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How do midwives and moms handle laboring at home with preeclampsia?

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Is it possible to have preeclampsia and labor at home or is it too dangerous? My blood pressure has suddenly become high and Im 34 weeks with my first baby. I dont have preeclampsia yet but my mom and sis both had it.I am planning to labor at home without a midwife and then deliver in the hospital. I am worried that my blood pressure and possible preeclampsia during labor will hinder this. I just ordered a blood pressure wrist moniter so I know when my blood pressure is too high. Any advice is appreciated.
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by on Feb. 22, 2013 at 11:10 PM
Replies (21-30):
peaches_04
by Platinum Member on Feb. 24, 2013 at 1:14 AM
My mw gave me a bottle of magnesium(on top of the prenatals) to take bc i got reaalllly bad charlie horses but took it away bc my bp got too low. I remember her making a comment about how she usually uses it for pre e patients to lower their bp

Quoting Corina1987:

Im pretty sure my prental vitamins have it. I will check,thanx:)




Quoting peaches_04:

Oh and magnesium supplements

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Corina1987
by on Feb. 24, 2013 at 1:17 AM
Thanks. Im sure youre right. It wouldnt make sense to stay home when you can get a seizure while giving birth.


Quoting TTC2Long:

I'm no expert! That's just what I've gathered from hearing others' experiences. :)



Quoting Corina1987:

Thats disappointing. I really want to labor at home.






Quoting TTC2Long:

I've always read in birth stories where pre-e is the reason a planned homebirth is moved to the hospital. I'm curious to see what others with more knowledge on this say. :)


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Corina1987
by on Feb. 24, 2013 at 1:18 AM
I will bring it up during my next visit. I didnt know I could take more.


Quoting peaches_04:

My mw gave me a bottle of magnesium(on top of the prenatals) to take bc i got reaalllly bad charlie horses but took it away bc my bp got too low. I remember her making a comment about how she usually uses it for pre e patients to lower their bp



Quoting Corina1987:

Im pretty sure my prental vitamins have it. I will check,thanx:)






Quoting peaches_04:

Oh and magnesium supplements


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somuchlove4U
by Bronze Member on Feb. 24, 2013 at 1:49 AM
The Epsom salt soaks are for the extra magnesium.

Quoting Corina1987:

Thanks for the info. I would think salts of any kind would be bad.




Quoting peaches_04:

Eating Cucumbers





Epsom salt soaks

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Corina1987
by on Feb. 24, 2013 at 1:54 AM
Thanx for the info.


Quoting somuchlove4U:

The Epsom salt soaks are for the extra magnesium.



Quoting Corina1987:

Thanks for the info. I would think salts of any kind would be bad.






Quoting peaches_04:

Eating Cucumbers







Epsom salt soaks


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TTC2Long
by Bronze Member on Feb. 24, 2013 at 2:44 AM
1 mom liked this
You should get 400-800mg of magnesium per day. I doubt your prenatal has that. I take my multivitamin in the am and multimineral, with calcium and magnesium, in the pm. The reason is that iron and calcium block the absorption of the other, so if they are both contained in the same vitamin, they cancel each other out. Also. If your vitamins are from synthetic sources, rather than food-based, you're only getting a fraction of what is on the label.
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GoodyBrook
by Silver Member on Feb. 24, 2013 at 6:56 AM
1 mom liked this

 

Yes.

Epsom Salts are made of magnesium sulfate.  This is the EXACT thing that women are put on in L&D to keep them from "stroking out" from high blood pressure.  (Of course, mag in the delivery room is administered via a liquid through an IV, not a lovely warm bath!)

My naturopath did say that epsom salts baths would lower blood pressure, but he didn't indicate that it would be a permanent thing.  Rather it will bring your blood pressure down temporarily.  This is still a good thing!  (After one bath, my blood pressure went down from 140/90 to 117/80).


 

Quoting somuchlove4U:

The Epsom salt soaks are for the extra magnesium.

Quoting Corina1987:

Thanks for the info. I would think salts of any kind would be bad.




Quoting peaches_04:

Eating Cucumbers





Epsom salt soaks


 

GoodyBrook
by Silver Member on Feb. 24, 2013 at 7:08 AM
1 mom liked this

 


Quoting Corina1987:

Im 34 weeks. The only thing the gyn said was to reduce salt intake. I dont have any proteins in my urine. I think my blood pressure was 133/83. Occasionally i get swelling in my legs/hands. Thanks for the info.


