BP question

[J-Max]

I have a question on Blood pressure for any of the midwives that have time to answer :

Back ground
- completely normal preg #1
- consistently high BP (140-160/90-100) throughout preg turned into pre-eclampsia at 38 weeks
- consistently high BP (140-160/90-100)throughout preg - no pre-e

now on preg #4 at appt last week, my bp was 162/95. I know it has not been that high at home and think it was the stupid dr (trying to talk dh into homebirth, may be UCing it). I have been taking my bp at home and it is consistently 125-127/80-84. Now everything I find says normal BP is below 120/80, what do you think about my pressures?

I have been mostly following Eat To Live (very healthy vegan - low carb diet) for the past 1.5 years. I do eat some meat, but I really limit my white/processed starches. I really fell away from this during the first tri, but am getting back on track. I lost over 40 lbs before i was preg (am still about 25 lbs over what I would like to be)

any help - insight would be greatly appreciated

[Charmie981]

My gut says that because of your past experiences with high BP, you're stressing yourself out about it and having high BPs at the doctor. I know they shouldn't be able to be "that" high, but having seen an OB for the past 4 weeks or so, every time I've been in there, I've been nervous (about my pregnancy, his desire for me to have my baby in the hospital, whether I was going to miscarry, having to go to the appointment alone, or having to yell at DH to get him to come so I don't have to be alone) and my BP has been ALARMINGLY high...138/94 once. It kinda freaked me out and I've been watching it in other situations, and its not nearly as high...like 112/78. The nurse has been dismissing the BP because she knows I'm totally freaked out, so it's not been a big deal (and then I miscarried anyway, so no risk of harrassment later in my pregnancy anyway).

Have they been rechecking your pressures? Do they ask you to lie down on your left side for a little while and check again? My general rule is that if BP can be changed significantly by positional changes, it's not anything to worry about, but if it doesn't come down, I would be concerned as a midwife. I know they make BP units that do printouts. Maybe you should ask your OB to prescribe one of those and you can check yourself every day? I also wonder if the equipment is faulty? The nurse in the practice I've been seeing uses a wrist BP cuff, which I've been told as a midwife is "notoriously unreliable" and encouraged not to EVER use as the only source of BPs for my clients (another reason why I checked my BPs elsewhere!). Also, do you need a different size cuff? Long story short: there are so many intricacies of BP that I would want to explore thoroughly before I accepted a high BP diagnosis!!

ETA: I wouldn't worry at all about the 120-128/82-84 range. I do get concerned when it's over 140/90, or an increase of +30/+15 from your normal.

[J-Max]

Thank you so much! The 120s/80s are taken at home at different times throughout several days. I have a really good home bp machine that I got when I was having bp prob with #2. It is the correct size cuff and has been checked for accuracy several times.

[Alison Cole]

In addition to everything Charmie said, I would also be really conscientious about getting lots of protein (75g daily), lots of water, and adequate salt. Anne Frye, author of Holistic Midwifery, says if you know mom's diet includes enough of these things, then you can relax a little about high BP. Check out her book for more details...

[lilsishomemade]

Here's another thing: Are you overweight at all? I know you said you lost a lot of weight before pregnancy, but if you're overweight, they may be using the wrong BP cuff. With my last, I gained quite a bit at the end of the second and into the third trimester, so when my mw took my bp with the normal cuff, it was very high, but the larger cuff it was normal.

If this couldn't possibly be the issue (and even if it is), I agree with Alison, make sure you're getting enough protein and salting to taste. Lots of water.

ETA: If they are using a bp machine, ask them to check it manually. When I was a nurse, the machines were good for getting an idea of where the bp is, but if we got an abnormal reading, we were trained to recheck it manually.

[pamamidwife]

agreed with what everyone has said, including the cuff size issue.

how was your pre-ecl diagnosed? sometimes high blood pressure is just that - nothing else. were labs run?

I would only worry if it the diastolic reached over 100.

[J-Max]

Thank you all so much, I think I just needed the reassurance that I know my body and I am fine.

I am slating to taste, and drinking lots of water. I have slacked off on my protein the couple of weeks (I just can't eat that much food, my digestion has really slowed), but I plan on buying some protein powder when I get groc next week and adding that to my smoothies. (any recommendations for a good one?)

I am still a little heavy, but I have both size cuffs, and it does not seem to matter which one I use, they give reading with in 2 points of each other. They do not use a machine at the dr, but I do at home.

The pre-e (preg #2) was diagnosed thru blood and 24 hour urine labs. I did the labs with #3, as well, but they were always well with in normal ranges, and just had high BP.

I have been taking it at home for almost 2 weeks now (at different times of day) and it is very consistently in the 125/80 range. The only time I had a high reading (like 145/80) I had a kid crawling all over me, and I took it a few minutes later and it was back to "normal"

Thank you all so much, I really value your knowledge.

[jlpetitte]

This was just in the news recently and may be something useful if you are not opposed to supplements:

Pregnant women who take calcium supplements reduce their risk of developing preeclampsia, sometimes called toxemia of pregnancy, according to a new study. However, calcium supplementation has no effect on the risk of preterm birth or stillbirth.

Dr. G. J. Hofmeyr, of the University of the Witwatersrand/University of Fort Hare, East London, South Africa, and colleagues conducted a systematic review of 12 clinical trials, involving over 15,500 women, that compared at least 1 gram of calcium daily during pregnancy with an inactive "placebo" supplement.