Updated!! High blood pressure but don't want to be induced?

[kenser14]

Has anyone had experience with this? I'm 37 weeks pregnant with baby #3. Last week my BP was 136/90, this week it was 139/90. First time I've ever had high BP and of course OB is concerned. He offered to induce me yesterday at 37 weeks. I have no other signs of pre-e, non-stress tests/blood tests came back good.

I've had 2 natural, vaginal births with no complications and am really hoping for a 3rd. OB said risk of c-section goes up to 50% with an induction. I declined the induction yesterday and he was fine with it, I will go back next week and we will reassess.

I of course want to do what is best for baby, and me...but I really don't want to be induced unless it's medically necessary - which my OB hasn't totally convinced me of. Has anyone been in this situation? I wish baby would come before next week on its own! Thanks in advance for reading.

UPDATE! Thank you ladies so much for your responses. On Sunday, my water broke at home and 3 hours labor my baby boy was born! My blood pressure was high during labor, and afterwards they tested my urine. It came back with protein in it, so they officially diagnosed me with pre-eclampsia after the baby was born. So thankful he came on his own, early and quickly. It's been 2 days and my blood pressure is still elevated. I guess they will check it again in 10 days. The doctor said it can take up to a month to go down and if I were to get pregnant again I would be at risk for pre-e. Thanks again for your responses!

[dearprudence]

I've been in this exact situation - and my BP wasn't even as high. My BP all through the pregnancy was right around 116/75. At my 39 week appointment it was 130/85, which my doctor was concerned about because it was so much higher than usual for me.

I really really really didn't want to be induced. As I said earlier this week, my kid was nowhere near ready to come out. He hadn't dropped, I was 0cm and 0% effaced, my cervix was just about as long as you can get. So I was sent to triage for tests. Liver, blood, urine - all came back clean and beautiful.

But I was admitted for an induction anyway. In retrospect it was completely unnecessary (soon after I was admitted my BP dropped back down to 109/65) but my doctor is very overly cautious.

FWIW, I was a terrible candidate for induction based on my progress and I still had a vaginal birth.

Some thoughts for you:
1) When I was admitted, the on-call doctor gave me a c-section risk of 50% due to the whole "state of the uterus/cervix" so I think your doctor is being a little conservative with that 50% number.

2) The nice thing about being induced for blood pressure without pre-e and before my due date was that there was no hurry to get the baby out. Which really helped with lowering the need for a c-section. They told me I could stay in bed all week if I wanted, waiting for the baby to come, because they could monitor my vitals and make sure things were going okay.

3) Something my anesthesiologist friend told me, is that often when mothers don't want an epidural, the hospital will provide pain medication through the IV. "Getting IV Fentanyl can cause fetal bradycardia (slowing of the heart rate). . . Slowing of the heart rate of the baby makes the OBs panic and sometimes rush to C-section." I only mention this because I don't know if by "natural" you meant with "no epidural" or "no pain medications" or "no induction medications." So it's just another factor to keep in mind to put you in the best position to avoid a c-section.

[jennistarr1]

I think you're fine to delay...and if you weren't, your doctor would really push you.

[centralsquare]

Keep a VERY close eye on the preeclampsia. I haven't written up my birth story yet, but up until 38 weeks, my story looked similar.

I had excellent blood pressure throughout until 37 weeks, when it was on the higher side (similar to yours.) Minimal swelling in hands/feet. No other signs or issues. At 38 weeks, I had a similarly high bp reading -- and had gained 6 lbs from the previous week (clearly all water weight.) They ran bloodwork, and I had 3 of the 5 markers for pre-e. I was admitted a few hours later for monitoring, and induced a few hours after that. Preeclampsia escalates VERY quickly and can get dangerous for mom and baby VERY quickly.

I had planned on a med-free, short birth like both my mom and sister had. I was delivering with midwives. Hadn't even had a cervical check or seen an OB until this happened. The high-risk OB said I could have waited another day or two, but he didn't recommend it b/c it was too risky. I ended up with all kinds of interventions that I hadn't planned on -- foley bulb, epidural, pitocin -- but I still had a vaginal birth, even though it took 33 hours. My doula said any other hospital likely would have sectioned me much earlier than I delivered, so I think it's very much up to your OB and hospital. I would talk to your doctor about how strongly you want a med-free vaginal birth vs. the potential for issues with the hypertension.

Watch for signs of pre-e, such as headache that doesn't go away with Tylenol, additional face/feet/hand swelling, etc. I would ask your doctor specifically about what s/he wants you to watch for, and what your level of risk is. What are the benefits of being induced now? What are the risks? What happens if you do nothing?

Good luck!

[kenser14]

Thank you girls for your responses!!