Quoting GoodyBrook:

In my state you risk out of a midwife's care at 140/90.  They are required to take you in for a consult with an OB at that time.


What other signs of pre-e do you have? 


Typically an induction is the route most OBs will go if you are beyond 37 weeks.  Prior to this they will try to treat your high blood pressure with medication until the baby reaches "term." 



 If you have rising blood pressure and no other signs, it doesn't sound like you are pre-eclamptic yet.  GREAT!  (Likely your diagnosis will be Gestational Hypertension, rather than Pre-Eclampsia).

OBs have a great wealth of information, but nutrition isn't high on their list.  Limiting salt is NOT common practice anymore, but when the OB went to his nutrition class it probably still was.  Before you take his advice and limit salt, I'd recommend you consult a nutritionist who is familiar with pre-natal care.  The nutritionist can advise you on foods that you can eat that will help manage your blood pressure...

To address your swelling, you might want to consult a midwife or nutritionist or naturopath who is familiar with the supplement called Butcher's Broom.  I began taking it at 35 weeks, and it eliminated my swelling by improving my circulation.  It sounds like a scary supplement to take if you read about it on WebMD etc., but if you look at European studies, you'll see that it's a common supplement for women to take as it has wonderful benefits in addition to lessening swelling...  (In my case the bottle recommends 2 tablets per day, but I was told to take 9.  Within the first few days my swelling was down, and within the week it was gone!)

Terpsichore
by Member on Feb. 24, 2013 at 11:53 AM


Quote:

Thank you for sharing, What is a normal heart rate for the baby? 

120-160 beats per minute I believe, with 140 being average. It fluxuates during contractions. May I suggest having a list of questions available to ask at your next prenatal appointment. My mother thinks I'm scaring myself by asking the doctor these questions, I think I'm preparing myself for possibilities in advance.

Quote:

It is scary to not know if you and the baby are in danger when you are home.

 

Tell me about it. I think I'll talk to my doula about a doppler.

Quote:

My blood pressure was 133/83, I think. I havent had any proteiņs.

From what I've been reading, high blood pressure without protein spilling or other signs is hypertention (PIH = pregnancy-induced hypertention). One of the books I have been reading is "When Pregnancy Isn't Perfect" by Laurie A Rich, published 1996. From the book:

"The American College of Obstetricians and Gynecologists (ACOG) defines hypertention as a systolic blood pressure of at least 140mm of mercury and a diastolic blood pressure of at least 90mm  of mercury. ACOG also defines hypertension as a rise in systolic blood pressure of 30mm of mercury over normal for the individual, and 15mm of mercury in diastolic pressure over normal."

Signs PIH may be progressing to preeclampsia:

"Swelling of the hands, face, feet, and legs." Particularly the upper half of the body, as many women have some degree of water retention in pregnancy. 

"A sudden increase in weight." More than two pounds a week or six pounds a month.

"A headache that won't go away. This isn't a headache that lasts just a few hours. It must linger no matter what you do to relieve it. With preeclampsia, such headaches are very serious; severe headache almost always precedes the first convulsion of ecampsia."

"Visual disturbances." From slight blurring of vision to partial or full blindness, another very serious symptom.

"Pain in your upper right side and shoulder."

Quote:

How did they know your labor wasnt fast enough? I heard women laboring for days. 

It would have been ok if I could have gotten sleep, but I was unable to. We did try things both to speed up labor and for me to get sleep (not at the same time).  Without sleep, my body didn't have the strength to have good contractions. That's a personal experience and has nothing to do with your pregnancy.  

doulala
by Gold Member on Feb. 24, 2013 at 1:11 PM
3 moms liked this

We need salt though--    Diet is very relevant!
:-)

Quoting Corina1987:

Since the high blood pressure has been brought on by pregnancy, I dont think there is much I can do. Im not having salt anymore. Ive been eatting fruits,veges the whole time. How else can I avoid problems?


Quoting doulala:

Monitoring is good, but even better might be prevention so you can avoid problems.   Are you working on improving your health?



A study conducted at Harvard University found that by eating at least 75 grams of protein per day, pregnant women could prevent diseases of pregnancy such as preeclampsia (metabolic toxemia of late pregnancy).
During pregnancy a woman's blood volume increases as much as 40 to 60 percent, and in order to reach this necessary level and maintain it, a woman's body needs adequate protein, salt, calcium, potassium and water from her diet.

