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Discussion Starter · #1 ·
Hi. this will be long. I posted here years ago, long time reader of Mothering, don't see any names I recognize from the old days. Anyway, here is my situation.

I'm expecting #5 in mid-late december (the due date itself deserves a thread of it's own). I have preexisting hypertension, have had it since I was 20 y/o with no known cause (I'm 35 now). Been through the gamut with each pregnancy. 1st: highly medically managed, but easy pg and delivery at 40 wks, no bp meds during pg or labor. 2nd: saw midwife who put me on aldomet at 20 weeks and turned me over to OB at 36 weeks, labor immediately induced, but still a nice birth with healthy baby, 3rd: different midwife, aldmomet from beginning of pg, turned me over to OB at 30 weeks, induced at 35 weeks due to poor bio-physical profile. Cytotec and magsulfate hell on earth with unhealthy baby and mom. 4th: You won't believe this, home water birth of 43 week 9# baby, best birth and healthiest of the lot. I had "high" bp through that pg, but my lay midwife just felt it was "normal" for me, and not to worry unless I spilled protien in my urine, swelled or had other signs of problems. Never did, felt great, babk on my feet within the day. ONly meds were CoQ10 and blue green algae. My bp was usually in the 140-150/80-90 range, sometimes 160. Keep in mind, my nonpg normal is the same.

So, this pg, I am living in a new state, where lay midwifery is illegal, and I could find NO ONE to attend a homebirth. My husband REFUSES absolutely to entertain the idea of an unattended birth at home, so I went with the most liberal of the three docs in my town that attend deliveries (all are family practice, no "OB/GYNs" in town. REally I had little choice, b/c one fo the three would not even accept me as a pt due to "high risk", and the other would have fired me long before now. My doc has been pretty good actually, but she is still of the medical mindset, and now at 30 weeks we are headed for a lot of conflict.

I'm taking the max doses of aldomet and hydralazine now, and my bp is the same as it was at the beginning of the pg, usually 150s/80s. No matter how much medication they give me, it stays relatively the same. Sometimes, higher, sometimes lower, but is fairly consistant in this range. My dic feels this is unacceptably high, has told me my midwife and I were irresponsible and lucky in my last pg, and it is time to stop "living in denial." I know she just want the best outcome and is doing what she thinks is right, but I'm getting VERY stressed out about the whole thing. She calls me at home to check on me, has been trying to find a doula for me (more on that later), lent me all kinds of Reiki and meditation CDs, etc. I was taking prenatal yoga, but I had to quit for $ reasons (my doc even internened and got the instructor to charge me a little less, but it is still too much for me), time constraints, and the odd fact that I cannot STAND being around other pregnant women. I do not want to discuss my pg or theirs, and it seems pg and babies are all they are capable of talking about. People ask me about my pg and I just say "fine" and change the subject, even family and friends. Weird I know.

I take cal-mag, blue green algae, coQ10, fish oil, multivitamins, folic acid and alfalfa. I take more pills than a nursing home patient. I am supposed to meditate every day, but I don't have the psychic energy, so I just sack out on the couch.

Problems ahead: My doc has mentioned on SEVERAL occassions that I will not go to term, and to get used to the idea of an induction. She told me point blank water birth is out of the question since I will have to be on the monitor (the hosp doesn't have a tub anyway), and probably need IVs. I told her I would refuse mag-sulfate, and she told me that in that case I might have to be transferred to the big hospital 80 miles away b/c the nursees will refuse to take care of me here. I will be assigned to the obstetrical teaching team on call and have a nightmare birth for sure in that case. She wants me to have an epidural to help lower my bp, and placate the nurses . i had an epi during my first birth, and hated the foley catherter, internal monitor, and all the other crap that went with it. Never had any pain control with subsequent deliveries, even with pit, etc. I don't know anything about this so called epi-light, except that I don't want it.

My doc recommended a doula, and I thought it was a great idea, until I met her. I didn't click with her at all, it seemed like she was more in support of my doc than she was of my birthplan. Very nice, but no spark. She also made several comments that didn't exactly turn me off, but indcated she isn't of the same mindset as I. She is very religious, (I am not) and made several comments to the effect of "The Lord want you to have a healthy baby, the Lord is blassing your pg, and will watch over you in labor, etc etc etc..." Even if we clicked, she charges $350, and I siply cannot afford that. I work, and as it is we only have enough money saved up for a 3 week maternity leave. I'm hoping to have enough for 4-5 weeks by delivery, but paying a doula would take a weeks leave off, and if I go out earlier than my "due date" I'm screwed.