[sarahsas]

I'm being induced next week, just past 37. I had high BP starting around my third tri and went on a low dose of beta blocker. My BP has been fine since, and I've had multiple tests to keep a close eye for pre-e (many 24 hr urine tests, blood tests). I have no swelling or signs and all tests are fine. My doc said the protocol is to induce earlier to prevent an emergency BP situation later on. I had a long discussion about it with her because I've had a very good pregnancy otherwise. I ultimately decided to go through with it because I would rather be safe than have a scary situation. That's my personal decision though - and I agree with the above poster that if he didn't push you, you probably can wait a bit.

[emoflamingo]

Why does he say the increase to 50%? Are you at all effaced or dilated? I was induced with my second (because I spent the night in L&D the week before in labor before I stalled and stayed at a 3) and everything went smoothly.

[busterpup]

My docs must be super lax bec I had similar BP numbers and they said they wouldn't consider an induction unless it got higher. But I haven't had headaches or seeing spots, and they told me to call if that happens. But these are the same people who refused a c section when I have degenerative discs and have had 3 spinal surgeries, so I wasn't too surprised about the pre-e dismissal.

[centralsquare]

Mar 26, 2015 19:10:34 GMT -5 busterpup said:

My docs must be super lax bec I had similar BP numbers and they said they wouldn't consider an induction unless it got higher. But I haven't had headaches or seeing spots, and they told me to call if that happens. But these are the same people who refused a c section when I have degenerative discs and have had 3 spinal surgeries, so I wasn't too surprised about the pre-e dismissal.

I've also had disc problems and spinal surgery, and I wanted nothing to do with a c section! I need those abs in tact to support my spine.

[busterpup]

Mar 26, 2015 19:15:21 GMT -5 centralsquare said:

Mar 26, 2015 19:10:34 GMT -5 busterpup said:

My docs must be super lax bec I had similar BP numbers and they said they wouldn't consider an induction unless it got higher. But I haven't had headaches or seeing spots, and they told me to call if that happens. But these are the same people who refused a c section when I have degenerative discs and have had 3 spinal surgeries, so I wasn't too surprised about the pre-e dismissal.

I've also had disc problems and spinal surgery, and I wanted nothing to do with a c section! I need those abs in tact to support my spine.

That's a good point. I'm worried about the labor but I guess there's the rest of my life to think about!

[centralsquare]

busterpup, fwiw, I had no back problems whatsoever in labor! Hopefully you'll have the same luck.

[Deleted]

I had no high BP, then at 37.5 weeks had higher BP. Ended up being monitored, than admitted to the hospital the next day for more monitoring. I went home on bedrest. They weren't sure what they were going to do but we're going to induce at some point.

Well, my water broke the next day at 38 weeks exactly. I did not start contracting at all though. So I was obviously induced at that point since things need to get moving after water breaks:)

I had a pretty easy labor, despite being induced. I progressed quickly and had my son via vaginal delivery about 13 hours after they started pitocin.

One thing to keep in mind is extra intervention is needed during labor if you do have high BP--I'm not sure what the threshold is, but I had to have a magnesium IV to prevent seizures. This meant a catheter immediately after I got to the hospital and I could not get out of bed or drink more than one ounce of water per hour for 24 hours after delivery. I also had complications to breast feeding. You may ask if inducing sooner would prevent the likelihood of magnesium being necessary.

Keep an eye on the situation. Quick weight gain was my only symptom until the day before I was hospitalized with high BP.

Good luck!

[pinkpeony08]

My OB is pushing for induction as well, although not for BP but for a "small baby." They have ton tons of extra monitoring and everything has come back perfectly. Baby is growing, just on the 8th percentile and they freak out if it is below the 10th percentile. I'm over 38 weeks now, induction scheduled for Friday. We plan to discuss it more on Monday at our OB visit. I also had a natural, doula supported, not even an IV birth with my first and am really really really wanting to avoid an induction. I would talk through with your OB it here is other monitoring you can do to ensure everything is okay. I hope you can avoid the induction!

[jennistarr1]

Mar 28, 2015 10:28:51 GMT -5 pinkpeony08 said:

My OB is pushing for induction as well, although not for BP but for a "small baby." They have ton tons of extra monitoring and everything has come back perfectly. Baby is growing, just on the 8th percentile and they freak out if it is below the 10th percentile. I'm over 38 weeks now, induction scheduled for Friday. We plan to discuss it more on Monday at our OB visit. I also had a natural, doula supported, not even an IV birth with my first and am really really really wanting to avoid an induction. I would talk through with your OB it here is other monitoring you can do to ensure everything is okay. I hope you can avoid the induction!

So on Friday you will be 39 weeks? Maybe you will go before hand

[pinkpeony08]

I will be 39 weeks, 1 day on Friday..... have had several signs that labor might be coming soon (more tired, less comfortable, baby is SUPER low, more and more braxton hicks). I've been going to acupuncture, had a pedicure yesterday, lots of sex and starting to add in the breast pump too. REALLY hoping I can go before then.