q's about high bp and gd...

[maybebaby]

Last time I was here we were just thinking about a third (hence the username) and now I'm 14 wks pg!

Anyway, on to my question. With my first pg I had pregnancy induced high blood pressure and with my second I had gestational diabetes. I'm really worried about these things repeating as I want a homebirth this time (first two were hospital births). I'm eating more whole grain foods, I'm vegetarian now and I know more about nutrition. I feel those first two pregnancies, eating whatever I wanted and lack of exercise led to the problems.

Now I'm eating lots of protein to avoid the GD and taking extra calcium to avoid the high blood pressure. I'd read that helps anyway! I'm trying to get enough exercise also. What else can I do to avoid these things?

And, will either of these problems totally rule out a homebirth for me? Even with the dietary changes and exercise, I'm still overweight so I worry about that also (but I don't feel that's as big a problem as the GD and BP).

I have my first appt with the h/b midwives on Wednesday and we'll go from there, but I just wanted to get more info.

Thanks guys!!

[Corriander]

High bp is an interest to me because I had it with both my pregnancies and nurses kept telling me that I had pre-eclampsia. I had to keep explaining that it is not the same thing, while thinking, "these people are responsible for my healthcare?"

Anyway, here are some of the articles that I found a few months ago when researching this issue. Hope they are helpful.

1. Atallah AN, Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems
Calcium supplementation appears to be beneficial for women at high risk of gestational hypertension and in communities with low dietary calcium intake. Optimum dosage requires further investigation

2. Niromanesh S, Supplementary calcium in prevention of pre-eclampsia. Int J Gynaecol Obstet 2001 Jul;74(1):17-21
METHODS: Thirty pregnant women at high risk of developing pre-eclampsia were randomized to 2 g of daily calcium and placebo. The inclusion criteria were positive rollover test, having at least one risk factor for pre-eclampsia, between 28 and 32 weeks of pregnancy, and blood pressure less than 140/90 (mm Hg). RESULT: A sevenfold reduction in the occurrence of pre-eclamsia were seen among the calcium group compared with the placebo group (7 out of 15 developed pre-eclampsia in control group vs. 1 out of 15 in calcium group, P=0.014). No major effect on pregnancy induced hypertension was seen but the onset of hypertension was delayed 3 weeks in the calcium group. CONCLUSION: Calcium supplementation is beneficial for preventing pre-eclampsia among Iranian women at high risk of developing pre-eclampsia.

3. Ziaei S. Eur J The effect of garlic tablet on plasma lipids and platelet aggregation in nulliparous pregnants at high risk of preeclampsia. Obstet Gynecol Reprod Biol 2001 Dec 1;99(2)01-6
The administration of 800mg/day of Garlet (Garlic tablet) during the third trimester of pregnancy was effective in reducing the occurrence of hypertension alone, but it was not effective in preventing of preeclampsia.

4. There is an article about treating hypertension in pregnancy with prepared rhubarb, but the article is in chinese so I don't know how the rhubard is prepared.

5. Adam B, Magnesium, zinc and iron levels in pre-eclampsia Matern Fetal Med 2001 Aug;10(4)46-50
Our results suggest that low cellular magnesium levels in women with pre-eclampsia may contribute to the development of hypertension in these patients, and that the measurements of plasma zinc and serum iron concentrations are of doubtful clinical value in the management of pre-eclampsia. Abstract does not state how much magnesium should be supplimented.

6. Saeed SA, Not pre-eclampsia. J R Soc Med 2001 Jul;94(7):351-3.
This article looks interesting just for its title. I don't have access to the abstract now, but I'm putting it here so I can remember to look it up later. If this article is about high bp not automatically meaning pre-e, then I may carry a copy with me to every prenatal appointment!

[tara]

It is my understanding that well-controlled gestational diabetes does not preclude a homebirth. I had GD with my pregnancy, and luckily was able to control it very easily with dietary changes. How did you eat when you had GD before? If it worked, start eating that way now! I stopped all sugar, honey, and fruit juice and counted carbs really diligently. I ate 30g of carbs for bfast, 45 for lunch and 60 for dinner with 30g snacks between meals and in the middle of the night. Lots and lots of vegetables. It was a little bit of a challenge because I'm a carb freak and I'm vegetarian so my protein sources are carb. But, it forced me to eat healthier while pregnant than I would have otherwise, and I'm grateful for that. Good luck to you!

[Ari'smum]

You can

I had elevated bp with my first as well. I am 30 weeks with #2 now and got some pretty creepy readings at the beginning of this pregnancy. For me going to a hypnotherapist for a session really helped a lot. I was so traumatized by the cuff with my first baby that I feared the worst this time around.

The great thing about midwives is that they consider normal to be a much broader range than an OB. They see successful births on a regular basis with their clients so they know what is possible even if you have a 'condition' like high bp or gd. (Unlike OBs who will induce women with conditions like this, see the condition worsen and then 'save' them with some other intervention.)

Tom Brewer's 'What Every Pregnant Woman Should Know' is a great book but hard to find. His research shows women who eat 75gs of protien a day have a nearly 0 percent chance of pre-eclampsia.

Good luck, good health, good birth to you . . .

[bluevervain]

Hi...
In my midwifery practice, many of the ladies that come to us have a history of white coat syndrome (their BP goes up just at the sight of a doc coming to take it!) We also make a point of not taking a BP at the beginning of a visit. Most clients are a bit stressed out getting in for their appointment, may have climbed stairs etc which would give them an artificially high reading.

A client I worked with when I was apprenticing had pre-eclampsia with VERY high BP with her first child. We had her to get an automatic BP cuff and told her to take her BP at home and bring us the readings. We recommended that she follow the Brewer diet (plenty of protein from a variety of sources, moderate carbs (no sugar perse)salt to taste, and enough water). She had little or no symptoms of pre-eclampsia AND her BP remained well within safe limits. She had a lovely homebirth.

If you have "had" GD, please, please, please limit your consumption of refined sugars, juice, soda, caffeine dried fruits etc. Even "natural" sugar (Succanat, Rapidura, Florida Crystals)are out. Also, please ask your practitioner to use a 2 hour post-priandrol (I believe I spelled it wrong) instead of the glucose drink they usually give you. It's slightly more complex (you need to take a fasting level (a finger prick) and exactly 2 hours after you finish eating they need to draw your blood). The PP test uses 100g of carbs in FOOD which will give you a far more accurate reading. As an apprentice I drank a bottle of glu-cola and it made me throw up (and I wasn't pregnant!) If you would like the PP breakfast list, email me and I'll be happy to share it with you.

Love,
Christina

[Pupcake]

About Dr. Brewer's book...

Just a note for anyone interested in Dr. Brewer's book...

It's available in ebook format at http://www.blueribbonbaby.org

What he has to say, and his course(s) of treatment make a lot of sense and were very reassuring to me, as I was concerned with being labeled (or stamped across the forehead in dayglo colors!) as "WARNING: HIGH RISK" for this, that & the other, while being ignored as an individual, or duo as the case may be.

Just my 2¢! Best Wishes!!