For much of this pregnancy I've wondered what is up with my body. I had only very mild morning sickness for just a few weeks in the first trimester, and haven't had any issues like food aversions or cravings. It seems like this has been a fairly mild pregnancy and, other than some backaches if sitting for too long (like on our drive out west) and a bit of reflux, I've been feeling just fine. For that I am very thankful, and I am enjoying the easy pregnancy this time since I know that each pregnancy can be very different and I'm sure that I'll have completely different experiences in future pregnancies.
But the flow of this easy pregnancy has changed a bit now, starting about mid-way through this third trimester. First of all, let's go back a few months. Back in January in Maine, at my very first midwife appointment, when my midwife took my blood pressure she commented that it was kind of high and took it again a few minutes later. It was lower that time, but not in the “normal” range. I told her that I have a vein phobia and very highly dislike anything touching or being put into my veins. This is a sentiment I've had since childhood, when I used to have to get a lot of blood tests for various things doctors thought I might have, namely Type I Diabetes and Anemia. These blood tests never came back positive for those diseases, but I still had to get many blood tests over a few years of my young childhood (about ages 4-5), which gave me my vein phobia. Now whenever I have to get a blood test, it requires a lot of self-control and deep breathing on my part to get through it, and even getting my blood pressure taken makes my heart beat faster (which of course makes the blood pressures go up). For the rest of my visits to my midwife in Maine, my blood pressures were lower than that first one, but still higher than she liked to see. Nothing in the dangerous zone, though, which we were both very happy about.
Then at the start of May, at my first appointment with my new midwife team here in California at 31 weeks, I again told all present (this practice includes two midwives and three midwife students) about my vein phobia and also that as an extreme introvert, I get more nervous and uptight the more people there are around me, especially if I don't know them well and especially in a medical setting. The first blood pressure they took was quite a bit lower than my first one in Maine, but they still said they would watch out for my BPs as we went along with my care. My BPs were a little higher at the next appointment and again at the third one. At that appointment the midwife seeing me was quite concerned and said that a blood pressure that high really necessitated having me see an OB, especially because their licensing regulations require that clients with blood pressures at that level needed to be transferred, at least temporarily, over to the care of an OB to be checked out further.
Two days later, on June 5, at 34 weeks, I had an appointment with a recommended OB. Before the appointment, I went to a nearby lab to have my blood taken. When we met with the OB, she talked to us about pre-eclampsia, which is the main concern associated with high blood pressure during pregnancy. She then did a routine exam, which I hadn't had before since we had been cared for by midwives prior to this, and we only just had time to say we weren't finding out the gender of the baby as she started our first ultrasound. At the end of the appointment, the doctor said that everything looked fine except for my blood pressure, so that was good to hear. She told me to stay off my feet as much as possible, and scheduled us for a visit the next week.
At that 35 week appointment, we found out that my labs had come back negative, and everything looked good except for my blood pressure. Because of the higher blood pressures, the OB said that she'd like me to stay with her rather than going back to the care of the midwives, which was somewhat disappointing to us. She did tell us, when we asked, that it would be fine for us to have a doula at the birth, which did relieve us quite a bit, as we had been feeling a bit lost at the idea of being without our team to help us. The doctor then suggested a more specific plan for bed rest - I was to sit or stand for only 20 minutes in any given hour during the day, the rest of the time I should be reclining. This was to help my blood pressure as well as the swelling in my ankles that had started a couple of days prior to the appointment. At the end of the appointment, she mentioned the option of a non-stress test at the hospital for closer monitoring of me and the baby, but said she didn't recommend it at this point as it was not necessary.
The following week, on June 18, my 36 week appointment was different. The diastolic number in my blood pressure reached 100, which was apparently the threshold which the doctor used to determine risk. After asking me if I had any of the symptoms of pre-eclampsia, she told us that I would need to go across the street to the hospital for a non-stress test. She seemed to think that I just had chronic high blood pressure, and it wasn't related to pre-eclampsia, but wanted to have the test just to see if the blood pressures would come down. This was still a pretty big surprise and a big change from the week before, and I was a little worried, because the necessary blood pressure monitoring would probably keep the levels up rather then let them go down. At any rate, we went over to the Family Birth Center at the hospital, and they settled me in a room and hooked up a fetal heart monitor, a contraction strength monitor, and an automatic blood pressure cuff. Unfortunately, the nurse stayed in the room for quite some time entering information into my files on that computer, which kept my blood pressure up. At some point, one of the nurses came in and said the levels were making her nervous, and she put in an IV lock just in case medication would be needed. I had never had one before, and was pretty anxious about it, but it didn't turn out to be as bad as I had imagined, though it was certainly not pleasant. Finally, after bringing me some supper, everyone left the room for quite some time, and my blood pressures eventually began to come down. When the OB finally came to visit, she said she'd make a call to a OB high risk specialist to find out what she recommended, possibly medication for high blood pressure. While she was gone, though, I had a really good blood pressure, and when she came back, she was really glad to see that, and finally said we could go home, around 9 p.m. - four hours after going over to the hospital.