Here is the rest:

 

 

 

Nutrition during Pregnancy   by Amy V. Haas

The single most important thing that you can do for your baby is to eat a healthy, well-balanced diet. A well-balanced diet is one that includes foods from all food groups in appropriate amounts, so as to ensure proper nutrition. Proper nutrition ensures that all essential nutrients (carbohydrates, fats, protein, vitamins, minerals and water) are supplied to the body to maintain optimal health and well-being. Good nutrition is essential for normal organ development and functioning; normal reproduction, growth and maintenance; for optimum activity level and working efficiency; for resistance to infection and disease; and for the ability to repair bodily damage or injury. While pregnancy is a normal alternative condition for the female body, it is stressful, and all nutritional needs are increased in order to meet the needs of the pregnancy.

Dr. Tom Brewer found through more than 30 years of research that each day, pregnant women need a well-balanced, high-quality diet that includes 80 to 100 grams of protein, adequate salt (to taste), and water (to thirst), as well as calories from all of the food groups. The World Health Organization recommends that a pregnant woman eat a minimum of 75 grams of protein per day, but protein is just a marker for a nutritious diet. It must be obtained from a wide variety of whole food sources in order to get all of the important nutrients a woman needs during pregnancy. While the government's food pyramid is a good example of a well-balanced diet, pregnant women need more protein and calories in general. This means including:

  • 2 to 3 servings of meat, fish, nuts or legumes, and tofu
  • 2 to 3 servings of dairy (milk, eggs, yogurt, cheese)
  • 2 servings of green vegetables; 1 serving of a yellow vegetable
  • 3 servings of fruit
  • 3 servings of whole grain breads, cereals, or other high-complex carbohydrates
  • salt to taste
  • 6 to 8 glasses of clean, filtered water each day.

While this may seem like a lot of food, it will supply the 2000 to 3000 calories needed per day to make a healthy baby.

saladA study conducted at Harvard University found that by eating at least 75 grams of protein per day, pregnant women could prevent diseases of pregnancy such as preeclampsia (metabolic toxemia of late pregnancy). During pregnancy a woman's blood volume increases as much as 40 to 60 percent, and in order to reach this necessary level and maintain it, a woman's body needs adequate protein, salt, calcium, potassium and water from her diet. In April of 1996 the Journal of the American Medical Association published an article indicating that calcium may also help reduce the incidence of preeclampsia. Other recent research indicates that pregnant women need adequate folic acid (a B vitamin) to prevent neural tube birth defects such as spina bifida. The Food and Drug Administration now recommends that breads and pastas be fortified with folic acid to ensure that all women of childbearing age get enough of it. Four hundred micrograms of folic acid a day is recommended. This can be obtained by eating whole grain breads, citrus fruits and dark green leafy vegetables.

As long as junk food and excessive sweets (sugar) are avoided, or kept to a minimum, weight gain should not be an issue. The diet listed above (or something similar) should provide all of the necessary nutrients, and a woman should have little problem obtaining everything she needs. A "whole food" is one that is unprocessed and is as close to its natural state as possible. While vitamin supplements are very popular these days, there are risks to taking supplements of certain vitamins while pregnant (i.e., vitamin A), and others are simply poorly assimilated (i.e., calcium or iron). The B vitamins, for example, must be taken in congress (B complex supplement), as absences, insufficiencies or excesses of one or another can cause problems. Check with your care provider before taking anything while pregnant. Vitamins and minerals should be obtained from natural, whole sources whenever possible, to ensure quality and proper assimilation by the body. A qualified nutritional expert should assess special dietary needs.

Cravings for foods are common in pregnancy and, in theory, can indicate a need or deficit in a diet. Cravings for healthy foods can be indulged, but cravings for non-food substances such as clay or laundry starch, a condition known as "pica," can be harmful and should be reported to your care provider.

eggsMilk, eggs and other dairy products are inexpensive sources of calcium and protein. For those who are vegetarian, or simply to provide variety in an omnivorous diet, soy products, beans and nuts can be substituted. Dark green vegetables provide carbohydrates, water, bulk fiber, vitamins A, C, and B, calcium, iron, and magnesium; the darker green, the better. It is best to eat these vegetables raw whenever possible, but steaming or baking will also retain most of the nutrients. Citrus and berry fruits provide a great deal of vitamin C, and yellow fruits and vegetables such as cantaloupe, sweet potato, carrots and mango are good sources of vitamin A. Both of these vitamins are important for fighting infection, boosting the immune system, cell structure development and preventing placental detachment (abruption). Zinc is another important mineral for pregnant women, as it aids in supporting the immune system. According to the Journal of the American Medical Association, zinc also helps to improve birth weight and certain aspects of fetal development.

