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Myuzikalsoul's avatar

Has anyone experienced gestational hypertension beginning at 36 weeks and gone on to have a natural birth at 40 weeks or beyond without complications?

Asked by Myuzikalsoul (598points) August 26th, 2014

I have always considered myself to be a bit anxiety ridden, and it runs in my family. My mother gave birth to me naturally after 42 weeks + and everything turned out fine, even though she developed toxemia towards the end.

These days, pre-eclampsia is monitored extensively and taken very seriously. I had a lot of major unwanted changes in my life beginning in late July (moving to in-laws, no say in any aspect of my life, etc.) and that is when my Dr.‘s began to notice a rise in my blood pressure readings. The thing is, the first reading would be high, and they would take it again and the second reading usually dropped dramatically.

Now, I am 38 weeks pregnant, and I have been seeing the Dr. twice weekly since 36 weeks. Regardless of all of the testing I have undergone, they cannot find anything wrong with me or the baby, other than my having a high BP reading at the Dr.‘s office. I am talking in the high 130’s/80’s, and occasionally in the 140/90 range, but never much higher than that. At home my bp after resting is usually SIGNIFICANTLY lower, like 110’s/70’s…unless I take it right after sitting down, which it then reads much higher.

My problem here is that the Dr.‘s have been telling me since the first high BP reading that they have decided that I need to be induced. At first they told me 37 weeks. Here I am at 38 weeks and now they are telling me no later than 39 weeks.

I do not believe that it is necessary for an artificial induction because I do not have ANY OTHER SYMPTOMS of pre-eclampsia. No protein in urine, blood platelets are normal, baby heart rate is always SO PERFECT that the nurses comment on wanting to keep her tracings to show as an example to nursing students as a perfect heart rate. I have had one migraine in the past few months and I think it was due to eating way too much sugar and not drinking enough water that day. And I do have flashes in my vision and spots at times but that was a PRE-EXISTING condition due to my having been in a car accident years ago and tearing a hole in my retina.

I do not, under any circumstance, wish to be induced or to have a C-Section, but I want to trust in my body’s ability to have a completely natural (I will not accept epidural or other drugs either) birth. I believe women were made to give birth and we shouldn’t need all of these interventions unless it is medically necessary. These Dr.‘s I feel have been strong-arming me into being induced way too early, and are now saying frightening things to me like that my baby could die due to placental abruption – yet this is all based on statistics and not on me personally.

I’d like to add that I am on medicaid and that I was only given one choice of practices to go to, and so I see about 6 different Dr.‘s for only a few minutes spread out throughout weeks. There is a baby boom in my area and I almost feel as though I am being treated differently than if I were not on medicaid – more as a statistic than as an individual. I feel as though they want to schedule my birth to make it easier on them.

I understand that pre-eclampsia is a serious condition and if I had any other symptoms then I would feel differently about their advice, but that just is not the case. I am diagnosed with ‘gestational hypertension’ and even at the hospital after being monitored for 9 hours straight they could not find cause to diagnose me with pre-e.

Does anyone else have any experience with refusing an induction for these reasons and having a favorable outcome? I am tired of Googling and reading horror stories.

Thank you so much for your input!!

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22 Answers

downtide's avatar

My mother did, when she was pregnant with my brother. She was aged 39 at the time, got gestational hypertension way earlier than 36 weeks, she spent pretty much the last 8 weeks in bed under medical supervision, and went on to have a natural birth at 41 weeks. She wasn’t even induced.

Myuzikalsoul's avatar

@downtide I am spending most of my time in bed as well, at home. My bp is low while resting.

However, to play the devil’s advocate, I realize that labor is a very laborious task, and that it will rise significantly while in labor. Then again, being induced will have the same effect on my bp only with the use of artificial drugs such as Pitocin involved – and a possibility of an emergency C-Section due to my cervix not being naturally ready-to-go.

I just feel as though I could go through every possible frightening delivery outcome whether induced or not. I feel like natural is the way to go, and if complications are to happen, they would happen either way. My Dr.‘s, however, are telling me that I could save my baby from stillbirth by having her early. I think that this is a bit overboard because I am not even pre-e, and although I know it can come on quickly, I am being monitored twice weekly – NST’s twice a week and AFI’s once a week; I am submitting a 24 hour urine sample and a blood test once per week, and I am monitoring my bp at home on bed rest.