I should tell you that this was an unwanted pg, I came very close to having an abortion (dh wanted that baby and told me it would "grow on me") and honestly, wish every single day that I had. I know abortion discussion is not allowed, and I don't bring it up to start controversy, just to point out where my head it at here. The whole idea of going to the hosp to have this baby, much less bringing it home and taking care of it makes me physically ill and I cry all the time. I have toured the hosptial birthing area, and it is a nightmare. In fact, I literally have nightmares about it. I dream that I am running through the hospital trying to get away from people who want to do things to me. I spoke cosicidentaly with a nurse who works there, who rolled her eyes at me and called me "one of those earth mothers." She counselled me NOT to bring a doula, b/c it will just piss the nurses off more, and after a few moments of discussion abhout what I wanted and what I'm afraid of, she said "You have better be careful, they will call it endangerment and call social services on you if you refuset he standard of care."

So what do you suggest? I can't stomach the idea of going there, and fear the worst if i do, but what choice do I have. Dh won't support birthing at home, there is no other doc and no other hospital to consider, I have no friends to turn to (just moved to town) and distant family who think I'm nuts and should just get a c-sec at the earliest possible date and stop whining.

I work nights, so I'll be back tonight and appreicaite you thoughts and suggestions.

3,060 Posts
Oh, wow, you need some big big
s !!!!! So much on your plate and such a transition to be going through...not just with the pregnancy but perhaps with your family as well...

First off, you might try and see if there are midwives around who are opperating w/o mandate, so to speak. You can always head to the hospital and take what you get if things get too tense to complete a homebirth, but most likely you'd have a good experience since you've already been proven to birth well that way. Also, it might help to have a heart to heart with your doctor and try to approach her with all the dilemmas in your heart...emphasize that you are seeking prenatal care to screen you for CHANGES in your condition, since you are aware that the medical establishment deems continuous high blood pressure to be a risk to your pregnancy, but that it seems to be a baseline for you and you have had four previous healthy babes despite the fact that your blood pressure didn't go down. Also, it might help to ask for literature from her or even seek some studies on your own that could pertain...I'm certain there is a TON of information out there on hypertension in pregnance, as it is so common, and perhaps there have been studies done on other women like you who BEGIN a pregnancy with hypertension in order to compare them with women who have PIH. There have to be differences...I know that just personally in my family there is a tendancy to have low blood pressure/high cholesterol...and the two sort of counterbalance each other. Nature works in mysterious ways and each body is a wonder of balance...

Another thing you might try is to find a provider farther away but not an OB. At 30 weeks, you have time, especially if your "naturally started" labor was a late one. It's not uncommon for people to travel to a neighboring town to have a child when the options are limited where they are, and perhaps starting fresh with a new caregiver might let them place their trust in your well tested body, rather than in medical norms. Are there any la leche leagues in your area? They might have some recommendations. Also, you might find a doula on your own, and many will do volunteer births (I'm attending a doula training myself this weekend and our instructors only do free births now...) or barter. But a doula cannot change the comfort zone of your care provider, and ultimately in a birth they are the ones you are most likely to have a conflict with.

Okay, and here is perhaps the biggest suggestion that I have, though it's the hardest one to give...perhaps you and DH need to come to a new understanding about how to approach this birth and this child. It sounds like you've been doing a lot of compromising with him, and respecting of his opinions and feelings, but that he might be able to do more support for you in 1)making this whole birth experience something that you can accept (especially if this is your last birth...women's mental health is so closely tied with birth experiences that it is essential for your whole family, including the new child, that you find peace with the experience) 2)being a real provider of care for the new child, so that you are not left alone with that responsibility. Perhaps there are compromises you could make in terms of care, work, leave of absences, etc., and perhaps you can still work or find some sort of out of the house experience to continue.

Being in a new town is so incredibly difficult, especially when you feel attacked on all sides, but there are bound to be some great people there. Though you say you aren't religious, are there any other networks you might be able to establish? Are your other children in schools, activities, etc., that might connect you with other people? Are there any more natural parents there who might be able to give you support? I wish I could give you a big hug myself, and help you through all this, and I am sure there are many, many other people who would love to help if they only new that there was a need. Have you tried the "finding your tribe" section to see if there are any mothering moms in your area?

I am sending you a PM as well...
[edited to add:] ooops! looks like you don't want private messages, understandable...I just wanted to add that my grandmother, who is otherwise somewhat conservative, got pregnant after her 5th child was born and decided that her family was complete without that child. It had to be a very difficult decision, but I know that she has a lot of peace with it. Since you've felt a similar need to keep your family steady, is there any alternative (adoption perhaps?) that your husband might be able to accept? So many people have such a families that aren't completed or barely begun, and many have the means to assist in the birthing care as well. But it would be a tremendous choice and perhaps something your husband would not accept, or that you personally couldn't. Feel free to email me if you need to talk any more, and sorry this message is so long!!

s, and lots of luck and peaceful thoughts to you...
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