I was called in to the hospital 2 weeks before my estimated due date since my “blood pressure was high”
Q: I was called in to the hospital 2 weeks before my estimated due date since my “blood pressure was high”. At a regular visit the doctor found my blood pressure on the high end so she ordered me to check my pressure twice a day, which I did for several weeks. I was further ordered to call in if the pressure reached a certain point, which I did, and which was the reason I was called in (I was feeling fine, btw, hadn’t worked for a while, took my vitamins, and ate home cooked organic meals.)
At the hospital, after being monitored for a while and after almost being sent home again, the doctor decided to do more tests to “be on the safe side”. They noticed that I had mild contractions, and that the baby’s heart beat “struggled a bit” (as they expressed it) while the contractions were going on. The verdict was that I had too little amniotic fluid, and that my contractions squeezed the umbilical cord which made it harder for my daughter to breathe. At this point, they appeared concerned, and let me know that I couldn’t leave the hospital until the baby was born.
They gave me a drug to increase the strength of the contractions hoping to induce labor (2 weeks early), while at the same time pumping me full of fluids to the point that I swelled up so much that I could barely walk. All of this happened in a 5 hour period.
A c-section was scheduled the day after, and went successful as far as c-sections go.
My question:
I’m hoping to maybe have another child, and my question is what would a midwife have done in a situation like this. When you’re on the receiving end it’s hard to know what’s serious, what’s procedure, and what’s “let’s do it the way we know how so we don’t get sued” -way.
Was this an unusual scenario, was my kid’s life in danger, did they over react? I realize that with limited data it’s impossible to say for sure, but what’s your assessment.
Thank you for your time
Katherine, 41, Hayward CA
A: Dear Katherine,
Overall, it sounds as if you got the care you and your baby needed, but of course it is difficult to give a complete professional opinion without all of the facts. If blood pressure exceeds a certain point, it is prudent to evaluate further with certain lab studies. If those are abnormal, at 38 weeks the general consensus is that the risk of inducing labor is outweighed by the risk of keeping the baby in utero. Elevated blood pressure in the mother can mean decreased perfusion to the placenta (leading indirectly to decreased amniotic fluid and then to decelerations in the fetal heartbeat, as you and your baby experienced). If the blood pressure becomes seriously elevated, this can also put the mother at risk for an eclamptic seizure, which can be much more serious for both mother and baby.
Of course every provider’s comfort threshold is different in terms of the blood pressure and lab studies. Some may intervene at the slightest change in pressures or lab values, while others may take a more wait-and-see approach. Overall, though, it sounds to me as if your doctors did not overreact.
The good news is that blood pressure conditions do not necessarily present in subsequent pregnancies, so there is a good chance you will not deal with this issue if you decide to have another baby. If your desire is to try for a vaginal birth next time, I would recommend that you find a practice that is strongly supportive of VBAC. Many community hospitals can no longer offer vaginal births after cesareans due to ACOG’s position on immediately available anesthesiologists. You will need to find a provider who not only believes in VBAC, but also practices in an institution which supports it.
In the meantime, I wish all the best to you and your baby.
-Carolyn Havens Niemann, CNM
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