If I were to have a full placental abruption it is SO rare that I would not have any symptoms and that it would be fatal to the baby that I feel like their warnings are more of a scare-tactic than based on a sound medical opinion of my particular condition.

canidmajor's avatar

Harsh reality check. Do not, I repeat, NOT second guess the professionals on this, no matter how much you might want a “natural” birth experience. I felt like you did, I resented being put on bed rest when I felt fine, I resented having my birth plan messed with, I resented being treated like a child. Then a family member who is an OB who specializes in high risk pregnancies called me and read me the riot act. I followed doctors’ orders and, after many weeks of bed rest, then induction, had a healthy baby.

Not the story you want to hear, I know.

Let me ask you: why would you question the experienced advice of professionals? Labor is a temporary thing, the effects of a catastrophic birth situation can last a lifetime. If you know more than they do because of training you’ve had; or if you don’t trust them, get a different team.

Asking strangers on the Internet to support your view probably isn’t the wisest course.

Sorry this doesn’t sound very nice, but I worry for you and your baby.

snowberry's avatar

I agree that Medicaid doctors do treat people differently than the rest of the population. and that they likely will try to schedule your birth for their own benefit. I had my children at home because I had doctors who told me I didn’t have the option of a vaginal birth, and I disagreed. I fired those doctors and went on to have a vaginal birth at home with a midwife and no intervention or pain killer and I did just great.

But I did not have gestational hypertension. My prayers are with you.

snowberry's avatar

I have never been on Medicaid.

Myuzikalsoul's avatar

@canidmajor I don’t believe that these Dr.‘s have a valid reason for diagnosing me as hypertensive in the first place because my blood pressure readings are not consistently taken the same way. They are always taken by different nurses on different arms, using automatic monitors and never after any sort of resting period. When given a moment to sit (it is supposed to be 5 minutes), and taken with a MANUAL monitor my bp is always fine!!

The Dr.‘s are going off one reading back in June and one reading three weeks ago that were considered high, but that went down immediately after the second reading was done with a manual monitor. The hospital observed me for nine straight hours and found nothing wrong with me or the baby. All of my tests come out great. And this has been going on for weeks.

I have a weekly 24 hour urine test and blood test and I never have protein over the limit and never have anything wrong with my blood platelets. NSTs are GREAT and AFIs are GREAT. Induction is an unnatural process and I believe my body is well equipped to labor on its own – when it, and the baby are ready.

I am not “asking strangers on the internet to support my view”. I am asking anyone who has EXPERIENCED this very thing to share their stories with me.

canidmajor's avatar

You may well be fine. However, I suggest you carefully read, in it’s entirety! any “informed consent” form you might be asked to sign. If you go against medical advice and something bad happens, you may sign away your rights for reasonable compensation.

Good luck with your baby.

snowberry's avatar

@Myuzikalsoul The one experience I’ve had with Medicaid was a very unfavorable one. My friend asked me to assist her in labor. The birth was horribly managed by her doctor. It was so bad that nursing schools in the area were talking about it, and it also was a “planned” (induced) birth.

So perhaps I’m prejudiced, but not without reason. I am sure there are doctors who are careful and kind with their patients, but every time you intervene in the natural birth process (and inducing labor is the first step), statistics say complications arise. Here is one of many links to “the domino effect” in childbirth.

Your best bet might be to get someone knowledgeable and assertive to be with you and help you stand up for what you want as your birth progresses. You shouldn’t have to fight for what is right for your own health, especially when you are pregnant. You are right to insist that your doctor takes your blood pressure properly. And I’m wondering if they’re screwing up on something as basic as blood pressure, where else are they messing up? I wish you could find a different doctor!

jca's avatar

When it comes to the health and wellness of your baby, your personal opinion and your feelings are lovely, but you don’t want to second guess the doctor and then have something terrible happen. You may never forgive yourself.

Better safe than sorry is all I can say.

You can get other people’s stories from their experiences, but as you know, everyone’s body is different. Someone else is not you. Someone else does not have your other medical history, your weight, your genetics, whatever.

Cupcake's avatar

“Outcomes in women with gestational hypertension usually are quite successful, although some of these women experience BP elevations to the severe level with outcomes similar to women with preeclampsia (6). The cause of this entity is unclear, but many of these women have preeclampsia before proteinuria and other organ manifestations have occurred. Thus, gestational hypertension, even when BP elevations are mild, requires enhanced surveillance.” link

The risk is that you actually have preeclampsia and that your labs are not yet showing it. The risks to your fetus can be severe. If you don’t understand the medical recommendations, it is your responsibility to let your provider know that you need more information.

