Need Advice From Some Pros... (long)
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  1. #1
    Posting Addict marymoonu's Avatar
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    Default Need Advice From Some Pros... (long)

    That's why I decided to post here (I usually just lurk around).

    My doctor is convinced that I have pregnancy-induced hypertension. My BP has been high or borderline high at every office visit during this pregnancy. I had a month of bleeding early in the pregnancy (from weeks 9-13) and my doctor is concerned that it is related to poor placenta attachment which could cause pre-E. Okay. That's fine.

    So I've been watched pretty closely. Here's the run-down of the last few weeks...

    32 weeks: 24-hr urine test. Results normal.
    33 weeks: NST x 2 and 24-hr urine. All results normal.
    35 weeks (today): NST. Results normal.

    At all 3 of my NST's, they checked my BP every 15 minutes. And every single one was normal. One of mine today was even 105/60's. This is AFTER it was supposedly 150/100 at the office. I also monitor my BP at home. It's just fine.

    The nurse and the midwife from L&D both think I'm perfectly fine and I think I'm perfectly fine.

    Now for the SHADY part... My doctor told me today that he wants to induce me at 37 weeks (only 2 more weeks). The nurse in L&D came to me tonight and told me that it's just not adding up for her. She doesn't know if my doctor's office has faulty equipment or if the girl doing the BP needs better training, but that I'm not the only person this is happening to. She said she has been seeing it TOO much from my OB's office (multiple different doctors) and that she's passing the information along to her boss because she just thinks something is not right. Then she came in privately and said to me very seriously that if the baby is reactive and moving, my BP and labs are fine, and I'm not having any symptoms of pre-E, that I CAN say no. Of course I know this, but the fact that she came to me and said that just reinforces to me that I'm NOT crazy when I think I'm fine and that I do NOT have to consent to an induction at 37 weeks.

    Where I need your help is how to approach it with my doctor. I'd really like to call him up and talk about it tomorrow, even though I feel it might be more appropriate to just sit on it until my next appointment (a week from today). My concern is that if he is planning on inducing me at 37 weeks and I go in for my appointment next week (36 weeks), that he'll be ready to schedule it that day. I'd like to bring it up to him before we get to that point. I just do NOT want to be induced already. My cervix was still very thick, high, and posterior today and was only a fingertip dilated. They did an u/s because I measured a week behind, and baby is estimated at 5lb 5oz. I just don't want to do it two weeks from now if my baby and body aren't ready. I just need advice on how to deal with my doctor.......

    Sean Thomas - 6/30/09 @ 7:17pm 8lb 8oz, 19", 40w5d
    Calvin Michael - 2/28/11 @ 7:39pm 6lb 8oz, 18", 37w5d
    Nolan Matthew - 5/1/13 @ 11:54pm 6lb 4oz, 19", 38w4d

    May 26, 2010 - 7w1d

  2. #2
    Mega Poster krazykat's Avatar
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    Any way you can switch providers all together? That's what I would do. They have already set the game up against you, and if it's happening to other people besides you, I don't think you will change his mind any. The last thing you want is a hostile environment b/c you have stood up to him and said no.

    I switched providers at 38.5 weeks and though it was a very daunting decision to make, and caused a huge amount of stress for me, it was the best decision I ever made.

    ETA: At the very least, I would request a second opinion.
    Ariel & John: Military Family since May 17, 2006

    Sylvia: 12/18/08, Justus: 9/17/10, Bunni: 5/11/12, Surprise Baby: Guess Date 11/5/13



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    Posting Addict mommys's Avatar
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    Just wait for your appointment. You have more NSTs scheduled before then, right? I'd gather all the information and be sure he has the records or you have your results in writing.

    You don't want to come across as aggressive about it and cause a rift with him, but you also will have to be firm in your choice to not have the induction unless the NSTs and other results start to point in that direction. I think that is completely reasonable and he should too. If he doesn't, I'd worry there is a bigger problem.

    By the way, I'd never heard of ANY connection between first trimester bleeding (poor attachment) and pre-E. I'm interested in how much validity there is in that - maybe it is true, but I'm curious.


