MIDWIVES - Homebirth and HBP

[thatgirliknew]

So, first off I am not pregnant. BUT I do want to have another baby, I am trying to get a little healthier and lose some weight before TTC. WHEN I have another baby I'd really like to have a homebirth. Both of my previous pregnancies I had very high blood pressure and was induced. Personally, I think a lot of it was being stressed about the doctor's office and giving birth at a hospital and the other part of it being so overweight from the beginning. Since I'm waiting to TTC until I'm healthier and I plan on having a homebirth next time, those two factors shouldn't exist.

BUT, just in case I still have it (my non-pregnant blood pressure is usually borderline) is it safe to have a homebirth with high blood pressure? What are the risks and what can be done at home about those risks?

[JamieCatheryn]

Usually you have to have the blood pressure well controlled to avoid being risked out of midwife care. If on meds of course they have to be safe for pregnancy. Keeping your BP down would be an ongoing process, with low salt, exercise, and maybe medications. They'd watch it carefully for any serious increases due to the pregnancy since it can lead to pre-e or organ failure or preterm labor. You can get a cuff to check at home if it's an issue. My husband has very high BP and takes medication for it until he can lose more weight. Short term BP spikes give him headaches, hot flashes, and exhaustion - none of which would help you in labor.

You should talk to the 2 midwives here to see under what conditions they accept clients with BP issues, when they would transfer care, and how they recommend controlling it if borderline. I live in the same city as you and homebirthed with Jennifer, I know these ladies aren't under restrictive regulations so it's up to their experience and judgment whether it's safe or not.

[cathicog]

I think it depends on the midwives. Homebirth mws are usually a little more flexible and take the "white coat syndrome" into consideration when looking at your charts. Since you are now working on weight, diet, etc, already, there is a better likelihood that you would minimize any bp issues, if it arises at all. Diet, amt of water drunk daily, exercise, etc, can do huge improvements in maternal health in a subsequent pregnancy...You would probably be a much better candidate for hb...

[HeatherB]

My BP has been borderline in my last two pregnancies, and my MW has been fabulous about it. She is familiar with a variety of natural options to help bring it and keep it down. I've had to take passionflower tincture at different points in both pregnancies, which is pretty effective for lowering BP. For one, I only needed it postpartum, and for another, I took it at the end of pregnancy and in labor. Other simple things like swimming (being in chest-deep water) can bring down BP, and obviously diet and exercise can be factors, too.

My MW has never even talked of risking me out for it - simply kept an eye on it to ensure everything is in good shape. I also keep a wrist cuff at home and keep an eye on my BP on a regular basis. Thankfully, this time around, my BP is on the low side for me, so we're both very happy!

Do make sure that, whenever you get pg, you have your care provider using the right sized cuff. I've had weird experiences with that. My first MW had the right size cuff, but risked me out because she said my BP was so high (like 150/110?) that I was about to stroke. Three weeks later, when she had in a NEW cuff to replace that *broken* one, my BP was perfect - 120/80. My current MW doesn't always have the big cuff, and so I use a digital wrist cuff. If, in the past, your OBs were using a too-small cuff, it would absolutely inflate your numbers. I'm sure you may know that, but it's always worth tossing out!

Good luck with your efforts to get healthier! (I always say I'll do that, then end up getting pg...)