really?? At GW, my doc only delivers one day a week. She was pretty clear in the beginning that the odds of her delivering me were pretty slim.

Anonymous wrote:

jindc wrote:hm I've never been told to lie on my left side and relax - I take it on the dr's office bed thingy every time.
What is considered high if 140/90 isn't the standard some of you are using here? I think last time I went my BP was 131/73.

also, can't change practices at 36 weeks. Any doctor on call will deliver me, though - it's GW.

131/73 is actually relatively high. At that BP my docs were having me rest periodically on my left side during the day and eventually bedders when it got around 135/80-something. Especially if it is on an upward trend, your doc is correct to keep an eye on it.

but it's not any higher than it had been previously, which is why I'm wondering if there isn't an upward trend, why it is a sudden discussion of induction. It's regularly been, as I can remember, in the 120s-low 130s, and when I got a higher reading she said that the lower number was what was important and if it got to 90 that would be a concern. If it had regularly been in this range, why wasn't it brought up before so I could have extra monitoring or whatnot?

I'm just confused, I guess. It wasn't really explained to me why it automatically meant we should discuss induction at my next appointment, etc.

hm I've never been told to lie on my left side and relax - I take it on the dr's office bed thingy every time.
What is considered high if 140/90 isn't the standard some of you are using here? I think last time I went my BP was 131/73.

also, can't change practices at 36 weeks. Any doctor on call will deliver me, though - it's GW.

Anonymous wrote:I remember your doctor also being so sure that you would have GD just based on your weight, right? It sounds like she is just super sensitive/anticipatory when it comes to overweight women. Maybe she just errs too much on the side of caution for whatever reason. I have no experience with pre-e or HELLP but I HAVE been induced before and even if you have to go through an induction, they're really not *that* bad! I was a FTM and my induction resulted in a labor that was 12 hours, start to finish, with only 14 minutes of pushing and no tearing or episiotomy. Healthy 6 lb 12 oz baby. So, even if she does try to schedule an induction, try to remain positive that it can still be a totally fine birth experience!

thanks for this - it makes me feel a bit better.

Yes, I've taken two GD tests, passed both with flying colors. I'm also not a fan of the "what should I eat to pass my GD test" questions because if I HAVE an issue, I want to KNOW so it can be managed for the healthiest pregnancy possible.

Maybe I've read too much about inductions and epidurals for my own good lol

Hi all - thanks for the info - I'll definitely read the study when I get home (I can't get it to load here).

And thanks, Pumpkin - I know you know I'm not trying to make light of this! Your questions are really helpful - I'll put them in my notebook. I am seeing another doctor, which might be helpful because it'll be another set of eyes.

I've also asked for an additional blood/urine test either prior to or at my next appointment.

I've never had another doctor say anything about my BP (before pregnancy), nor did they say anything when I went to the monitoring a few weeks ago.

le sigh

thanks, PP - I wouldn't ASK for a c-section, but the idea of not being able to move around or help labor along without more drugs just makes me even more anxious.

I am going to see if I can come in for the blood work/urine test before my next appointment so that the results are there when I see the OTHER doctor.

I know HBP/pre-e/HELLP aren't easy to diagnose and it's obviously better to be cautious, and I definitely don't want to come across as minimizing the problems.

ok, thanks all.
I'll ask about the additional blood work and all that - I see a different doctor Thursday.

If my normal BP is higher than Larla's, if it's normal for me, it's normal for me - until pregnancy I was very active and when I saw a PCP was never told my BP was high. I can ask if they can send my chart(s) to the OB to compare, but that'll be a pain in the ass since they're members only and don't really care to help former patients.

I'm sure I'll figure it out, but the responses are a mixed bag - I guess it is what it is.

And docs definitely DO push interventions on chubby mamas. Luckily my dr is not a fan of c-sections, but to me, at some point, when you're hooked up to so much and you can't help labor along in the ways you naturally should, it SEEMS counter productive to just lie there while they pump more drugs into you<shrug>

well, the whole "induction/magnesium" sounds completely awful - at some point, wouldn't I just rather have a c-section?

I'm fairly certain mine runs high, but I have a pretty strong case of white coat hypertension (fairly common in my family)

if the only indicator is BP, no protein, other blood tests fine, is that enough for them to order an induction?

I'm trying to stay calm, but I am frustrated like I'm branded with a certain diagnosis from week one because of my weight vs. being treated as a patient who is trying for the most natural outcome possible.

my doctor told me I'd probably get GD, for example. Based on nothing but weight alone.

also, how does monitoring your BP during delivery work?

If I have to be induced, I'd like to avoid magnesium and all that (and I know the risk doesn't go away right after delivery).

are you just hooked up to monitors? catheters for your urine?

and what happens if you're not ready to deliver and you get induced? I worry about forcing my body to do something it's not ready to do.

Sorry about all these questions...I want to be prepared and it sounds like there's no sure fire way to understand if a patient has pre-e or not, so they just error on the side of inducing.

