to dilate AND I would have to push. I needed sleep more than anything in the world, so I sadly let go of my Birth Center birth in favor of an epidural and a safe vaginal delivery at the hospital across the street.

I made the call to transfer at around 5AM on Sunday 4/18 and within half an hour I was in a hospital bed waiting for an epidural. Unfortunately, the anesthesiologist was doing a c-section, and apparently would not be available for some time. I screamed "YOU HAVE GOT TO BE F!@#ING KIDDING ME" and apparently I was screaming so loud during my contractions that someone decided it was very important to get me some pain relief. About 3 minutes after I started yelling, the anesthesiologist was in the room getting the epidural set up. (Some poor resident got pulled out of bed to finish the c-section). I had been so afraid of a needle in my back and I must say, it didn't matter in the slightest at that point. When the spinal kicked in (I had a combination spinal block/epidural) about 2 minutes later, it was probably the best feeling I have had in my entire life. The pain was completely gone. I could feel a bit of pressure, but the pain just went away and I felt my body relax in a way that I don't think it had since I woke up 27 hours before.

Once I was hooked up to the monitor (previously we had only used a doppler) we learned that my contractions were "coupling," or basically coming right on top of each other with hardly any break. That helped to explain the extreme pain I was experiencing, unfortunately, the contractions did not appear to be strong enough to get me fully dilated on their own, so I agreed to pitocin. Then the most amazing and beautiful thing happened - DH and I fell asleep for about five hours. When we woke, I was fully dilated and it was time to push. To my shock though, I woke up feeling every contraction. As it turned out, the spinal had worn off, but thankfully as soon as I pressed the little red button (I didn't even know it was there) the spinal took effect again and I was again pain free. I was still totally exhausted though, and apparently I did not know how to push. The student MW had her hands in my vagina, which I found to be horribly distracting and I yelled at her to get her hands out of there. I guess I wasn't pushing effectively and our MW decided that I needed to sleep longer since I was kind of out of it and yelling at the midwives, so they let me "labor down" and go back to sleep for another two hours. When I woke at noon on Sunday 4/18, I felt like a new person. My head was clear and I was ready to finish what had started a day and a half ago.

After two hours of pushing, our sweet Finley Rose was born. She weighed 8lbs. even, and was 19.75 inches long. She did not look like a post-dates baby AT ALL. She wasn't wrinkled at all, and still had some vernix on her back. The only indication that she was a bit overdue was that she had ridiculously long fingernails.

The most amazing moment of the whole birth was about 1 minute before she was born; everyone in the room stopped what they were doing and scrambled to get their robes on and set up tables and trays near me. Until then, I swear I didn't believe she was ever going to be born. I mean seriously, I was 42 weeks pregnant, and the labor had lasted 36 hours. But it was that moment that DH and I both realized that our baby was really coming now!

Shortly before she crowned, the fluid started to show some very light meconium staining, so as soon as she was born NICU examined her quickly, but she was back on my chest within no more than 3 minutes. DH was able to catch her and cut the cord, and while we wanted to delay the cord clamping until after it stopped pulsing, I had no objection to cutting it earlier to ensure that her airway was clear of meconium. Fin's APGAR score was 9/9, and she cried immediately. What a sweet sound! Then, as soon as the NICU was done with her, she was laid on my chest for the breastcrawl and extended skin to skin. She did crawl, although she didn't quite make it to the nipple. But she was SO alert! I had been avoiding any type of pain relief partly because I was afraid that it might have a negative effect on my baby's awareness at birth. That was definitely not the case. I had a large number of first degree tears, one second degree tear, and at least one internal tear, so it took my MW and the student MW about an hour and a half to stitch me up. Fin was on my chest the entire time.

We stayed at the hospital for two days, and in retrospect, it was SO great to have that buffer. The nurses were all totally amazing and supportive. No one ever took Fin out of our sight, and no one questioned our decisions not to give her the erythromyacin (sp?) or the Hep B vac. I was in pretty rough shape after the 36 hour labor and lots of tearing, so having people there to check in on me every couple of hours was actually very reassuring.

It was not the birth that we had planned, but it was every bit as beautiful and joyous. Our sweet baby was safe and healthy, I was safe and healthy, and every step of the way, I was in control. No one pushed me into anything, and every single decision that had to be made was made by me and DH. Incredibly, what I was told about labor amnesia has been totally true for me - only one day after the birth I was already starting to forget things. At this point a month later, I absolutely cannot remember the pain (yay!) and I am actually kind of looking forward to being pregnant again soon (well, in a year and a half anyway)! Breastfeeding is going beautifully after a rocky start, and although Fin is definitely a high needs baby, I love every minute of being a mom.
post #17 of 19
I had the same type of lightbulb moment when I was pushing and everyone suddenly scrambled to get the instruments ready and the midwife and nurse put gowns on and stuff. It was like, "whoa! this baby must be coming soon!"
post #18 of 19
Thank you for updating and huge congratulations on your little girl!
post #19 of 19
congrats!!!
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