Hellobee Boards

@JMOM: oh man, I would be so upset if the doctors wanted to knock me out for the delivery. My first needed to be resuscitated and I wasn’t able to hold her for about 4 hours and I was so hopeful that I might get a better birth/bonding experience this time. Thankfully no one has mentioned that to me yet 🤞🤞🤞

@poppygirl15: doula in training is a good idea. I’m in a very small city, but it’s known for being pretty lefty and is a regional hub so I bet we have some sort of doula training around here.

@Clementine12: Thanks for sharing your experience. I was a little concerned that there could be long term impacts, but it seems like that’s usually not the case. Did the hospital monitor your newborn? It sounds like mine probably will, but I don’t fully know what that entails or even who to ask because my OB doesn’t know the procedure. My clotting time was actually normal on the blood work they did, but the platelets were really low. Idk about individual anesthesiologists, but apparently the hospital sets a floor for epidurals and right now I’m under the floor and trending down over the past 6 weeks, so unless something changes it’s not looking good.

@bhbee: it’s been a bit of a rollercoaster (the cascade of interventions is real). Based on the platelet count and other lab work the doctors recommended prednisone to suppress my immune system. One of the common side effects of prednisone is increased blood pressure and at my 36 week visit on Wednesday mine was borderline (literally the lowest systolic pressure to be considered high and normal diastolic pressure). So I have a blood pressure check on Monday and if that isn’t lower they’re going to diagnose me with gestational hypertension and recommend induction as soon as I hit 37 weeks (end of next week). I spoke to the hematologist and based on the fact that my platelets are back in the normal range we cut the prednisone dose in half and I’m just hoping my pressure is down enough on Monday that the doc will let me stay pregnant.

It’s really frustrating because I had a conversation with a different doctor at the practice before starting the prednisone where I literally said if there’s a chance this won’t be safe I don’t want to do it and she assured me it was safe and wouldn’t impact my or my baby’s outcomes. But the timing is too suspicious especially given all the side effects I felt immediately once taking the pills and the fact that after gaining 0lbs from 28-34 weeks I gained 7 between 34 and 36. The side effects have been less in the two days since dropping the dose and I bought a home bp cuff, which I’m hoping is accurate, because all my readings yesterday and today have been 120-135/75ish. So 🤞

I’m curious if anyone has experience declining induction. I can’t find any evidence that high bp alone leads to poor outcomes and it seems like in studies done in the US patients presenting with high bp at or after 36 weeks only progress to pre-eclampsia ~10% of the time. There is a really well done study out of Holland that shows better outcomes with induction for gestational hypertensive disorders, but they included women based on diastolic pressure, which for me is fine, and when they disaggregated pre-e and regular gestational hypertension there weren’t significant differences between induction and waiting for the gestational hypertension group.

@togetherthroughlife: and I should also say that I’ve been taking my bp 3x per day at home (plus any time I have even a tiny headache) I’ve had the pre-e/HELLP labs (plus a lot more for the hematologist) twice in the past 2 weeks and am fine doing any testing the docs want to do to catch anything more serious. I’m just anti induction when there isn’t a clear indication that it will improve outcomes.

@LemonJack: thanks for sharing. I think my docs were particularly worried because I had single readings (but never sustained pressures) in the 155-160 range, which is where it starts to get dangerous. Immediately after delivery I went down to 120-130/80ish, but it’s been creeping up today so I started meds this morning with the expectation that I’ll wean off sometime over the next 6-12 weeks.

I wound up accepting induction at 37+6 because all the literature showed that 38 weeks was the point where health outcomes (though maybe not long term behavioral outcomes) are statistically indistinguishable, and the doctor on call that day was one I know and trust. My platelets dropped after cutting the prednisone so we wound up doing a fast but short acting infusion to get the platelets up for delivery (another benefit of planned induction) before the bp went up too much. Baby was born overnight on 38+0. Incidentally I was in very early labor when I went in, so it’s unlikely she would’ve stayed in much longer. I did get an epidural that (mostly) worked. The doc, nurse and I talked a lot about my fears both in terms of baby’s outcomes and pitocin induction before anything got started and they were great about managing it in a way that meant that I had a normal early labor phase and at least a 30 second break between contractions even in active labor. I almost went unmedicated but towards the end was retching continuously throughout the contractions and that’s when I got the epi because I couldn’t imagine pushing effectively through that.

Ultimately I’m so thankful for having a team that worked with me to get to an outcome that balanced my risk tolerances and my desires for labor and got me to the best place I could be.