I have no idea what my normal BP is because I don't have a primary care doctor so haven't had an actual check up in a long time (I know, it's not good....but it is what it is and I couldn't find a PCP that took insurance once the one I used to see went "members only").

I'm not trying to downplay anything, I'm trying to avoid a doctor forcing me into a medical procedure that might not be necessary because of possibilities.

Like I said, I'm not one to downplay any of these very serious pregnancy issues - my mom had a stillbirth at 8 months for her first pregnancy, so I'm perhaps "tainted" in how conservative I am in pregnancy. I worry about everything.

re: fasting...the blood lab told me that some of the tests requested required fasting - there were like 18 tests in one blood draw!

maybe when I go in for my appointment Thursday I should ask for the blood panel done again?

Anonymous wrote:Did you ask her why she thought you'd get it?
Are you extremely overweight for your height, or just marginally?

I'm not sure why she thinks it - she thought I'd get GD, too, because of weight and my sugar was fine (102!) so I took GS test in first and second trimester. I feel like if I could have taken it in my 3rd, she'd have wanted that.

I'm overweight - not obese. I don't really know how to quantify if I'm "extremely", I'm heavier than I'm happy at, but it isn't the main cause of pre-e or GD. My coworkers wife had severe pre-e with both pregnancies and she's a tiny little thing.

It makes me happy to hear people have been induced and had natural delivery.

I'm also worried about the avoidable early delivery of a child. I feel like if he's delivered early when it might not be medically necessary, it's not the best for him.

what do they look for if pre-e isn't based on protein in urine or the blood panel? Just slightly elevated BP? Even if it's below 140/90?

isn't pre-e swelling pretty dramatic? how do you know the difference between mild pregnancy foot/hand swelling and pre-e? I thought pre-e swelling was more all over (legs and face not just feet and hands?)

I do not have GD and I'm overweight. I've gained 34lbs and after losing 75lbs before pregnancy, I have every faith that I can get back to where I was even if takes longer than before I had a kid.

I took the "hypertension blood panel) in August - everything was fine. Should I take this again? I ask because it's apparently a fasting blood test and they never told me this, so I had to come back a different day for it since I had eaten breakfast.

Also, isn't there a difference between high-ish BP and pre-e?

I guess I am just looking for options to bring with me to the next appointment. I'm seeing a different doctor, so the perspective will be good. Is it worth saying that since she is so concerned, why don't I come in more often for BP/urine checks? I tried this before, but no one would take my BP without an appointment and I didn't think it was worth a doctor's appointment when a nurse can do the BP/urine testing....

To be clear I'm not trying to AVOID dealing with pre-e if I develop it - I'm trying to avoid being convinced of something that isn't a real health issue. If it IS a real health issue, I'll definitely deal with it the best way possible!

I haven't posted for a while...
I'm 36+ weeks pregnant and at my last appointment, my OB mentioned that she thinks I'm going to develop pre-e/high BP and therefore need to consider the reality that I could have to be induced.

The issue is this: I have had ONE occurance of high BP my entire pregnancy (it was taken after I walked from my bus stop to the office in the August heat, and when she took it again towards the end of the appointment, it was back to normal). Additionally, I went once for NST monitoring at the hospital where I had my BP checked the entire 4 hours I was there, and it was only on the higher (not pre-e high) end when I first got hooked up and was nervous.

Secondly, I have never had excess protein in my urine (or glucose). I don't think I have excessive swelling - my feet and hands have JUST this past week started to get a little bigger (can get my wedding ring on and off sometimes, but have just decided to keep it off). I don't have chest pain, excessive headaches, etc. The only horrible part of my pregnancy (other than the baby is bigger now and walking isn't much fun!) is that I have had reflux/heartburtn the entire 2nd and 3rd tri- it's caused me to throw up a number of time, which I know some of you have said can actually be a sign of pre-e.

I have a BP monitor at home (wrist one) and haven't had a high reading.

I'm worried - not that I'll get pre-e....I'm not a fool, I know how serious it is and trust me - if ever a patient wanted to know if something were an issue, it would be me (I didn't try to cheat the GD test, which I had to take in the first and second tri). I'm very realistic about the fact that between a monday and a tuesday, pre-e can pop up and from a tuesday and a wednesday, it can skyrocket to HELLP.

However, I think my doctor is just assuming these things are going to happen to me because of my weight. I get it - I'm overweight. I talked to her about this at my first appointment (losing a lot of weight, then gaining back a bunch during fertility treatment and curbing a lot of my hardcore physical activity like kickboxing and step while pregnant, but I gain weight fast when I'm not as active). I get the impression she is dooming me to induction because of a misconception about weight and pregnancy vs doing what is best based on legitimate health concerns.

Does anyone have experience with this? I know pre-e can develop at the end of pregnancy and there really is nothing you can do about it. But if I don't have signs, other than I've gained more weight than she wanted me to, what actions should I be taking? Should I ask for more monitoring before we go the route of just assuming I need an induction? Anyone with a similar situation make it to going in to labor naturally? I'm OK with extra monitoring before and during labor/delivery, but I don't want to enter the post-induction slippery slope of interventions (I have planned for a natural birth).