Mears, a b/p homebirth question if you're out there?

[dandycandyjellybean]

After having previous complications all ironed out (low placenta turned out fine, ob consultant predicted 12lber and subsequent c/s ruled as rubbish, I have been told I'm okay for a homebirth. However, white coat syndrome has kicked in big stylie and my b/p is consistently up (was averaging at 130/80-85, is now tending towards 150/90-100) which my midwife is obviously saying will rule out my much wished for homebirth. I am convinced it is anxiety that is doing it with me, urine is clear, as are blood tests, as soon as I know I'm due an appointment to have it checked I start to get anxious about it and up it shoots! Is there anything I can do (other than chill out, if anyone else tells me that I think I'm going to pop!) Would one of those 24 hour monitor things help maybe? I came home from docs today and went to bed in an effort to rest, but lying in bed isn't lowering my anxiety levels. How high can it be before it totally rules out a homebirth (or would this depend on the individual m/w?) and if the worst comes to the worst and I have to go to hospital, could I do the 6 hour turnaround, even if my b/p stays a bit high? It's just that I think that going into hospital is going to make it go up even more,iyswim. Sorry if this is desperate and hysterical ranting of hormonal pg woman.

cubby, I had a 'white coat' BP as well and was threatened with hospitilisation from 30 weeks

However, DH (a docotor) measured it twice a day at home for a week to show it was perfectly normal.

Could you get a community midwife to come out and measure it?

That would be my suggestion too Highlander.

Remind me if this is your first baby Cubby? It is important to know if it is WCS, or early signs of pre-eclampsia. Have you hads any blood tests done? It would be reassuring to know that they were normal too. If you were here we would monitor your BP over a length of time (serial BPs) to see if it settles when you get used to the environment. Lying in bed isn't going to help much IMO. Just frustrating. Hopefully when you go to have it checked out it will turn out to be only 'white coat syndrome'

Try hypnotherapy for relaxation.

Yes it's my first baby. Had bloods a couple of weeks ago which were totally clear, and at my midwife's request I have been and had some more today, she was going to ring up for the results later on this afternoon. My midwife, who is absolutely lovely, is coming out tomorrow to take my bp at home, however, she came out 10 days ago for my homebirth chat and took it at home then, but it wasn't brilliant. Having said that, a couple of days previously, my sil had gone into prem labour at 28 weeks and had a baby, which was obviously very stressful / emotional for us all and I had been in a real state about it. My midwife is being brill about it, she didn't write my bp on my notes today, will only do that after she's taken it tomorrow in the hopes that it has lowered by then, and by the sound of it she is coming for a coffee, so she will take it a couple of times to let the white coat syndrome wear off a bit. Last time I had to go to hospital it was 168/110 the first few times, but after I had seen and had a chat with a really nice consultant (only one I've ever encountered!!!) it had returned to 130/85 which he didn't feel ruled out homebirth. So, I'm hoping that will happen over the next few days. Thanks so much for your reply Mears, and all.

How did you get on with BP and bloods cubby?

My b/p seems to have settled at about 150/95 and the only thing on my bloods is my uric acid levels which were 365 on Thursday and 362 yesterday. No swelling or headaches or any other symptoms. Despite the fact that both of those things seem very borderline to me, I have been told categorically that my homebirth is off, which I suppose given that blood pressure goes up during labour is understandable. The (very newly qualified) registrar I saw yesterday gave me a sweep, but said that she couldn't really do it properly as she could only get the tip of her finger in, (sorry if tmi!!) so I don't feel particularly hopeful about that doing any good. I have to go back yet again on Monday for bloods and monitoring (which forgive me for being niave but I feel all this backwards and forwards to hospital and seeing a different person every time is adding to my bp problem, particularly given that I am caring for a disabled husband into the bargain!!). She also booked me in provisionally for an induction on Wednesday, which I am really unhappy about. Feel very gloomy about the whole thing to be honest, within a few days my lovely homebirth with lots of movement and one to one care has disappeared into the wild blue yonder and I face being strapped to a bed being monitored for most of my labour. I suspect the midwifery will be extrememly stretched too as we are having even more of a baby boom than normal locally; every clinic appointment is at least double booked there are so many nearly full term women on the books at the moment. Boo hoo hoo.

I am sorry that your homebirth is off the agenda now Cubby, but TBH you are better to be cared for in the hospital. Your uric acid levels are raised although only marginally. Normal is 330. However, your blood pressure is raised. Now it may well be that it is white coat syndrome but equally it could be the beginnings pre-eclampsia. The problem with pre-eclampsia is that you do not feel unwell, however your blood pressure could rise very dramatically which would mean inducing your labour sooner. It also can rise dramatically in labour and, if that happens, it can be treated appropriately when in hospital.
Is there any way that your community midwife can go in with you at all? She could look after you assisted by the labour ward midwives if there are blood pressure issues.

I do get the b/p issue, it makes total sense that it doesn't matter why it is raised, it is up, and knowing that it will go up again in labour, I need to be in hospital. It doesn't help that my experiences of hospitals are all very negative; both encounters with registrars and one very unpleasant midwife during earlier pregnancy complications and also relating to my husbands accident 12 years ago (and subsequent contraction of MRSA which has had some very long term effects) hence the desire for a homebirth I guess. My community midwife is on call this weekend and reassured me that she could come with me if he came then, but I don't think it is an option during her normal working week. My sister's first birth was a very negative experience when she developed pre-eclampsia, had an unsuccessful induction (full on labour for 36 hours with nothing to show for it) and then ended up with an emergency c/s. And it seems as though each stage of my experience is echoing hers in a very scary way. I know it could be totally different for me, but the similarities are uncanny and making me feel pretty upset. Thanks for your concern and advice though, it has been reassuring.

Discuss it with your community midwife anyway just to be sure she can't come. What would have happened if you had gone into labour during the week? The midwife still would have needed to come. In my area community midwives have update days in the labour ward. Perhaps she may be able to do the same. Just a thought. Good luck and think positively. I can understand why you are concerned but you may well have a really good birth experience even if you end up being induced.