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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Pressure to induce due to high blood pressure - so angry

256 replies

jezza1234 · 12/04/2021 13:38

Hi all,
Have to vent. I am 39+3 wks and have borderline/high blood pressure that has been creeping up a bit during pregnancy, which i take medication for and monitor at home. I have never had any protein in my urine or sign of pre-eclampsia, baby growing absolutely fine (50th percentile), doppler of the Umbilical cord absolutely fine, all CTGs absolutely fine, no other symptoms.

About 2 weeks ago the midwives and doctors start telling me that i’m going to need an induction at 39/40
Weeks. I ask for evidence to better understand the risks and benefits of induction vs expectant management, and after a long conversation the doc agrees that it’s fine to wait until 41 weeks, the main issue is pre-eclampsia and slightly high bp is manageable. I agree to go into hospital for regular monitoring.

First monitoring appt today. I get bp reading of 140/90 and 145/90, slightly high but the same as i’m getting at home. New doctor comes in and starts telling me that my baby is at risk of stillbirth and i need an induction.

I was so angry and upset. I said to him that that the word ‘stillbirth’ is a very inflammatory word to throw around and asked him to explain why it was necessary to have an induction now. He immediately backed down, apologised for using that word and said ‘it’s pre-eclampsia we’re worried about not high blood pressure’.

What if I hadn’t done my own research and gathered evidence? What if I was younger and less self assured and not able or comfortable challenging the assertions about stillbirth?

I have never in my life experienced the kind of pressure and emotional manipulation from medical staff that I have since becoming pregnant. I usually am quite happy accepting the recommendations of medical staff because I feel comfortable that these are based on good evidence and research. This is absolutely not the case in obstetrics, and given the different information i have been given by different doctors at different times, there doesn't seem
to be any internal logic either.

The only thing doctors seem to want to do is induce, induce, induce - yes it might be the best way to prevent the possibility of something happening, but that’s like saying that leg amputation is a great idea because it will prevent 100% of sprained ankles! I know that in some cases induction is important and useful, but rates of induction have gone up and up with only small drops in stillbirths and negative outcomes for women. That means many hundreds of thousands of women are being needlessly induced.

This is what the research is showing - but it’s so hard as a pregnant woman to stick to my guns on this in the face of emotional pressure basically saying ‘you’re going to kill your child if you don’t induce’.

Please excuse the rant - just so frustrated that the last weeks of my pregnancy have to be spent feeling like this.

OP posts:
FTEngineerM · 14/04/2021 20:44

If there are risks it isn’t necessarily good enough to argue ‘well she didn’t ask so I didn’t share’

I know, I’m not talking about lying by omission and stuff like that, that sentence that you half quoted was meant to highlight that we need to ask about risks. If a doctor says no risk here you’re fine then there is a clear breech of care there. As my post went on to say Hmm

Mummyof2Terrors · 14/04/2021 20:44

No local for the tear. Local for the episiotomy but they said no other pain relief available so I felt every stitch internally and external. The situation so bad that the midwives felt the need to apologise for the consultant after.

Women are the bottom of the priority list in all forms or healthcare.

ancientgran · 14/04/2021 20:50

They can't have given you enough local, I was really numb and couldn't feel a thing. Took hours to wear off which was nice.

Alyosha · 14/04/2021 22:04

Getting stitched up was almost worse than birth for me. I begged for more pain relief. Excruciating. I asked them to top up the epidural and they told me it wouldn't work. I had a debrief with the anaesthetist a year later - was told that was bollocks & actually epidurals do work for stitching too.

timeisnotaline · 14/04/2021 22:12

@Mummyof2Terrors

The OP chose to bow out after being unfairly attacked. This was about the language HCPs use.

The consultant told my husband in labour that if I didn't consent to forceps, there would be absolutely no other options to get the baby out. Coerced consent at it's very very worst. That was to avoid a C-section but left me with a terrible 2nd degree tear. Why do I know this? Because the anethetist was stretched and that was also the reason they didn't bother calling someone for pain relief as they sewed me up for 2 hours unmedicated as I screamed through the process.

