Essential hypertension and a natural birth....

[CharlyH]

I really need some help as am being given really conflicting advice.

I had high blood pressure before I was pregnant - it was recognised and treated and is controlled by drugs (Methylodopa). Since I have been pregnant it has been stable with no problems at all.

I am very keen for a natural birth with no drugs and as little intervention as possible. The obstetrician is supportive and has put in my notes that I should be allowed to give birth in the midwife led birthing centre (they are not happy to recommend a home birth - understandably). Dr has said though that it will be 'up to the midwife on the day' as to whether my wishes are honoured. They may not take me and send me to hospital labour ward instead.

I feel very worried by this and one midwife I have spoken to says that I will be 'strapped to a bed' the whole time and ideally they would like to give me an epidural straight away as a 'precaution'. This seems madness to me that they would give you significant drugs without anything actually being wrong.

Left feeling upset and confused when I just want to look forward to the birth. Has anyone one got a relevant experience /advice they could share?

Obviously, the above is based on everything continuing to be fine and normal. If BP rises then I will need to take advice and change plan as necessary.

I am and at the MW talking about strapping you to a bed and precautionary epidurals...

I had raised BP during my pregnancy (caused a bit of concern towards the end), but I was regularly monitored, allowed to go a week overdue and went into labour spontaneously and had a natural birth with some G&A and my TENS machine.

So, provided your BP is being monitored and is not giving any cause for concern, I can't understand why you shouldn't have a natural birth. Even using the hospital labour ward (which is where I was during both my labours) doesn't automatically lead to loads of unrequested, immobilising intervention - it should just mean that help is readily available if required.

I had pre-eclampsia and whilst I wasn't "strapped down" - it's pretty hard to be mobile when you've got a CTG and a barium drip. :(

Oh dear, how could I forget I had a catheter too? My little yellow handbag.

Firstly you can refuse anything - if they want to 'strap you down' you just say no if that is what you want. Or you agree to monitoring for parts of the labour.

What is your blood pressure at the moment?

I was exactly the smae as you. I have PCOS and I had high blood pressure before I got pregnant which I was taking medication for (Moxonidine I think). When I found out I was preg I got switched to methyldopa. My BP was absolutely normal during pg and spot on the normal range. I had some extra scans and frequent BP checks while I was pg which were all fine. It was never suggested to me that I couldn't have a natural birth though I had to go to hosp as there was no nearby MLU and I think for me I would have gone for home or hosp rather than MLU anyway. I was offered a home birth but as it was my first, decided to go with hosp.

I stayed at home for most of my labour until my waters broke as found the pain manageable, then went off to hosp and was already fully dilated and gave birth with no additional monitoring or pain relief. This was in Dec 2006.

It was never suggested I should have an epidural! Or a catheter! What would these be for exactly?! Did they give any explanation?

I too was quite worried about being in hospital and found it a rather scary prospect. The delivery itself was actually a very enjoyable experience, I think because I stayed at home as long as possible and the midwives didn't have the chance to intervene when none was needed!!!

Since giving birth, my BP has been in the normal range and I've never had to take any medication for it again. I'm now 33 wks with no 2 and it's still fine!

Do look forward to the birth, I spent a lot of time worrying about going to hosp because of BP and was terrified of staying in. As it happened I did have to stay in and it wasn't great, but it was because my dsughter had jaundice and nothing to do with BP!

Do you have any more appointments to discuss things?

I had a homebirth last summer with Pregnancy Induced Hypertension. I was admitted into hospital at 39 wks for 1 wk as BP had shot up, and had pre-eclampsia in previous pg needing EMCS at 34wks. They managed to stablise my bp and all tests for pet came back negative. So I chose to go and have my planned homebirth - whilst medicated for bp. I obviously would have transfered to the hospital if my bp went up during labour. But it was perfect throughout!

Thank you all very much for your helpful advice.

piprabbit - hope I have an experience like yours. The good thing is that at the moment by bp is absoulutely fine (35 weeks) which is why I am so concerned about them wanting to intervene when nothing is actually wrong.

hopingforanother - I have had the same, extra scans, etc and all fine. They have said that both pain and a problem could put bp up (abruption, etc), so by giving an epidural, if it is just pain pushing it up, it will go back down. Seems like a lot of ifs to me...

So helpful to hear other peoples positive experiences. Sounds like we just need to stick to our guns (and cross our fingers we get a supportive midwife!)

Hi CharlyH. Just wondering if you've had any more info on what might happen for you or even had your baby yet?!!?

My BP has gone up and I'm back on Methyldopa and thought of your post - they say it's a return of the essetnial hypertension I had previously and not pre-eclampsia which is a releif. I'm 36 weeks now and having experienced the continuous monitoring for an hour am feeling slightly worried, given I'll be in early for antibiotics anyway, they will have me captive from the early stages!

Wondering if you've had more info on whether you will have to have continuous monitoring or not...

peppapighastakenovermylife Did you ask for monitoring in parts of the labour and how did it go?

Hope all is going well for everyone!

Sorry - that sounds confusing - I had some continuous monitoring for an hour in the assessment unit when they found BP had gone up... Now feeling slightly worried about having it when I am in labour as it was horrid without having to cope with the pain of contractions whilst lying still!!

Thanks for the email hopingforanother. Have discussed further with Dr at hospital who seems much more relaxed. Says that can ask not to be monitored constantly and can ask to mobilse during monitoring rather than being in bed. I am finding the conflicting advice quite hard to manage...

I am 39 weeks now and getting some rumblings so fingers crossed won't be too long to wait. I think the key thing for me is to ask why they are doing things to make sure they are necessary rather than just taking what they are doing for granted. Good luck with your birth, hope it goes really well for you.