Preparing body for labor

[JTA Mom]

Quick background: 33wks currently. Previous pregnancy was a c/s. I had mild, term pre-eclampsia, was induced and pretty much strapped to a bed, lying down the entire time. At 22hrs, labeled failure to progress, c/s.

I want to go for a VBAC. I have recently been diagnosed as hypertensive, yet mild (130/70s). My OB said due to that she won't let me go past 40 weeks.

So, if everything goes well with my bp and the pre-e stays away, I have my deadline. If, for some reason, they want to baby out before then (bp going higher and higher, etc), I want to at least try a foley induction.

That aside:

I am starting with a cup of strong red raspberry leaf tea and will ramp that up in a few weeks.

At 36 weeks, I will start taking 2000mg of EPO vaginally & orally to ripen my cervix.

I am already doing lots of the moves recommended on spinning babies for getting this little one in the right position.

If push comes to shove, I am thinking of talking my OB into possibly stripping my membranes at 39weeks-ish, since that causes most women to go into labor within 72 hrs.

Is there anything else I am missing? What can I do to give myself the best chance of birthing vaginally?

Thanks!

Ami

[AustinMom]

Couple things...

Have you looked into increasing your protein to get rid of pre-e signs? This usually works, and that is why most MW have moms on a high protein diet throughout pregnancy, and increase it if signs occur, and why most MWs have a very low pre-e rate. I'd look into more of that to get rid of your 'deadline'. Magnesium sulfate has been shown to work better than valium, etc, and it prevents the progression of pre-e. With your readings now, you don't have pre-e, as pre-e is determined by more than one symptom of pre-e including BP over 140. So, so far, you are healthy and fine, and so is your baby.

stripping the membranes does sometimes cause a woman to go into labor. It did us, but it also turned baby's head to an acynclitic position, which means, yet we went into labor, labored 27 hrs (active) and only got from 4cm to 6cm, so had a CS. So I'd avoid this at all cost, as it does have a risk of AROM as well. Something else that will most likely put a shorter deadline on you.

It seems that at 40 weeks is when you have to have your final decision made according to your CPs deadline. I would say don't do any kind of membrane messing (stripping or rupturing) or induction until then. Also, it's still YOUR Choice at 40 weeks. I'd learn as much as you can about your BP and pregnancy and what really is dangerous for baby or you to continue the pregnancy. I'm pretty sure induction is only recommended if you have sever Pre-e. It sounds like this is not you, and I'm not trying to beat up your CP, but it seems like she's assuming that your going to be 'unhealthy' at 40 weeks and the baby will need to be out. That's kinda far away to make such a harsh assumption on someone who is not only a VBAC, but has BP issues already, I think it's unnecessary stress to give a mom a deadline. I would also assume that since you are a VBAC, this *MAY* be the reason for the 'deadline' as most CPs try to put a deadline or find a reason to put one on a VBAC mom.

Here are some sites that might be helpful:

http://www.gentlebirth.org/archives/pih.html
http://www.aafp.org/afp/2004/1215/p2317.html
This one is kinda my stance:
http://www.ivillage.com/induction-hy...ary/6-n-138504

Is there a reason she doesn't want you to go past 40 weeks if you are not showing signs of pre-e? Like right now, you aren't showing signs of pre-e, maybe signs that COULD indicate a future diagnosis of pre-e and that you and your birth team should be trying to use preventative measures, but not talking induction or deadlines. JMO,

[MaerynPearl]

Originally Posted by AustinMom

Have you looked into increasing your protein to get rid of pre-e signs? This usually works, and that is why most MW have moms on a high protein diet throughout pregnancy, and increase it if signs occur, and why most MWs have a very low pre-e rate.

Wow... I didn't know that but it explains why my MW told me to eat more protein the time I had raised blood pressure!

[JTA Mom]

Originally Posted by AustinMom

Is there a reason she doesn't want you to go past 40 weeks if you are not showing signs of pre-e? Like right now, you aren't showing signs of pre-e, maybe signs that COULD indicate a future diagnosis of pre-e and that you and your birth team should be trying to use preventative measures, but not talking induction or deadlines. JMO,

Thanks for all those sites, I will definitely look into them.

How much protein should I be aiming for?

I know I don't have pre-e right now. I keep reminding myself of that. After last go around with ds, I am watching everything closely though. With pre-e, even if mild, they WILL induce at 37 weeks. Period. Pre-e can go bad too fast for them to let it go longer.

Her reasoning is that my bp will just worsen as we go along. She doesn't seem worried about the pre-e, unless I start showing more symptoms. The only reason for the first 24hr urine test I got was to get a baseline protein level. The second one I've had was because the vision in my right eye went blurry one afternoon. Since visual changes + higher BP are a bit much with my previous history, I had another test done. Turned out fine.

I am definitely feeling like she is being 'jumpy' about certain things. From my 3hr GTT I had one high number so she wants me to follow the GD diet just in case. Ummm, same situation with ds, no dietary changes, he was 4lbs 13oz at 37 weeks. Plus, the babies on dh and my families are all small, 6 lbers.

She's also sending me for an NST and a growth scan. The NST to check the baby due to my BP. And the growth scan to check size of baby for either small (due to BP) or high (due to GTT). I am doing them both to humor her, and because if those come out normal, she has less reason to 'bug' me about it. However, with the growth scan, I know I can argue with her if she tries to push me into anything. I know how widely inaccurate they are. As long as this baby has grown nicely since my 26wk anatomical scan, I am fine with it.

There really aren't many preventive measures for pre-e. For pregnancy induced hypertension--yes. Pre-e is more of a placental issue, according to recent research. So whether I get it or not, that was determined at implantation. However, I think it's more PIH than anything. I have very reactive bp anyways and have been feeling pretty stressed recently. Plus, with the heat, I've not been into cooking as much, so my protein intake has dropped. So, if it IS PIH, I want to do everything to work with it.

I've heard nettle is good for reducing bp. Anyone know?

I can't switch OBs (I'm on state pregnancy aid), but I am not afraid to, well, just not show up if need be. I will also NOT schedule a repeat c/s. If baby is obviously not doing well, okay. But otherwise--nope.

Also, do you know any good sources about bp and pregnancy? All the ones I've seen are scaremongering and vague. The whole 'high bp is soooo dangerous you need an immediate c/s' type stuff.

Thanks!

Ami