If anybody is reading this thinking they have to submit to everything in pregnancy, trust me, they really don't. Due to give birth to second in 12 weeks time and things will be so so different this time. I am not a piece of meat.

Agree she objected very strongly to the language hcps use. A lot of people on this thread feel equally strongly that the language her hcp used is appropriate and to not use such language is bordering on negligent.
Nith · 15/04/2021 08:55

The OP chose to bow out after being unfairly attacked

Not what OP said. For all we know, she bowed out because she was busy being induced.

ancientgran · 15/04/2021 08:58

There is no excuse for pain during stitching. I am a bit phobic about stitches due to an accident when I was 7 so I obsessed about it during pregnancy. I got lots of apologies when they had to do an episiotomy but they gave me so much local for the stitches I was completely numb over an extensive area, I couldn't feel my buttocks let alone my perineum.

randomsabreuse · 15/04/2021 09:12

With my stitches I couldn't feel pain but could feel the thread moving which was very very odd. Apparently this is normal and not just in humans...

CovidCorvid · 15/04/2021 09:19

@ancientgran

There is no excuse for pain during stitching. I am a bit phobic about stitches due to an accident when I was 7 so I obsessed about it during pregnancy. I got lots of apologies when they had to do an episiotomy but they gave me so much local for the stitches I was completely numb over an extensive area, I couldn't feel my buttocks let alone my perineum.
Local anaesthetic for perineal stitching is a 20ml max dose allowed due to the risk of local anaesthetic toxicity. Must admit I don't know if that's a local policy or national and I'm not sure of the evidence. But strictly adhered to where I am. For most women it's enough, but not for all. So some women need gas and air as well. Not ideal I know.
Alyosha · 15/04/2021 10:46

I had an epidural in situ at that point and I had asked - repeatedly! - if it could topped up (at the end of labour & for stitching), was told that epidurals don't work for stitching. Which is apparently wrong, according to the anaesthetist I spoke to.

Kind of hard to trust medical professionals after my first birth to be honest. A litany of errors start to finish.

Mummyof2Terrors · 15/04/2021 11:15

Outside my episiotomy, I felt every stitch internally and externally. After 90 mins I told them I withdrew the consent for stitching and they needed to get me some pain relief.

Lots of huffing, moaning, complaining that they'd have to take me to theatre and surely I could just do another section without anything. Hadn't even held my baby for more than 2 mins at this point. 30 mins later stitching completed.

Wouldn't happen in any other area of medicine. If a bloke had his cock ripped open, nobody would suggest stitching without pain relief. It's a disgrace.

Summerofnofun · 15/04/2021 11:25

@Mummyof2Terrors sorry if you’ve already said but why on Earth didn’t you have pain relief for your stitches?

I distinctly remember a local anaesthetic!

Mummyof2Terrors · 15/04/2021 11:27

I had the legal maximum for the episiotomy. They wouldn't give me any for the extensive tear both externally and internally and it was too much of an inconvenience for them to take me to theatre at 10pm. So I was stitched for 2 hours no pain relief.

The midwives apologised after for the consultants behaviour. Says it all.v

Summerofnofun · 15/04/2021 11:31

That’s horrific so sorry you went through that.

And as you say it would never happen to a man!

FTEngineerM · 15/04/2021 11:39

I had an epidural in situ at that point and I had asked - repeatedly! - if it could topped up (at the end of labour & for stitching), was told that epidurals don't work for stitching. Which is apparently wrong, according to the anaesthetist I spoke to.

Definitely wrong, is it different in different trusts? Because mine was controlled by me I didn’t have to ask anyone, I clicked a button every 20 minutes to keep the drugs flowing and there was a massive bag that probably could have done me for a few days. Then they said it would be a good idea for me to feel contractions so I let it wear off HAHAHA no thanks, awful, so anaesthetist came in straight away and gave me something he referred to as ‘test’ which made me totally numb within a few minutes.

I think it was the same drug as they give for spinals?

What did they do for you after the 90 minutes where you requested pain relief @Mummyof2Terrors ?