I haven’t had gestational hypertension, but I have had unwanted (but necessary) inductions that led to wonderfully healthy babies born by vaginal deliveries.

Please be aware the the preeclampsia/hypertension guidelines do not require your blood pressure to be read at rest. Also, there are many other factors of which we are unaware that your doctors are taking into consideration (edema, weight gain, fetal growth, your baseline blood pressure before pregnancy, etc.).

Feel free to grieve that your birth plan is changing against your wishes and outside of your control. That can be a terrible and painful loss. But please focus on what is important here… the lives and health of your and your baby. They are much more important than whether you get an induction or not.

St.George's avatar

I had twins, and preeclampsia at 36 weeks. They called me at home and told me to come in for the c-section. I did it without question and am grateful.

Oh, and I’m a bad-ass and a feminist.

Myuzikalsoul's avatar

I don’t feel like anyone is listening to what I am actually saying. I DO NOT HAVE PREECLAMPSIA. All of my tests are outstanding and the baby is doing amazing. I do not have high BP at home, and when it is taken at the Dr.‘s office, it is not taken at rest.

I have found countless resources indicating the danger of preeclampsia, and if I honestly had this condition then I would go ahead with the induction. But it is very evident that as of now, I do not have preeclampsia. I know it can develop quickly and this is why I am being monitored around the clock. My bp is rarely up to or above 140/90 and at rest it is in the 110/60 range.

I have taken information from several different sources and many people are not even diagnosed with gestational hypertension unless their bp reaches 160/110 range, which mine has not even come close. I have also found resources that state that gestational hypertension is no cause for concern UNLESS it develops into preeclampsia, and all of my tests that I continue to have, continue to state that I am far from it.

The baby is extremely active and happy in the womb, she has not yet dropped, I have had no other symptoms of impending labor other than a few contractions about a week and a half ago that resulted in my being 1cm dilated and 50% effaced. I have 1 week + 4 days before my due date and I see no reason why I should rush my little girl into the world before she is ready. I, myself, was 2 weeks late, and my Mom was developing toxemia towards the end but went on to have me naturally and I was extremely healthy.

I really do believe it is best for me to wait for her to begin labor when she is ready, especially in knowing that ‘due dates’ are not always all that accurate, especially for people like me who have irregular cycles and have had my due date pushed up THREE times. She was originally due in October and they have pushed it all the way to Sept. 8th.

I will not risk putting my baby under unnecessary distress and risk having an emergency c-section and not bonding correctly with my baby (I intend to breastfeed), all so the Drs. can have a nice neat scheduled birth without any legal implications should something go wrong. I believe that if something was meant to go wrong with my birth then, A) it is going to either way, and, B) My rigorous tests would show something more (anything) wrong.. and they all reveal outstanding healthy results.

I consider myself to be very intelligent and intuitive, and I am not one who just accepts things without using my own critical thinking and judgment skills. I have already made my decision regarding this situation and I wish more people would read my original post correctly and see that I am asking for people’s EXPERIENCES with having this particular situation – ie. elevated bp without preeclampsia, AND refusing an induction with a favorable outcome. I’d like for anyone out there who has EXPERIENCED this very thing to share their stories with me. Otherwise, I get plenty of opinions already.

With that said, there have been too many contradictions in my particular situation that for me to ignore would be going against the grain of my own common sense. I just can’t ‘give-in’ and ‘go-along’ when it comes to the welfare of my child. I am sure that if I had access to a midwife or doula that they would be in agreeance with my stance at this point. America is too reliant on interventions and there is not enough individualized care and attention given to the patient. I am just glad that in this country women are given the right to choose to refuse interventions…no matter how ‘rare’ it may be for someone like me to do so. (As told to me by my Dr.).

jca's avatar

@Myuzikalsoul: You seem determined to do things as you want to, although you are not an Ob-Gyn.

There are several things that can happen:

The main goal is a healthy baby. If you listen to the doctor and have a healthy baby, you will forget all of this debate, and I promise you, you’ll be so thrilled that the baby is fine.

If you don’t listen to the doctor and the baby is not healthy, you will never forgive yourself. It will be too late to go back and wish for what you could have done or should have done.

To me, it’s a gamble and I wouldn’t like to gamble with my baby’s life or health.

By the way, there’s no such word as “agreeance.” I think you meant “agreement.”

Best of luck with everything and please post an update as to how things go.

