Urgent question about home births and raised blood pressure.

[bunjies]

I'm currently 38+5 with my 3rd pregnancy (ds and dd born at 37 & 38 weeks respectively) and when I was initially booked in by m/w my blood pressure was 100/60 and has not exceeded 120/80 throughout. However, at my a/n check yesterday am it had gone up to 140/96 and my urine protein level by +1. On this basis I was advised to go to the hospital to be monitored which i did. They took my bp at 10.30am which was 138/90 and hooked me up to a sonicaid. The baby's heartbeat was fine and it was also showing I was having mild contractions every 10 mins or so. They measured bp two more times. At 3.30pm it was 154/94 and at 5.30pm it was 130/100. The Registrar's advice was to keep me in for 24 hrs and monitor bp every 2 hrs despite everything else being ok (including bloods which were not indicating pre-eclampsia). If bp did not reduce they would induce. This was not good news for me as I have had a pathological fear of induction since my first labour where things were taken out of my control and the whole experience throughly traumatised me. Second time around I managed a home birth which was fantastic and I am determined to do what I can this time to ensure I can have another. Having spoken to horrible Registrar (who was more or less implying that if I left the hospital I would be putting my baby at unecessary risk of placental abruption and subsequent fetal death ) and the lovely snr midwife (who was a lot more supportive) I discharged myself thinking well I've got at least 24 hrs to do something about this myself. I am therefore going to take castor oil this morning in the hope it will kick start labour (worked with no. 2 when I started leaking early and wanted to avoid induction - see a pattern emerging here!)

Anyway, my question is this. If my bp remains at the levels I have mentioned can I still have a home birth and ideally a water birth or will I have to go into hospital anyway? Does the bp have to come down before they will allow me to labour at home? I realise the most important thing here is the health of my baby and I am willing to be induced if that is the only course of action open to me but if there is any way I can avoid this without causing harm I would like to take it. I would really appreciate any responses to this asap (especially from any midwives/doulas out there) but all contributions welcome.

Thanks bunjies.

I don't know - but bumping this up for you and wishing you all the best.

I've found a link for you . Also ... I wonder - is it possible the high blood pressure is due to stress? If you're terrified of a "managed" labour (understandably), that will shoot your BP up. If the other signs aren't pointing at pre-eclampsia, then I think this is a reasonable idea.

(Also, from what I know, pre-eclampsia is a bit of a misnomer. Eclampsia is a really really rare nasty thing, but pre-eclampsia doesn't generally turn into it. And at any rate, you haven't got pre-eclampsia.)

One idea - can you do relaxation breathing next time you're getting your BP done? (Also, if you want to cheat a bit, make sure your arm being measured is a bit higher than it "should" be, relative to your heart. Will reduce your BP a bit. Just slouch ...)

I'm sure someone more professional will be on in a bit.

Sounds like a serious case of scaremonguering... but I am not a medically qualified person... I am only a doula.
I woudl not go with castor oil but as you ahve tried already I guess you are happy with that.
You might find labour is too quick and you can't go to hospital anyway.
Sounds to me like a relatively high blood pressure bit not that amazingly high.... so I'd stick to home birth plans....

Can you monitor your blood pressure at home? How far are you from hospital? So, if something did go wrong at home could you be at the hospital in say 5 minutes or less? Obviously, you already know what you in for with a home birth and have already decided this is your preference. But, I do think the owman at the hospital is advising you on what she feels is best for your baby. Just as with any line of work, the medical profession is made up of people who have opinions. And, this woman probably has a more "medicalised" view of birth than you do.

Anyway, if you could get a bp monitor and use it at home over the next few days, then you could demonstrate that it is staying down consistently. Maybe it will stay down and all would be well. However, it is probably wise to monitor it... but not necessarily in hospital.

I don?t think the registrar was deliberately trying to scare you, I can see why they recommended monitoring your BP as there are risks associated. I think there is a big problem though with our society today being so litigious, especially in the field of obstetrics, that I think the doctors themselves can get overly scared about risks and often medicalize things more than they need to be and sometimes leap in sooner than they really need to. I think what is important for you and your baby now is that you continue to have your BP monitored some how to check it is not continuing to rise and keep a check on your urine tests. Also for someone to keep a check on the baby with at least the occasional listen-in. Have you spoken to your community midwife about this? It would be really good if she could visit you at home to keep a check on your BP. You should hopefully feel nice and relaxed in your own home and the BP readings should then hopefully be accurate.
There is some info here on high BP in preg and some here on pre-eclampsia.

I have to say though that it is normal for yourt BP to rise in end of pregnancy as it is a sign of good working placenta and increase blood dilution (I think).