Risks of beta blockers /high blood pressure

[CharmingChampignon]

I have had a problem free third pregnancy until the last couple of weeks where I've had high bp at each mw appt. I've been fully monitored/blood tests etc and all seems well with baby and me. BP was high for 3 readings in hospital so I was started on beta blockers before being sent home. These seems to be working and I have a normal bp now but I've been told that I will have to give birth in a consultant led unit, not use a pool, be continuously monitored, have drugs for placenta etc. But no one has explained why. I understand that high bp could lead to stroke - but if my bp is within normal range, albeit on meds, then is the risk still the bp or the meds or ?? And are there risks to the baby from the drugs? Why would I need drugs for the placenta?

I have contacted the hospital and asked them to arrange for someone to clearly explain the risks - and why their plans for this birth combat those. I will of course do what I need to to keep me and dc safe but I want to understand.

As it's my third and I've had quick labours, I'm also anxious that I may deliver at home in a rush and I want to know what the main concerns should be ie would I need takin to hosp post delivery regardless.

Does anyone have any experience or knowledge that might shed some light?

TIA

There are a number of risks with high blood pressure. It is rather unknown whether it is the placenta causing raised blood pressure, or raised blood pressure causing poor placental flow. Because of this your baby will be monitored continuously to check that the placenta/baby is coping with extra strain and stress caused by contractions.
Depending on the drugs you are on, some effect the baby's blood sugar after delivery so baby will need to be monitored afterwards.
The afterbirth injection for placenta is entirely your choice. You are at higher risk of bleeding without the injection especially if you are induced or put on the hormone drip, or have an instrumental delivery.

I hope this helps. Make sure you ask your midwife for all of this information.

Thank you so much - that's great info. I've had the placental Doppler checks and all seems v well at the moment and baby v happy on CTG and growth can.

I've now been told that my bp is not yet in the category for continuous monitoring but I'm guessing it's likely to go up in labour . They have got lots of wireless monitors apparently so it doesn't have to mean immobility which is a relief.

I'm on Labetalol and was told it shouldn't impact on the baby or breast feeding after ?

Re the injection - is there any mileage in a 'wait and see' approach? Ie if I bleed yes, but if we can wait for cord blood to reach baby first that would be preferable?

Waiting for a minute or two for the injection is certainly an option. You can leave the decision up to the actual moment.

With DC1, I planned a water birth so my MW and I agreed that, if all went well, we could delay things to allow us to stay in the water for cuddles, but if I bled, then they would give the injection, and I was happy to be guided by them at the time.

When I had DC4, the plan had been for delayed cord clamping, but delivery was very, very quick and then I had a small PPH so they ended up giving me the injection more quickly.

Next time (expecting DC5 at the moment), given the previous PPH and that I am more likely to have a PPH given the number of previous deliveries, I've decided that I've have a managed third stage.

Goodness me, that's a very long answer! Sorry!

Finally, labetolol is fine in breastfeeding:

www.drugs.com/breastfeeding/labetalol.html

Thank you Dino - that's good to hear. I'm more than happy to receive anything as needed but I've found the flip from low to high risk quite a shock with it feeling like nothing is a choice any more and If I question anything then I'm being naive or obstructive.

Labetalol is the drug that effects babies blood sugars after delivery. Do some research and googling on it. It causes hypoglycaemia in newborns / or puts them at risk of it.
Yes you can definitely ask to wait for the injection there is no harm in that. However I would recommend it if you are induced or with hormone drip. Xx

Thanks Jelly - I rang the hospital and they confirmed that baby's blood sugar will be checked so we will probably need to stay 3-4 hours for that at least but that I can give first feed etc as normal.

I feel so much better having had more information and time.