Continuing the story of my plan for a home VBAC, I was mulling what to do about Strep B testing, the enormous birthing tub was finally set up, and I was meeting with the midwife for a weekly appointment. It was then that she took my blood pressure and found that in the space of a week, it had jumped from about 115/70ish to 139/80ish, with 140/80 being the benchmark for preeclampsia, a mysterious and potentially fatal afflication for which the only cure is delivery of the baby. Yikes. For the first time, I was worried, even though she did not appear to be. She said she did not think I was preeclamptic; that elevated blood pressure was just one symptom and I had no others. I was swollen but not more than most pregnant women in the last weeks. Still, we agreed to monitor this closely.
The next day, I felt a bit more swollen, so instead of trekking a few miles to my midwife's office, I thought I'd go to the medical practice right next door to my office. In my naivete I thought I could simply call up and ask to have my BP taken. Which I did. And they all but laughed. Who is your primary care doctor, they asked. My primary care doctor had left the state some time ago and I never bothered to find a new one. (There is a shortage in Massachusetts, by the way, and long waiting lists.) Anyway, I was outraged that no doctor or nurse would take my BP, even though I had insurance and saw doctors in that practice.
I quit working that day and followed the midwife's advice to consume as close to 120 grams of protein per day as possible. Not easy to do. I tried to pack in the protein by drinking Kashi protein shakes, eating lots of eggs. It was gross.
A couple days later I felt a bit more swollen and wanted to check my blood pressure again. Although my midwife's office was not far away -- just a few miles -- it was more convenient to go to the medical practice office where my kids go for their pediatrician visits and where I had been seeing a certified nurse midwife for my primary screens and GYN appointments long before I was pregnant. I had not seen an OB in about 4 years, since my first son was born. So, I waddled into the office and asked if I could have my blood pressure checked.
"Do you have an appointment?"
"No," I said, giving her the name of provider I last saw there.
"Why do you want your blood pressure checked?"
I told her it was elevated.
She told me to take seat.
Then someone whom I think was a nurse called me in and asked with big huge eyes and hushed tones what was wrong. I repeated the situation again. She looked very concerned. She asked me what hospital I was delivering at. I stuttered. I said I just wanted my blood pressure checked. She asked me who my OB was. I felt like I was about to be grounded. For some reason I panicked and gave her the name of my last OB. I thought I would get kicked to the curb if I told her straight. Anyway, it was no surprise that when she took my blood pressure it was 140/80. The. Stress. Of. Going. To. That. Office. Was. Awful. She told me to get to the OB immediately.
I left really upset and called my midwife. She told me to go home and rest and offered to come to me to take my BP. It seemed like a silly thing for her to have to do, given that I had closer options.
I demurred, went home and had a protein shake. The next day, I was feeling stubborn. I figured I would go to the local health clinic around the corner from my house, a clinic where people without health insurance go. I knew they would gladly take my health insurance and co-payment and take my blood pressure. They did. It was a few points lower. I skipped the blood tests, went home, and had more protein. I talked my midwife, who reassured me that all was well.
Again she said she would come to me. But I figured I could wait until my next appoinment with her a few days out. At least I hoped I could. In the meantime, I fumed about the health care system.