High BP

[Pirogi]

I am 33 weeks, and my blood pressure has been creeping up over the last month or so.  I have been tracking my blood pressure with the machines at work since before I got the BFP, and it started out around 110s/70s.  It dropped a bit (10 pts systolic, 5-10 pts diastolic) from about 14-18 weeks, and then it came back up to 110's over 70s until the last 3-4 weeks.  Now it is consistently 120s/80s.  My midwife has always gotten a bit higher reading using her manual cuff at the appointments.  I have another appointment today, and I am afraid that I may be over her 140/90 cutoff.  I don't know what she would do if my BP reading goes over this cutoff.

I guess I am trying to figure out what the risks and options are.  I haven't (so far) had any signs of pre-eclampsia, and she has only dipped my urine at each visit.  No protein so far, no visual disturbances, minimal (normal) swelling.  I started at 137 and have gained almost 40 lbs.  Is a high BP in the absence of pre-eclamptic symptoms usually an automatic risk-out for a homebirth?  Is "just" PIH as dangerous as pre-e?  What are the risks for "just" PIH?

[Breathless Wonder]

Here are a couple of links I've found:

http://www.childbirth.org/articles/remedy.html#BP

http://www.gentlebirth.org/archives/pih.html

You aren't the only one dealing with it.  Our DDC has a bunch of posts, and mine is "creeping" up too, ever since I was sick last month...

I've also been told that supplemental magnesium is helpful.

Oh yeah, edited to add- acupuncture has been recommended as well!

Edited by Breathless Wonder - 12/3/10 at 8:43am

[msmiranda]

Two things:  are you exercising?  My understanding is that regular exercise and reducing salt intake (esp by eliminating as many processed foods as possible ... you would not believe how much salt is in, say, salad dressing or ketchup) are the only two things we can do to lower blood pressure.

Something else:  is is possible that you have developed GD?  I ask because during my first pregnancy, I passed the 3 hr GTT in like week 26, but barely, and I believe that I developed GD and it was uncontrolled (I was eating tons of sweets) and this caused my blood pressure to rise at the very end of my pregnancy.  Fortunately it never went over 140/90, but it was 130s/80s and that risked me out of the birth center.  Second pregnancy, I believe I also had GD but I strictly controlled it with diet and exercise, and my blood pressure stayed good right through to the end. 

I have also heard that bathing in epsom salts can help ... it didn't work for me, but who knows. 

[Pirogi]

Yes, I have been exercising 3-4 times per week since conception.  I swam today for the first time ... it felt great.  I will start doing that at least twice a week.  I actually don't believe that limiting salt during pregnancy is healthy.  I salt my food to taste, and we limit processed foods.

Not sure about the GD.  I didn't have the test, since I don't know that I agree with the science behind it, or how they determine who is "abnormal" and who isn't, or the protocols that get put into place if you have GD.  I eat sensibly and exercise, which is all I would do even if I were diagnosed with GD.

I have been taking cal/mag and taking epsom salt baths.  I also did the lemon juice/cream of tartar protocol recommended by Susun Weed.  Just about the only thing I haven't done yet is acupuncture.  

My BP today was a little high, but not pushing the "mild hypertension" limit.  My midwife told me, "You DON'T have a blood pressure problem, so stop worrying!"  That helps.  :)  She also told me that she would work with me, as long as there are no pre-e signs, and it wouldn't be an automatic risk-out of home birth.  So phew!  I am feeling much better now.

[msmiranda]

I figured you would say that about the salt ... I also salt food to taste, but I also think that most people (probably not you) in the U.S. get WAY too much salt from processed foods and could stand to cut that back, even during pregnancy (while still using salt with whole foods).

I understand your hesitation regarding taking the GTT.  I didn't take it either, I did home monitoring, but I do believe that for some women GD is real and that keeping blood sugar under control during pregnancy can only be a positive thing for mothers and babies.  But I ended up homebirthing because of GD ... I was too afraid of getting that diagnosis with an OB and being subject to unnecessary interventions, so I get where you're coming from.  Like I said, though, I have heard from several places that uncontrolled GD can cause BP to rise, and it was true for me, so I thought I'd throw it out there.

I have white coat hypertension because of my experience in my first pregnancy (getting risked out of the birth center), and so I always go through all this rigamarole, taking my BP at home and reporting the numbers, etc.  But my midwife has been great about it.  I just saw her yesterday and she got a high reading for the top number, so she asked me just to give her a recent reading I had gotten on my own and wrote that in my chart.  While the OB requested that I do a 24-hour urine collection to test my kidney function.  Sigh.  Glad that your midwife is as relaxed as mine! :)

[tanyalynn]

Originally Posted by Pirogi 

I have been taking cal/mag and taking epsom salt baths.  I also did the lemon juice/cream of tartar protocol recommended by Susun Weed.  Just about the only thing I haven't done yet is acupuncture. 

It sounds like you've got a plan and a supportive healthcare provider, I just wanted to say that if you do have more BP changes that are worrisome, consider magnesium alone instead of with calcium.  It's the balance that's often important, and a lot of things (different for different people) can increase their need for magnesium without increasing the amount of calcium they need at the same time.