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MWs, etc: Different arms with different BP readings?  

post #1 of 8
Thread Starter 
Hoping for insight from MWs or other birth professionals with knowledge...

I'm 37+ wks pg with #3. My BP appears to be creeping up a bit now, which I know is not unusual at this stage. My MW has recommended passionflower tincture and cal/mag/zinc, which seem to help. I've also been spending more time outdoors in the heat as my oldest DS just started fall baseball. I've been feeling dehydrated and swelling up at every game. Yuck. By the next morning, with plenty of water in between, the swelling seems to go away. After an extra day, it seems to stay away, too.

So I've been monitoring my BP at home with a wrist cuff that has seemed to be pretty accurate. For instance, my MW took my BP with her cuff (albeit it too small - plus-sized mama here) and it matched very closely to what the wrist cuff said (using opposite arms). But in the last week or two, I've gotten such a variance in readings I don't know what to think.

I generally take my BP on my right arm while seated on my couch. I try to ensure I've been resting for a few minutes, but am upright, before taking it. I'm consistently getting borderline high readings now doing that on my right arm. If I take it again on the same arm a few minutes later, it will be much lower. I hesitate to trust those second readings, though, since the arteries were just compressed from the first reading. (Not sure if that should make it go up or down, but I know it can affect it.)

So I've tried taking it on my right arm - which, btw, has consistently felt more swollen/weird even when the left is just fine - and then on the left, figuring that won't affect the reading because it's different arteries. The left readings are always better! Not always a huge difference, but definitely different.

What to make of this? Should I rely on the right arm that I typically use for measurements? Or go with the left, which I used to use frequently, too? Is there any significance to this? Or to the fact that my right hand sometimes feels different than the left?

Thanks for any help in trying to make sense of this. : Just hoping baby comes soon so I don't have to worry about it!
post #2 of 8
I just have to say that IN NO WAY should your bp be done on a regular sized cuff if it is too small!! Why check anyway if the result it going to be a false reading? I also feel the same way about wrist and finger monitors - esp a wrist cuff. Do you know specifically that the wrist monitor is fit to your size? If your mw is using a cuff too small and you're getting the same readings, I'd have to believe that your blood pressure is NOT likely creeping up, but that the problem lies with the cuffs on both.

Regarding the arms, yeah if one side is swollen, again we're dealing with a cuff size issue, but I have a strong feeling that this whole thing is a cuff issue. I'm pretty solid about this kind of stuff. Does your mw not carry a plus-size cuff? If not, she SHOULD (this is a matter of fatphobia and if any mw is going to be a size-friendly mw, she has to have this on hand!). If she does, you need to check your bp with that.

And you're right about it creeping up. If the diastolic goes over 100, then I'd be more proactive. You're 37 weeks - and it's normal for the bp to rise at this point if your baby needs additional oxygen and nutrients.

You can go to any fire station and have your bp taken. And guess what? They have correct cuffs!
post #3 of 8
www.plus-sized-pregnancy.org
This site is an excellent pregnancy site for women of all sizes, but has a lot of good relevant information for plus sized moms. She does have specific information on there about blood pressure and blood pressure cuffs and women of size.
post #4 of 8
Thread Starter 
My MW had a bigger cuff last time, but has/had been waiting and waiting for a new one to come in with this pregnancy. She's definitely not fat-phobic!! She's wonderful! When the wrist cuff seemed to give accurate (and not abnormally high) readings from the get-go, we stuck with that rather than the cuff that was clearly too small.

My diastolic hasn't been over 100 with any readings - well, maybe one that was highly suspicious (like in an odd place and position). But instead of being in the 70s or low-mid 80s, it's been in the 80s to 90. Of course, then there are the really good readings and it's quite low! :

Thankfully my MW isn't one to overreact. She's recommended having the passionflower on hand especially for labor, when BP might go up even more. But I have little fear of her doing something like risking me out unless it gets to be an obvious problem. I'm not entirely sure what point that is, though. For instance, I know some swelling in late pregnancy is deemed normal, but how much? And when? At what point does it point to a problem with BP/pre-e?

I wish I knew if I could really trust *any* of these BP readings I've been getting!
post #5 of 8
heather, i didn't mean to imply your midwife was fatphobic -just if she didn't have any large cuffs, she might not be a size-friendly midwife. that is a piece of fatphobia.

pre-e does not just suddenly happen in the last three weeks of pregnancy. swelling is normal - in your face it's not (and the facial swelling I'm talking about is severe!).

for me, the BP becomes an issue at this point in preg if the bottom number is over 100. seriously. and I'd consider a waterbirth because your bp will lower in water.

having the diastolic in the 80s to 90s sounds normal to me, but I'm not your midwife. here's my take on bp at the end of preg: http://sagefemme.blogspot.com/2007/03/hypertension.html
post #6 of 8
Thread Starter 
Thanks, Pam. Having a concrete number like that in mind helps ease my mind quite a bit. No facial swelling at all. And sometimes I'm wondering if I'm not just feeling a little stiff, rather than swollen... So while sometimes I clearly am swelling, there are others when I *feel* weird that may have nothing to do with swelling. kwim?

I am definitely laboring in water and open to waterbirth. Even just a regular bathtub has been immensely helpful with swelling on certain occasions! Can't beat that for natural help.

Other than not having the right sized cuff on hand, my MW is actually one of the most fat-friendly people I've met. Totally supportive. I was risked out by a MW once who had a broken large cuff, so although my dear MW isn't always 100% organized , I can cope with her smaller cuff or my alternate one when there's no discussion of sending me to a high-risk OB 'cause I'm about to stroke! But I think I'll give her a call and see if she did get the bigger cuff, just as I think it will be more accurate over all. And then perhaps we can all relax more!

Thanks again!
post #7 of 8
Heather it's good to know that your mw is a size-friendly mw! We need more of those!
post #8 of 8
Thread Starter 
I talked with my MW earlier and she said that it was totally normal to have different readings, and that the left was more dependable. Whew! With all of the info and input, I'm feeling much more relaxed about any possible BP issues. My left-arm readings today have been great!

(FWIW, while I've had no significant BP issues in my past pregnancies, my mom had severe problems - not just pre-e but full blown toxemia - in both of hers. So it's always out there on the horizon for me, though I try very hard not to be concerned about it!)
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