Cupcake's avatar

I’m still concerned about your diastolic blood pressure. 90 is high… even not at rest. There is no requirement for your blood pressure to be at rest to be classified as hypertensive. My resting BP is probably 80/55 and in the office it was around 110/60. A diastolic of 90 is quite high. 110 is ridiculously high… and far beyond “gestational hypertension”.

I don’t know what resources you are using, but the gold standard is the American College of Gynecologists (ACOG) for anything having to do with pregnancy.

I’m so sorry that you feel that we are not listening to you. I’m also so sorry that you don’t trust your OB providers. I am very fortunate to not feel that my OB would ever schedule a c-section for their own convenience.

Money is obviously tight. Can you look for a doula who would advocate on your behalf? You might be able to find someone who would do it for free (like someone in training?) or maybe you have something you can barter. If I were you, I would look for someone to come to my OB appointments with me as well as to the hospital with me.

You have my very best wishes for good health and delivery for both you and baby.

Myuzikalsoul's avatar

@jca ‘Agreeance’ is a word of French origin used widely in the U.S. from the 16th century and is still used today. It is archaic, just like ‘thou’. I did not realize my post had anything to do with grammar.

I am not going to gamble with the risks of an artificial induction when it is clearly unnecessary. I have plenty of friends who have suffered consequences such as permanent nerve damage, and problems with breastfeeding due to untimely inductions. Again, please keep your opinions to yourself if have not experienced this exact situation. Stories of experience are what my original post is addressing.

canidmajor's avatar

I seem to be misunderstanding the purpose of your question. From the basic bare bones title, to all of your somewhat annoyed (justifiably, I guess) responses to our concerns, you keep saying that you only want responses of one kind.
Yes, I did.
Yup, that was me.
Am I correct? Are those the answers you want?

I’m not trying to be snide, here, but I am wondering how those answers will be helpful.

jca's avatar

@canidmajor: I agree the OP seems to want backup to do as she wants and put the baby at risk.

I would imagine if she delivers as she wishes, the doctor may not attend the birth as he would not want the liability. Either that or he may have her sign something that she is forming her own birth plan so that if there is an issue with the baby, he would not be held responsible.

canidmajor's avatar

Well, obviously a great deal of effort has gone into the Q, and her subsequent responses. Maybe she does indeed know as much as she says, and maybe the baby isn’t actually at risk. My first response was a knee jerk one, and my second was well thought out and actually was good advice for the circumstance in question.
But there may be something here we’re not seeing. I would like some clarification.

jca's avatar

I stand by what I wrote.

Myuzikalsoul's avatar

Sigh I do not want justification for my decision I want others to share their experiences with me who have been in my shoes. The last part of my question description was, “Does anyone else have any experience with refusing an induction for these reasons and having a favorable outcome?”. That is really what I am looking for are other women who have refused inductions.

I am sorry if I have come off a little aggressive it has just been a really stressful few weeks with all of this up in the air and having 6 different doctors that I have only met once or twice throughout my entire pregnancy for about 5 minutes giving me different opinions at different times. I hate that I am limited with medicaid to this one practice and I wish I could find a better one that doesn’t seem so rushed to get me (and the baby) in and out.

I am now 39 weeks and on day 2 and I have already declined to be induced on Monday after a 2 hour hospital stay where they monitored myself and the baby and could not find anything wrong with either of us. Not even my blood pressure. The Dr. told me everything looks wonderful, but just so you know, your baby could die! I was floored. She is not very friendly and even the nurse looked uncomfortable in her presence. After she left the room and I was signing the forms, the nurse told me that a lot of women choose to go all natural with this condition and that things are fine. If I was more elevated or had anything else going on then I would be much more willing to induce but I am only 1 cm dilated and 50% minus 2 stages effaced, having no contractions, and the baby has not even dropped yet. I don’t want to cause distress in my baby with all of these interventions when my blood pressure is stable, elevated more than it was before 20 weeks, but stable, not rising any higher, and I only have a few days left before her due date.

She has also been getting the hiccups a lot lately and I read that hiccups can be a sign that her lungs are not quite fully developed but are preparing themselves to be outside the womb. If this is true, then just to think what would have happened to her if I were induced at 37 weeks like that particular Dr. recommended, she would have likely ended up in NICU which from here is an airlift to a different city.

snowberry's avatar

For underdeveloped lungs you can take Lecithin. I had twins, and because of the concern of immature lungs that they might be born early (hyaline membrane disease) that’s what I did. They were indeed born a month early, but their lungs matured nicely with the Lecithin. PM me for details.

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