I am hoping to get some input from this community of women about my current conundrum: What would you do?
I am 31 weeks pregnant today and have all along planned for a homebirth. I am 36 years old and this is my first pregnancy. I have Kaiser HMO coverage and received all my early care at Kaiser until about 18 weeks or so when I transitioned my care to a private practice of homebirth midwives that came highly recommended in my community. Unfortunately, every time I visited the midwives for my regular visits, my blood pressure skyrocketed (white coat syndrome). Mind you, I've never had high BP EVER, not even white coat any where else, not during this pregnancy while getting my early care at Kaiser. My BP throughout this pregnancy has been about 120/70 pretty consistently, except with the MW's. At that first MW appointment it spiked to 140/88, that was back in August. The MW's reaction to this was one of panic and fluster with anxious requests for me to 'relax' and engage in deep breathing, which I did and my BP lowered immediately, not to their normal levels, but lower than the danger zone. This in turn totally freaked me out and I saw my visions of my peaceful birth vanishing. In response to this incident, I bought a home BP monitor and at home or work it never spiked over 138/79--even when I freaked myself out--which I started to do as my anxiety about this issue escalated and compounded. The MW's were concerned and requested my Kaiser records and saw that my BP has always been normal there. I gave them a copy of my home BP log as well to show them I've been keeping a close eye on it. We had some discussions about them possibly not being the right providers for me and they assured me they thought I was healthy and would stand by me and see me through this, even with the white coat syndrome. They promised they would trust my home BP readings and we would communicate about them and they promised to stopped taking my BP in their office. We agreed we would keep working together as I liked them and I guess on the surface felt comfortable with them.
Well, at every subsequent appointment they insisted on taking my BP, and of course it was sky high, like 148-150/90-100. At home, my BP continued to be normal. To me, this BP problem became a demon I could not wrestle down and left me feeling helpless and out of control--like maybe I really have a problem with my BP and this might be more than just white coat syndrome. I started dreading visits with the MW's. At this point I started exploring firing the MW's altogether to bring me some relief and thinking about a hospital birth just in case I might actually have a real health issue. My last appt. with the MW's was couple weeks ago and they 'cut me loose' and told me they think I should work with an OB because they personally have never seen BP readings that high (REALLY?!) and they think my white coat syndrome may mask pre-eclampsia and/or gestational hypertension and I essentially 'risked out' of their services. Note: I currently have very minimal swelling and have tested negative 2x during urine tests for protein. I have to say that I felt relieved by their decision, which was what I had also settled on before meeting with them. They thankfully reimbursed me most of my $$ (homebirths cost $5000 in my area) and we parted ways amicably.
Things have not been easy since that appt. My partner was really attached and committed to a homebirth and is crushed that I am considering birthing in a hospital. He feels afraid for me and afraid for our baby if we choose the hospital route. He's in a bit of denial that I might actually have a real health issue, which may or may not be true. We've gotten into some nasty fights over it and I am left feeling very unsupported by him. He is angry at them and blames them for reinforcing this problem with their negative reactions and breach in trust around taking my BP's when they promised they would not insist on it. I agree with those points, but also wonder if they are right in me truly needing care from an OB as a result of this. I am leaning toward hiring a doula and just biting the bullet and giving birth in a hospital. I cannot bear the thought of having to get to know more MW's only to have them cut me loose like the previous ones did b/c of this 'problem.' I am terrified my white coat syndrome will follow me to Kaiser and I'll be labeled high risk and forced to endure lots more tests when I really don't think I need them. If I decide to hire another midwife and pursue a homebirth, I am afraid of disclosing the experience about the previous MW's for fear that 1) they would also say no to caring for me during a homebirth 2) it is a small community and if those 'well-respected' previous MW's would not work with me, then why would any other MW's?
I am left feeling more vulnerable than I have ever felt as a result of this. I really don't think I am 'high risk' and feel like those other MW's broke my trust since the beginning and are more worried about liability than anything else. I am committed to a natural childbirth and believe that it can happen in a hospital with the right support in place-and am very sad to imagine not birthing at home. If I need to be in a hospital, than fine, I can accept that. If I don't need to, I don't want to, but don't know if I should even attempt a homebirth with the BP issue and the anxiety around MW's I have developed. My partner is slowly coming around to supporting whatever decision I make, but it has been a painful journey with a lot of tears on my part. I have an appointment with Kaiser next week to see how things go there. I am trying to stay relaxed about it and am torn about whether I should even mention this experience with white coat syndrome to them or if it will cause more problems for me if I respond well to the BP reading at their office. Maybe I can start fresh there as ironically, I have felt totally comfortable there so far.
What is your take on the situation and what would you do? Thanks for reading!