While a vegetarian diet is a good, healthy choice when well balanced, vegetarians do have to work harder to obtain all the protein needed to increase their blood supply. If a woman follows a strict vegan diet, it may be even more difficult to get the necessary protein, but it is possible with diligence. See the supplemental reading list for sources of information on this subject.

 

Good Sources

meat fryingProtein: chicken, fish, beef, pork, turkey, tofu, nuts, legumes (beans), milk, eggs, cottage cheese, whole grains, wheat gluten, soy cheese

Whole grains: brown rice, kasha (buckwheat groats), whole oats, whole wheat bread, whole grain cereals, quinoa, wild rice, wheat gluten, wheat germ, whole wheat pastas

Fruits: strawberries, kiwi fruit, apples, oranges, bananas, mangos, cantaloupe, pears, grapefruit, plums, nectarines, and peaches

Green vegetables: spinach, broccoli, zucchini, dark green lettuces, kale, Swiss chard, green beans, asparagus, arugula, lambs lettuce

Dairy: milk, yogurt, hard cheese, cottage cheese, egg

Other good whole foods: baked potatoes, sweet potatoes, carrots, squash, green peas, soy products, corn

Iron: red meats, organ meats, eggs, fish poultry, blackstrap molasses, cherry juice, green leafy vegetables, dried fruits (raisins, apricots, etc.)

Zinc: pumpkin seeds, squash seeds, sunflower seeds, seafood, organ meats, mushrooms, brewer's yeast, soybeans, eggs, wheat germ, meats, turkey

Folic acid: spinach, asparagus, turnip greens, Brussels sprouts, lima beans, soybeans, organ meats, brewer's yeast, root vegetables, whole grains, wheat germ, bulger wheat, kidney beans, white beans, salmon, orange juice, avocado, milk

Trained and certified as a Bradley® Method Childbirth Educator in 1995, Amy Haas' educational history includes a Bachelor of Arts in Sociology from Plattsburgh State University of New York. For the past six years she has taught Bradley® classes to pregnant families, empowering them to make healthful decisions. Amy's article, "How to Stay Healthy and Low Risk during Pregnancy and Birth" appeared in the Winter 2001 issue of Having a Baby Today. The original version of this article was shared through The Rochester Birth Network.

Sources:

  • Dunne, Lavon J., ed. 1990. The Nutrition Almanac. 3rd ed. New York: Nutrition Search, Inc., McGraw-Hill Publishing.
  • Brewer, Gail Sforza and Tom Brewer. 1985. What Every Pregnant Woman Should Know: The Truth about Diet and Drugs in Pregnancy. New York: Penguin Books.
  • Frye, Anne. 1993. Understanding Diagnostic Testing in the Childbearing Year. 5th ed. Portland, OR: Labrys Press.
  • Frye, Anne. 1995 Summer. Unraveling Toxemia. Midwifery Today 34: 22–24.
  • Frye, Anne. 1995. Holistic Midwifery, Vol. 1. Portland, OR: Labrys Press.
  • American Medical Association. 1996 Apr 10. JAMA. 275(14).
  • American Medical Association. 1995 Aug 9. JAMA. 274(6).

Other Recommended Reading:

  • The Brewer Pregnancy Hotline by Gail Sforza Krebs and Dr. Tom Brewer (http://ebooks.kalico.net/)
  • Pregnancy, Children, and the Vegan Diet, by Michael Klaper, MD
  • Diet for a Small Planet, by Frances Moore Lappé
  • The Birth Book, by William Sears, MD, and Martha Sears, RN
  • The Pregnancy Book, by William Sears, MD, Martha Sears, RN, and Linda Holt, MD

 

 

 

 


Brewer Diet   to protect against pre-eclampsia, toxemia, and have a healthier pregnancy:

http://www.blueribbonbaby.org/





The Brewer Pregnancy Diet

Dr. Tom Brewer was a pioneer in women's health. At a time when doctors were trying to treat symptoms of Preeclampsia, Dr. Brewer attacked the problem at its cause: poor nutrition. He learned very quickly that when a woman is given the tools to make good nutritional decisions, she will eat healthy.

