What is normal/dangerous BP during labour?

[BunnyN]

I have a tendency toward high blood pressure anyway and I know it tends to shoot up under stress. When I got my bp taken after an asthma attack recently for example it was 150/90 (usually it's under 130/85). I'm worried about being given meds for bp because they could make my asthma worse and the rescue medications for asthma make my bp even higher (they also have the potential to stall labour). Thankfully I'm generally a very calm person but I can't imagine that you can get around the fact that labour puts your body under stress. I would think it's pretty normal to have somewhat elevated bp during labour but was just wondering at what point doctors will freak out about it? Does anyone have personal experience to share?

 

[LYLLJellyTots]

Heya sweetheart, not sure about labour bp problems but don't let them give you any ace inhibitors / beta blockers that they usually use. The beta blockers are not very selective in blocking the right channels. They block the Beta receptors in your lungs / airways as well as the beta receptors in the blood vessels and can cause serious issues for asthmatics x talking from personal experience it is scary as anything it can make your airways close x also the ace inhibitors mimic asthma problems with a dry cough etc that irritates & can make your asthma worse x It doesn't happen for every asthmatic but with your problems already it's not worth the risk x

Calcium channel blockers seem to be to safest but as you said some (like the one I'm currently on) stop contractions / labour so it's weighing up the benefits of each x nifedipine is what I am on at the minute but with someone with as many allergens as you have I'm not sure what they would give you x as far as I know there is one other option but that takes a while to start to work and wouldn't be effective in labour I'd guess? I think they will go for a calcium channel blocker like nifedipine in all honesty x I think they would try and keep your bp under 160/95ish in labour but I don't have a clue what they will choose, maybe you need to speak to your consultant and have a plan in place? As you said steroids raise bp and it's weighing up everything, how bad the asthma is, the bp levels, the affects of the bp meds and the steroids x

Wish I could help more hun but I think you're going to need more expert advice than people on here might know x will be worth having in depth convos with your medical team when you can big hugs xxx

 

[BunnyN]

Thanks JellyTots, you get where I'm coming from . We are seriously reconsidering a home birth because of my allergy situation. Thankfully so far my daily bp is still behaving itself reasonably during the pregnancy but knowing how it reacts under stress now I'm wondering about labour. If we do do a home birth high blood pressure could get me transferred to hospital and I'm trying to get an idea of when this is advisable. I don't want to be overly cautious and end up going to hospital when I don't need to only to receive interventions/medications that just make things worse but obviously I don't want to take serious risks either. Of course it's something I'd talk over with my MW but I like to do some of my own research too, so far I haven't been able to find much solid information.

 

[LYLLJellyTots]

It's hard babe as there's not a lot online that will take in to account all of your criteria if that makes sense

- pregnant
- asthmatic
- severe allergies
- third trimester controlled bp that is elevated by steroids / asthma attacks / stress
- not suitable for beta blockers or ace inhibitors
- calcium channel blockers stop contractions

Etc etc etc x maybe do some reading up on meds used to lower bp during labour and what bp level would get you transferred to hospital with a home birth if you can? I personally wouldn't take the chance on a home birth with my previous experience but you know that could be different for you hun x you need to weigh up risks, both at home and hospital, whether hospital with preparation is safer than emergency transfer too x wish I could be of more help hun x

 

[BunnyN]

Yeh, it's when you put it all together it seems impossible, if it was just one of the problems it would not huge problem because if it turned into an issue I could just be medicated but when you put the asthma, possible high bp and my allergies together it seems to make an impossible situation. I cant even have the steroids because I'm highly allergic, the only medication I take for asthma is Ventolin (albuterol) for attacks but I try not to take it much because it plays havoc with my bp.

Our reasons for considering a home birth is that because my asthma attacks are caused by environmental factors like perfume an cleaning products I never get attacks at home because I have worked out what I can and cant use. The idea of hospital makes me nervous because I spent one very stressful night in a&e. The floors had been washed with bleach and it was making my attacks worse so after several hours I ended up leaving, worse than when I had arrived, and sitting in the car outside until I recovered. We have decided not to go to the public hospital (except in the case of emergency) because they won't give me a private room and I cant be on a ward with people using perfumed products like baby wipes etc. Plus my husband can't stay with me after the birth and I don't fancy being stuck on my own in the middle of an asthma attack trying to explain the situation in my second language. We have found a private hospital that we might use which doesn't smell of bleach and my husband can stay with me in the room. They were nice about perfumes and said they can send out a message to doctors and nurses when I go into labour to say not to come on shift with any perfume on but they can't really do anything about the ones already on shift. It would only take one doctor to come into the room with strong aftershave/perfume on and I could be in serious trouble. At least with a home birth asthma should be out of the equation. Of course if anything comes up that makes me high risk I'd feel more comfortable in hospital. Thankfully the problems I had earlier on with the placenta etc seem to have resolved completely so I'm hoping the rest of the pregnancy will be problem free. We do live very close to the hospital so transfer should be fairly easy. The only thing I'm left wondering about is if my bp will be an issue for a home birth but it feels like if I go to hospital and have problems with my asthma then EVERYTHING is going to become an issue. Of course everything will probably go smooth as anything and I'll wonder what I was worried about . In the mean time I'm just trying to do my research because my experience with doctors in the past is that they don't tend to pay enough attention until you are already in trouble.

EDIT: Wow, I just saw what I wrote and it looks like a really long saga, sorry about that. I guess it kind of helps me get my thoughts in order when I put things down in writing.

 

[LYLLJellyTots]

Don't be sorry at all hun, if your bp only raises because of the ventolin then it seems your best chance of avoiding things going wrong is a home birth, like I said my only worry with that would be if you need to be transferred they won't be prepared and there will be loads of things around that will trigger your attacks x it's a difficult situation to be in hun but no-one knows your body better than you x if you think your best chance of not having severe attacks is being at home then I think you have to try babe x

Whatever happens I hope things work out babe x Wish I could be of more help xxxx

 

[BunnyN]

Thanks. It helps just knowing someone gets where I'm coming from. You have also had some useful information about bp medications. Hope everything is going well for you.

 

[mw1]

It should be lower then 140/90

 

[BunnyN]

It should be lower then 140/90

Well mine did get above that in labour. My midwife was not too worried because it was only really high toward the end, it stayed quite low for the first half of the labour. I didn't have any other symptoms of PE and seeing as my bp is usually on the high side it wasn't surprising that it was up after 30 something hours of labour and she thought my body would cope well with it for a short time.