    Edit: I agree with Ariel in the fact that you don't want a hostile environment. If he pushes really hard at your next appt, I would be suggesting another provider!
    Stephanie & Dave - Andrea 10/22/06, Natalie 6/24/11
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    Posting Addict MrsHooah2U's Avatar
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    (I'm kinda a lurker too.. but I wanted to comment since I've BTDT)

    Mary:

    #1, are the machines automatic? or are they doing it manually. IF it's manual ask for a second reading. When I was doing my NST and had my BP issues, I was CONSISTENTLY high, no matter where, what machine, who read it. I always had machines do it, my midwife did it once manually and even then got a high reading. It didn't matter if I was in NST, L&D, the Dr's office, I was ALWAYS HIGH. That would be my #1 first and foremost red flag. My final reading that warranted hospitalization and induction was 160/117. Heck, 100's weren't even "high" for me anymore.. that's how HIGH I was.. haha!

    #2- as far as approaching your doctor, I would be firm, blunt, but "nice". One thing I never really got the grasp on is that YOU are your only advocate. YOU have to stand for what YOU want, MOST of the doctors and nurses aren't going to fight in your favor, especially if they feel you NEED to have something done. If you go in throwing stones, you're not going to get anywhere. BUT, just from reading your post, things don't add up and inducing at 37 weeks is a big deal especially if it's not ABSOLUTELY necessary (especially if your urines are coming back normal). I would ask your doctor a few things, can you start having TWO BP readings done at each appointment, maybe when you first get there and then another one before you leave? Just to compare. Explain to your doctor your concerns, you're not getting the same "serious" readings at your other appointments and you're curious as to why they are so different, a difference from 60's to 100's is A BIG jump. I was only getting dips like that when they had me doped on meds and then it'd go down to the 60's and I'd get massive headaches and the MINUTE the meds wore off, I'd be right back into the 100's+. I would just calmly explain to your doctor you're not understanding why things are consistent and because of that you're not sure induction is the right path. I would usually play "dumb" in order to get them to "explain" to me their opinion which in turn gave me a chance to "fight" and present my case better without just walking in and saying "you're stupid, you're wrong, it's not what I want" kwim??

    Anyway, it sounds like other medical personal agree induction isn't the best option, so I would talk to your doctor, for me, I would NOT be able to wait, but that's just me.. and explain your concerns and as said, YOU DO have the right to refuse, just make sure you understand medically what is going on with your body and you and baby will be JUST fine
    Last edited by MrsHooah2U; 02-09-2011 at 10:43 PM.
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    Jacob James:10/17/09 @ 5:58 am/ 5.13 lbs 19"(37w2d)
    Aubree Olivia: 6/24/11@ 10:31 pm/ 8.3 lbs 19" (38w4d)

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    i would like to second the damn machine thing. at my 36 week appt the machine, which i TOLD the nurse didn't like me, read me at 150 something /100 something. so she redid it WITH THE MACHINE, even though i asked her to do it manually- it came out better the second time. my BP hasnt been over 120/80 ONCE when done manually yet. not even once. i liked that Dr but i sure didnt like her nurse, and i know next time i will tell her manually, or don't bother, i wll not do the machine, its not accurate.

    so if they are doing it manually, either they're idiots or have really faulty equipment.

    Next, you could call or wait until your next appointment, but either way, just say that according to YOUR extensive research, because you like to understand what is going on with your body, as long as the NSTs and urine and everything are coming back normal it appears to be safer all around to WAIT, tell them you'll come in twice a week if needed, but you will be waiting as long as possible, until there are CLEAR signs of need, before agreeing to induction.

    or better yet, DO get a second opinion! that sounds like the best way to go, especially with the concerns expressed by another expert- the hospital nurse who talked to you. this clearly indicates that ITS NOT JUST YOU, your OB might have a problem....
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  6. #6
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    I'm a bit of a lurker too, but wanted to ditto the others. I would definitely talk to your doctor and be as nice and "non-threatening" as you can be, like Pamela said. Is it possible he doesn't realize you really don't want an early induction? I know many women who would be excited to be induced at 37 weeks. Just explain your concerns and how important it is to you to wait until baby is really ready. Many times the person taking your BP has been to a 5-week training class and doesn't realize the importance of a very accurate BP reading. The nurse at my OBs office always listens through my clothing and it's always higher when she takes it than when I take it at home or work. Like Pamela said, when my BP was high with DS, it was high everywhere, not just with one machine or one person.
    Hope you can have a good conversation with him! Sorry you're in this position.
    Beth

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    Posting Addict MrsHooah2U's Avatar
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    I wanted to add a few more things:

    When you're getting your BP taken, NO TALKING, legs MUST be uncrossed and ask them to hold your arm at a 90ยบ angle to your body, not hanging down at your side. These are all things to help insure a most accurate reading! Also if you had been running around or walking up stairs to get to the office, ask the nurse to sit for a minute or two before she takes it, another thing just to help "calm" you from a false reading.
    Pamela ♥ Tanner
    Jacob James:10/17/09 @ 5:58 am/ 5.13 lbs 19"(37w2d)
    Aubree Olivia: 6/24/11@ 10:31 pm/ 8.3 lbs 19" (38w4d)

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    Posting Addict marymoonu's Avatar
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    Thanks for the input girls! I'm still trying to decide whether to call today or just wait until my appointment. Part of me wants to call today because I'm still fired up about it, but part of me thinks it would be easier to talk face-to-face, rather than try to put it in a voicemail and wait for a call back.