Since the doctor stressed the importance of staying off my feet, we decided that going to church wouldn't be a good idea, since in addition to sitting for a few hours, we'd have to ride in a hot (no A/C) car there and back. We spent the day together and tried to relax and rejuvenate. On Sunday, we met with our doula, and it was really good to talk with her again, since we hadn't seen any of the midwife team for a few weeks. She helped us understand some of the different options we had for the next few weeks, and asked us to think about our ideals for the labour and birth process.
On Monday, June 22, at 37 weeks, I drove the 20 minutes to the hospital for the non-stress test. It didn't take as long this time, and I was done in about an hour and a half. The nurses said my blood pressures were still elevated and not great, but my baby looked beautiful and was very responsive, just like the previous Thursday evening. There were a few mix-ups with my records and information, so I had to correct some of those, but before too long I was able to clear up the records and was allowed to leave.
Thursday was my next non-stress test. I went in at 2 p.m. and was supposed to have a doctor's appointment at 3:30 p.m. Well, that never happened. My doctor was on vacation starting that day or the day before and so the on-call doctor, a man I had never met, decided that my BPs necessitated staying in the hospital overnight for labs and a 24-hour urine test as well as intermittent baby and BP monitoring. The frustrating part was that my BPs that afternoon were about the same as they had been at my non-stress test on Monday, but this doctor was just more cautious than my own doctor (and, of course, had no previous knowledge or information on me or my condition thus far in my pregnancy). Instead of seeing my doctor's Nurse Practitioner (who was to fill in for her while she was gone), I spent the evening hooked up to monitors and visiting with Jonathan and my doula until they went home for the night, as well as having to fight off certain procedures and interventions that I didn't want to happen.
On Friday a different doctor was on-call and she called the high risk OB, like my own doctor had the week before. They both agreed that because my BPs were stable, although higher than either liked, and with all my labs coming back negative for any signs of pre-eclampsia, they were okay to send me home for the weekend, with strict instructions to come back ASAP if anything were to change. I was so glad to finally get out of the hospital again! It seemed like I had been in for days, although it was just a little longer than 24 hours.
Again we spent a quiet weekend at home, trying to relax. This Monday, June 29, now at 38 weeks, I had another non-stress test. In the morning, the blood pressures I had taken with our home cuff had been quite good, actually. However, as I went into the hospital, knowing that my own doctor was still on vacation and I would be at the mercy of whatever doctor was on-call, I was nervous and could feel my pulse go up, and knew that my blood pressures would go up with it. They were quite a bit higher than they had been in the morning, and the doctor and nurses ended up keeping me there for nearly six hours before we were finally able to go home.
Given all that has happened in the last few weeks, we're feeling pretty unsure about what will happen next. The doctors will likely want to induce me soon, but we and the doula feel that the longer the baby can stay inside the better, because it is on the small side for its gestational age. At 38 weeks, it's "safe" for the baby to be born, but we feel it would be best if the baby decides when to come, barring extreme circumstances.
We solicit your prayers as we continue this journey. We pray that God will allow my blood pressures to remain steady or even come down so that the pregnancy can come to a natural conclusion, and we pray that my and the baby's health remain good through to the end, as well as after delivery. Thank you in advance for praying. We believe God can do amazing things!
Then at the start of May, at my first appointment with my new midwife team here in California at 31 weeks, I again told all present (this practice includes two midwives and three midwife students) about my vein phobia and also that as an extreme introvert, I get more nervous and uptight the more people there are around me, especially if I don't know them well and especially in a medical setting. The first blood pressure they took was quite a bit lower than my first one in Maine, but they still said they would watch out for my BPs as we went along with my care. My BPs were a little higher at the next appointment and again at the third one. At that appointment the midwife seeing me was quite concerned and said that a blood pressure that high really necessitated having me see an OB, especially because their licensing regulations require that clients with blood pressures at that level needed to be transferred, at least temporarily, over to the care of an OB to be checked out further.
Two days later, on June 5, at 34 weeks, I had an appointment with a recommended OB. Before the appointment, I went to a nearby lab to have my blood taken. When we met with the OB, she talked to us about pre-eclampsia, which is the main concern associated with high blood pressure during pregnancy. She then did a routine exam, which I hadn't had before since we had been cared for by midwives prior to this, and we only just had time to say we weren't finding out the gender of the baby as she started our first ultrasound. At the end of the appointment, the doctor said that everything looked fine except for my blood pressure, so that was good to hear. She told me to stay off my feet as much as possible, and scheduled us for a visit the next week.
At that 35 week appointment, we found out that my labs had come back negative, and everything looked good except for my blood pressure. Because of the higher blood pressures, the OB said that she'd like me to stay with her rather than going back to the care of the midwives, which was somewhat disappointing to us. She did tell us, when we asked, that it would be fine for us to have a doula at the birth, which did relieve us quite a bit, as we had been feeling a bit lost at the idea of being without our team to help us. The doctor then suggested a more specific plan for bed rest - I was to sit or stand for only 20 minutes in any given hour during the day, the rest of the time I should be reclining. This was to help my blood pressure as well as the swelling in my ankles that had started a couple of days prior to the appointment. At the end of the appointment, she mentioned the option of a non-stress test at the hospital for closer monitoring of me and the baby, but said she didn't recommend it at this point as it was not necessary.
