How I Almost Got Kicked Out Of My Midwife's Practice At My First Visit

There is never a dull moment at my house. Yesterday was my first official prenatal appointment at 8 1/2 weeks. We are planning a homebirth with local midwife who we interviewed a few weeks ago and loved. The first prenatal appointment is scheduled for 2 hours and I wasn't sure exactly what to expect. Our interview was a full hour and that felt long but the 2 hours flew by yesterday. There was lots of paperwork, lots of paperwork, and regular stuff like weight, peeing in a cup, measurements, history, and blood pressure. This is where we ran into trouble.

I don't have hypertension, never have but it does run in my family. In the past when I have been really sick my blood pressure tends to be high but when I am healthy is always normal. It is never low but falls around 120/80. I don't go to the doctor a lot but every time I have been in the past couple years my blood pressure has been great. In the past my blood pressure tends to run higher at the doctor than at home, nerves I guess.

So yesterday about 3/4 of the way through my 2 hour appointment the midwife's assistant takes my blood pressure and gets some astronomical reading, like 164/104. Holy crap, I don't think my blood pressure has ever been that high! So she has me lay on my right side for 10 minutes or so and retests while I am laying down. It went down but still really high, like 152/90. Yikes, people with high blood pressure can't have homebirths.

So the midwife schedules another appointment in 2 weeks instead of in a month to follow me more closely and sends me home with a blood pressure cuff to monitor my blood pressure at home. She says to take my blood pressure several times throughout the day, resting, after working out, etc. to get different readings. She also gave me a handout on other changes I need to make to lower my blood pressure. Guess what was #1? Eliminate coffee! Going from 2 cups per day to one was a big change for me but I started when we started trying to conceive so at this point I have adjusted. She said I could do decaf for a week or two but my goal is to move to no coffee at all. Wait, did you hear that? The coffee lover has to do without coffee. A sad day in my house but my baby and my health is most important so you do what you need to do. She also says to increase my running to daily since I am a runner. She said that is the single most important thing I can do to lower my blood pressure. She also suggested some diet changes and additional supplements. The whole thing caught us completely off guard.

Typically at your first visit the midwife collects a $500 deposit and sets up a payment plan. How much my insurance is going to cover is unclear, $900-$1200 at most but her fees are very reasonable and we are prepared to pay completely out of pocket if necessary. She said she is going to wait to collect our deposit until we see if my blood pressure comes down, because if it doesn't than I'll be referred to an OB right away. No more homebirth for me if this doesn't resolve itself ASAP.

The interesting part is when I came home I took my blood pressure and it was still through the roof. Hubby took his, which is never high and it was through the roof too. I took mine again about half hour later after resting and it was still very high. Since the midwife said to take my blood pressure several times throughout the day after various activities I took it before bed after I had been up and down the stairs a million times and doing laundry, etc. and amazingly enough it was 121/86. This morning when I woke up it was 119/76 and even after running around for a few hours this morning it is still 127/80. I hope it stays low and the changes I make keep it there.

The negative part of me is thinking though if this homebirth isn't meant to be and if I am going to be kicked out to an OB at some point I'd rather it be now. The insurance piece of homebirth is tricky so if it isn't going to workout I'd rather just meet my deductible with the OB.

Not sure what the rest of this pregnancy holds, I still have 7 more months to go, but wish me luck and send calming, relaxing thoughts my way.