Dr. Brewer first recommended his pregnancy diet to women in his practice in the 1960's. He served women from a very poor community whose families had passed on seriously flawed cooking and eating habits. When he implemented his program, the health of the women and babies was better than that of their well educated neighbors. During his 12 years in practice over 25,000 women experienced healthy pregnancies with his diet. Dr. Brewer's research demonstrates that good nutrition can help prevent still birth, premature birth, preeclampsia, anemia, placental abruption, infection and miscarriage.

The Brewer diet is built around ensuring you adequate amounts of protein every day. Proteins are broken down into amino acids by your body and used to repair and build body tissues and organs. Your baby will be built from these amino acids. It is the minimum recommended food you should eat every day, if you need more food eat more.

Unlike carbohydrates which can be stored as fat, your body has no mechanism to store extra protein. The unused proteins are broken down until they can be made into fate and the unique protein part is excreted from the body. If you do not eat enough protein to repair your body and build your baby, your body will begin to break down its own tissues to get building blocks for your baby and neither you nor your baby will have what you need to keep your bodies healthy. Contrary to popular belief, you cannot build a baby from the extra stores of fat on your hips.

Every day you need just about .4 grams of protein for each pound of body weight (0.8g of protein per kilogram of body weight). So a 140 pound woman should eat about 56 grams of protein a day when she is not pregnant. When you are pregnant, your protein needs increase. Dr. Brewer recommended aiming for 80 to 100 grams of protein every day while pregnant.

Eggs and Milk

To eat this much protein, Dr. Brewer recommended building your daily menu around 2 eggs and 4 cups of milk. Milk and eggs are inexpensive, readily available, provide high quality protein and can be prepared in a variety of ways. In addition to the protein, eggs and milk provide a variety of vitamins and minerals and are a good nutritional value for the number of calories they contain. By starting with 2 eggs and 4 servings of milk, you will already have 32 grams of protein every day.

Beans and Meat

In addition to the eggs and milk, you should eat 2 additional servings of high protein foods each day. Choose the protein foods you prefer to eat. Lean meats such as turkey, chicken, pork, lamb, beef or fish are all acceptable. Depending on the type of meat or fish you choose, you will have around 25 grams of protein per 3 ounce serving. Vegetable proteins are also acceptable when they are properly combined, however they do not provide the same volume of protein per serving so you may need to eat more food to reach the recommended 80-100 grams of protein per day.

Vegetables

Dr. Brewer also recommended you eat one or two servings of fresh green leafy vegetables every day. Green vegetables are rich in vitamins and minerals and provide folate. This includes the leafy greens such as mustard, collard and kale, dark lettuces, cabbage and broccoli. A serving of leafy vegetables is 1 cup.

In addition to the green vegetables, you should eat a yellow or orange vegetable 5 times a week. This can be squash, carrots, sweet potato, rutabaga or any other yellow or orange vegetable. You should also have two sources of vitamin C every day, such as a whole potato, large green pepper, grapefruit, orange, strawberries, papaya or tomato. A serving of vegetables is 1/2 cup chopped raw or cooked. The serving size of fruit is 1 medium piece or 1/2 cup of canned or chopped fruit. This will average out to about 5 servings of fruit and vegetables per day.

Whole Grains

The Brewer diet also includes 5 servings of whole grains or whole grain products every day. These include oatmeal, barley, brown rice, whole grain cereals, whole grain breads and other less common grains. A serving of a grain is 1/2 cup of the grain, 1/2 cup of pasta or rice, 1 slice of bread, 1 tortilla (or 1/2 if they are large), or 1 oz of a ready to eat cereal.

Dr. Brewer believed this was the minimum amount of food needed to maintain a healthy pregnancy. If you are hungry for more, eat more but do not try to consume less in an effort to control your weight gain. The amount of weight you gain is not an indicator of the nutritive value of your diet. Concentrate on choosing good healthy foods and eating enough to satisfy your body's needs.

Many women read the Brewer pregnancy diet and become concerned it recommends too much food to eat in one day. However, when compared to the food guide pyramid (the recommended eating plan from the United States Government), it only requires an extra milk and protein each day.

Remember, the serving size is not the same as what you may be used to considering a helping. One slice of bread is one serving of a grain, so when you use two slices for a sandwich you are having at least two servings (and more with many of the larger bread products available).

Dr. Brewer concluded his diet by recommending you salt your food to taste and drink water enough to quench your thirst. Your body needs both salt and water to function properly.

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