The following week, on June 18, my 36 week appointment was different. The diastolic number in my blood pressure reached 100, which was apparently the threshold which the doctor used to determine risk. After asking me if I had any of the symptoms of pre-eclampsia, she told us that I would need to go across the street to the hospital for a non-stress test. She seemed to think that I just had chronic high blood pressure, and it wasn't related to pre-eclampsia, but wanted to have the test just to see if the blood pressures would come down. This was still a pretty big surprise and a big change from the week before, and I was a little worried, because the necessary blood pressure monitoring would probably keep the levels up rather then let them go down. At any rate, we went over to the Family Birth Center at the hospital, and they settled me in a room and hooked up a fetal heart monitor, a contraction strength monitor, and an automatic blood pressure cuff. Unfortunately, the nurse stayed in the room for quite some time entering information into my files on that computer, which kept my blood pressure up. At some point, one of the nurses came in and said the levels were making her nervous, and she put in an IV lock just in case medication would be needed. I had never had one before, and was pretty anxious about it, but it didn't turn out to be as bad as I had imagined, though it was certainly not pleasant. Finally, after bringing me some supper, everyone left the room for quite some time, and my blood pressures eventually began to come down. When the OB finally came to visit, she said she'd make a call to a OB high risk specialist to find out what she recommended, possibly medication for high blood pressure. While she was gone, though, I had a really good blood pressure, and when she came back, she was really glad to see that, and finally said we could go home, around 9 p.m. - four hours after going over to the hospital.
Since the doctor stressed the importance of staying off my feet, we decided that going to church wouldn't be a good idea, since in addition to sitting for a few hours, we'd have to ride in a hot (no A/C) car there and back. We spent the day together and tried to relax and rejuvenate. On Sunday, we met with our doula, and it was really good to talk with her again, since we hadn't seen any of the midwife team for a few weeks. She helped us understand some of the different options we had for the next few weeks, and asked us to think about our ideals for the labour and birth process.
On Monday, June 22, at 37 weeks, I drove the 20 minutes to the hospital for the non-stress test. It didn't take as long this time, and I was done in about an hour and a half. The nurses said my blood pressures were still elevated and not great, but my baby looked beautiful and was very responsive, just like the previous Thursday evening. There were a few mix-ups with my records and information, so I had to correct some of those, but before too long I was able to clear up the records and was allowed to leave.
Thursday was my next non-stress test. I went in at 2 p.m. and was supposed to have a doctor's appointment at 3:30 p.m. Well, that never happened. My doctor was on vacation starting that day or the day before and so the on-call doctor, a man I had never met, decided that my BPs necessitated staying in the hospital overnight for labs and a 24-hour urine test as well as intermittent baby and BP monitoring. The frustrating part was that my BPs that afternoon were about the same as they had been at my non-stress test on Monday, but this doctor was just more cautious than my own doctor (and, of course, had no previous knowledge or information on me or my condition thus far in my pregnancy). Instead of seeing my doctor's Nurse Practitioner (who was to fill in for her while she was gone), I spent the evening hooked up to monitors and visiting with Jonathan and my doula until they went home for the night, as well as having to fight off certain procedures and interventions that I didn't want to happen.
On Friday a different doctor was on-call and she called the high risk OB, like my own doctor had the week before. They both agreed that because my BPs were stable, although higher than either liked, and with all my labs coming back negative for any signs of pre-eclampsia, they were okay to send me home for the weekend, with strict instructions to come back ASAP if anything were to change. I was so glad to finally get out of the hospital again! It seemed like I had been in for days, although it was just a little longer than 24 hours.
Again we spent a quiet weekend at home, trying to relax. This Monday, June 29, now at 38 weeks, I had another non-stress test. In the morning, the blood pressures I had taken with our home cuff had been quite good, actually. However, as I went into the hospital, knowing that my own doctor was still on vacation and I would be at the mercy of whatever doctor was on-call, I was nervous and could feel my pulse go up, and knew that my blood pressures would go up with it. They were quite a bit higher than they had been in the morning, and the doctor and nurses ended up keeping me there for nearly six hours before we were finally able to go home.
Given all that has happened in the last few weeks, we're feeling pretty unsure about what will happen next. The doctors will likely want to induce me soon, but we and the doula feel that the longer the baby can stay inside the better, because it is on the small side for its gestational age. At 38 weeks, it's "safe" for the baby to be born, but we feel it would be best if the baby decides when to come, barring extreme circumstances.
We solicit your prayers as we continue this journey. We pray that God will allow my blood pressures to remain steady or even come down so that the pregnancy can come to a natural conclusion, and we pray that my and the baby's health remain good through to the end, as well as after delivery. Thank you in advance for praying. We believe God can do amazing things!
Joel and I are praying for you and the little one!
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