Tuesday, June 3, 2008

Strict bedrest

I went back to my OB yesterday. Despite having taken my blood pressure twice a day all weekend - and never having it as elevated as it was in the office (again, barely over the limit), it was up again yesterday. And my edema? Barely there too. I have seen pregnant women really puff up. I just don't understand what he is basing his concern on. Usually I can, with a little discussion, understand where my doc is coming from, but this seems so completely unreasonable.

Likewise, I am sure I seem completely unreasonable to my OB. He pretty much asked me why I was coming to see him. I told him I valued his opinion. "What is the point, if you don't take my advice?" was his reply. Can't I value his opinion without agreeing with it? I was trying to understand why a once-in-awhile, very slightly elevated b/p and slight edema would warrant bed rest - or even concern - but was getting nowhere. I finally asked, "What is your gut feeling about my symptoms?" He said, "My gut feeling is that you are heading toward toxemia."

So, there you have it. This OB - who I like a great deal, who was willing to let my sister go to over 42 weeks, who has told patients during labor to not push to hard to protect her perineum (two things I consider non-typical OB points of view), who comes highly recommended by my RE whom I respect a great deal, who has more than 20 years experience, has a gut feeling I am not going down the safest path. That is a little unnerving.

He reiterated that "If you were my patient, I would check your cervix and if it indicated induction would lead to labor, I would induce you today. If not, then I would put you on strict bedrest and see you in four days." His concern is that I would get worse during labor and he didn't want a phone call at 2:00 in the morning to hear that my b/p was 150/100 and my water had broken 18 hours ago. "Then we will be doing mag and (lots of details I missed) and likely end up doing a cesarean which is none of things that you want."

Then he softened a bit and asked which nurse took my b/p. When I told him, he said that nurse tends to hear it a little high - so he took it again. While he was taking it, I told him (trying not to tear up) that very little has gone the way I wanted it to on this journey and . . . "I know," he said gently.

By the way, the b/p was lower - I didn't quite catch the number because he was in a hurry to attend to an urgent situation in maternity. But it left me wondering . . . is all of this because a nurse tends to hear a higher number when taking blood pressures?

I left his office feeling more than a bit shaken. I called my friend (and doula) Stacey and asked if I could come over and figure out what to do. I probably mentioned Stacey before. She suggested we see a doctor after only 6 months of TTC - I ignored her advice. She was there for Ernest's birth. She used my midwife for the birth of her second child. She is also the middle ground neither my OB nor midwife are. Her suggestion? Take my OB's advice and take it easy then follow up with him in 4 days. What's the harm? "Wouldn't it be worth it to be able to have a home birth?" Brad concurred. So hear I am, taking it easy.

The good news is that when I called my OB to let him know - and to ask if he was willing to see me again (of course, he said) - he said that he thinks I will be ok. He was happy to see I hadn't gained any weight between the last 2 visits - meaning the edema hasn't gotten worse and if we manage things a bit now, it could mean keeping the PIH under control. "That way you will have the most options available when you go into labor." That was the most reassuring comment Brad and I could have hoped for. I felt like he was on my side again - that he wants what we want - not just a healthy baby, but a healthy baby at home.

12 comments:

Flo said...

Oh, I know how hard it is to be on strict bed rest! And I imagine it is even harder when you are actually feeling okay. Also, there is some unfairness in it all. You hope on an easy pregnancy if you have had a hard time before. Unfortunately it does not work like that...

I totally agree with your friend: no harm in taking it easy for a few days. Do try to enjoy it too, don't feel guilty about it! Let me know if you need any book suggestions! ;-)

xF

midlife mommy said...

Here's hoping that the four days will go by quickly, and that it turns out to be just a false alarm.

MrsSpock said...

Wow, by the time I delivered I has +3 pitting edema up to my thighs ( a total of 30 pounds worth by the time I got home), and had a couple BPs in the 130s in the OB office, but always fine at home. No one ever freaked out- of course, I had also stopped working by week 30. I have no doubt you will be fine- enjoy the extra rest and the homebirth!

m said...

kami, I am guessing it is probably very frustrating for you to be in bed for these next few days. But if a healthy home birth is still an attainable goal, chillin' for another 4 days won't be the worst, right? Please relax and enjoy it as much as you can. :)

familyoftwo98 said...

Wishing, hoping, and begging for an easy 4 days for you...followed by a healthy, happy uncomplicated home birth of the little butter fly.

My sister went through what your OB described...her husband called it "having toes on toes" when she was on the Mag for FOUR days while in labor for that whole time. So you rest up...and remember everyone has your best interests at heart!

Michell said...

Sorry about the strict bedrest part but your friend is right in that if it helps you with having a home birth it would be worth it. Hope the next 4 days go well and that things look better at your next appointment.

Summer said...

Oh, Kami. This sounds so hard. It's nice to hear you and your OB found a place where you both heard each other. It seems to me this situation is a tough one to call.

You will be in my thoughts these next few days and I hope you will be able to have some if not all of what you want from this birth.

Busted said...

Sounds like a stressful time - I'm glad you were able to get back to the comfortable feeling with your doctor. I hope your birth goes as you want it to.

Pamela Jeanne said...

Glad you're taking it easy...you've come so far. Want to see this result in a very happy ending! Take care, my friend...

stacyb said...

kami you're almost there...really fantastic that you have such good communication with your OB...four days bed rest will go by quickly. enjoy the time in bed -- actually it's great that you can rest up because birthing takes so much energy and all the days afterwards too!

singletracey said...

I can only imagine how hard it is to be on strict bed rest... but like you said.. if it allows you to have the baby at home.. then it will be worth it.

I dreamt of you last night. It was a beautiful dream :-)

JJ said...

Kami, Im so sorry about the *strict* bedrest--Ive never liked that word.
Do you like playing scrabble? Ill challenge you to a duel to keep your mind occupied=)