Mummyof2Terrors · 15/04/2021 11:43

Nothing. Huffed and puffed, said they could get me into theatre but they only had a little bit left so surely I could handle more. Gave up fighting at that point. Once again all about coerced consent.

PatsyStone39 · 15/04/2021 13:03

Please don't mess around with BP in pregnancy. A friend of mine has just had a baby ...and a stroke.

Peachee · 15/04/2021 13:31

I think the main thing is you have increased blood pressure.. this is your bodies way of saying something isn’t right..
I had increased blood pressure at 39 weeks exactly.. my baby was born by EMCS after a failed induction as he had a knot in his cord.. this could have been a stillbirth.. I had monitoring and even scans to check my umbilical cord.. it wasn’t picked up. No one knows what is going on in there no matter how many tests they do.. i unfortunately have to agree with others and say I would be guided by the professionals. I don’t think they enjoy telling people the risks. I don’t think they are out to get you or to make more work for themselves..

RuggeryBuggery · 15/04/2021 13:34

Sounds like bedside manner has been somewhat lacking

I went through similar, although in my case there was IUGR and actually baby was smaller than scans have shown.

All I can add is that at the time I was fairly chilled but like a pp said, it was when I looks back on it that I realise how fragile life is and how the outcome could have been different

Iminaglasscaseofemotion · 15/04/2021 13:49

OP BP is something to be taken pretty seriously. Mine was absolutely fine through pregnancy and labour, then boom! Soon as she was delivered it shot right up and stayed like that for a while even with medication.

Sleepisheaven · 15/04/2021 18:01

said they could get me into theatre but they only had a little bit left so surely I could handle more. Gave up fighting at that point. Once again all about coerced consent

They still offered you pain relief and then you declined.. for what ever reason. If you’d already told them you ‘withdraw consent’ which is an odd thing to say irl then you’ve already done the hard work in partly saying what you need, the next sentence would just be ‘yes theatre please I don’t care how much is left’. If you’re not able to communicate your needs then there should be a suitable adult with you who can.

Some of these ladies’ stories on high BP are petrifying.

I hope the OP is ok?

Mummyof2Terrors · 15/04/2021 19:28

It wasn't an offer. It was clear that my request for pain relief was an issue and that's why they put pressure on myself and husband to continue with the stitching.

No matter what, you're not willing to accept that in labour, women are forced into choices they wouldn't have to make in other forms of healthcare. If I was ill in any other situation, pain relief would be automatically given, you would not be an ask.

Why you feel the need to be an apologist for a frankly awful system is beyond me.

ancientgran · 16/04/2021 09:34

@CovidCorvid Local anaesthetic for perineal stitching is a 20ml max dose allowed due to the risk of local anaesthetic toxicity. Must admit I don't know if that's a local policy or national and I'm not sure of the evidence. But strictly adhered to where I am. For most women it's enough, but not for all. So some women need gas and air as well. Not ideal I know. Maybe it was different in my day or maybe it is the area, I was definitely very numb for a considerable time over a considerable area. They did offer me gas and air as well, I think that was to reassure me as there was no way in the world I needed it but I suppose it gave me some sense of being in control.

ancientgran · 16/04/2021 09:36

@Summerofnofun

That’s horrific so sorry you went through that.

And as you say it would never happen to a man!

Fairly obvious as a man won't have an episiotomy or tear in the first place.
ancientgran · 16/04/2021 09:41

@RuggeryBuggery

Sounds like bedside manner has been somewhat lacking

I went through similar, although in my case there was IUGR and actually baby was smaller than scans have shown.

All I can add is that at the time I was fairly chilled but like a pp said, it was when I looks back on it that I realise how fragile life is and how the outcome could have been different

The looking back is very true. I had some persuasion to have a C.section with my last after an EMCS with the previous baby. I wanted a vaginal delivery, it got very scary at the end and an unpleasant forceps with a 10lb baby who looked like he'd gone 10 rounds with Mike Tyson. I got what I wanted but as I looked at his chubby bruised face I suddenly felt incredibly guilty and selfish. I think sometimes we can forget that what we really want is a healthy baby safely delivered.