    Then there's the issue of... I just took my own BP and got 138/89, while I was perfectly relaxed. It's a little elevated, although not hugely so. But my doc did send me to L&D for a NST after 142/92 BP two weeks ago, not much higher than this (he considers it borderline). So I doubt he'd be thrilled with this reading. But like Pamela said... Her BP just STAYED high, and mine obviously does not. I don't know why I'm getting a random high reading here and there, but I'm still not convinced it's reason to induce.

    As for how they take my BP, they use a manual cuff at the doc's office. They sometimes do it only once, but sometimes do a repeat at the end. Usually the repeat is lower, but not enough lower to make the doc happy.

    I've made up my mind that unless the labs are off or my BP's start running high consistently, I'm not going to give in. He might not even fight me on it, but I'm preparing myself in case he does. Ugh...

    ETA: I do have another NST on Saturday. Maybe I'll wait until after then just to make sure everything is still looking awesome.
    Last edited by marymoonu; 02-10-2011 at 09:37 AM.

    Sean Thomas - 6/30/09 @ 7:17pm 8lb 8oz, 19", 40w5d
    Calvin Michael - 2/28/11 @ 7:39pm 6lb 8oz, 18", 37w5d
    Nolan Matthew - 5/1/13 @ 11:54pm 6lb 4oz, 19", 38w4d

    May 26, 2010 - 7w1d

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    Posting Addict mandi04's Avatar
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    If you decide to stay with your dr, I'd just simply tell him that if things stay as they are now, you will not consent to an induction but will go in for regular NSTs, best of both worlds, you don't get induced and he has proof that you and baby are doing just fine.
    I'd be really tempted to switch drs, I switched at 28 weeks with DD2 so not as late, but I definitely did not regret it. I mean IF it isn't faulty equipment/bad readings he seems like he's ready to do what's necessary to push medically unnecessary procedures and that would worry me, what's next? Will he say baby can't fit and push a csection? You're not dialating fast enough? It would just worry me, and you don't need the added stress in labor.
    Now, with your last home high reading I would start considering doing what you can to prepare your cervix. I'm not sure if evening primrose oil is still the reccomendation for that but from what I heard it won't put you into labor, it just helps get your cervix ready. At least that way IF you do develop true Pre-E and need to be induced your body might be a little more ready. Still, with one high reading at home I wouldn't be too worried, you might just be stressed out from everything that's on your mind.
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  10. #10
    Posting Addict marymoonu's Avatar
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    Quote Originally Posted by mandi04 View Post
    Now, with your last home high reading I would start considering doing what you can to prepare your cervix. I'm not sure if evening primrose oil is still the reccomendation for that but from what I heard it won't put you into labor, it just helps get your cervix ready. At least that way IF you do develop true Pre-E and need to be induced your body might be a little more ready. Still, with one high reading at home I wouldn't be too worried, you might just be stressed out from everything that's on your mind.
    I've been thinking a lot about this too. I mean it's possible (and I'll keep an open mind) that something WILL happen and these BP's will start being consistently high or something crazy will happen, and I'd like to be prepared for that. I'm just so nervous about the thought of being induced with my cervix SO not ready. I feel so torn on this topic... I feel like it's too early to be taking measures to change my cervix. But at the same time, there is of course the fear that something will happen to make an induction medically necessary, in which case I want my body to be as prepared as possible. Ugh...

    And he'd better not even attempt to tell me this baby is too big to fit out, lol. If I did happen to be induced early, this baby would definitely be smaller than my DS, and he came out with NO problems.

    Sean Thomas - 6/30/09 @ 7:17pm 8lb 8oz, 19", 40w5d
    Calvin Michael - 2/28/11 @ 7:39pm 6lb 8oz, 18", 37w5d
    Nolan Matthew - 5/1/13 @ 11:54pm 6lb 4oz, 19", 38w4d

    May 26, 2010 - 7w1d

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