Blood Pressure

Your body is making tremendous adjustments to support your growing baby during pregnancy. The changes  inside your body are as impressive as the visible changes on the outside.

One of the most important “pieces of the puzzle” of health and wellness for both mother and baby is the information we can learn from the mother’s blood pressure.  High blood pressure in pregnancy can be an indication of a few serious health concerns.

Frisco Midwifery has created this resource to help you understand what the changes in your blood pressure mean, and what you may be able to do to support your body to try to reduce the risks of high blood pressure in pregnancy.

What’s the big deal about blood pressure?

For most women, the relaxing effect of progesterone causes the blood vessels throughout the body to relax a bit, causing her blood pressure in pregnancy to be a little lower than her non-pregnant blood pressure.  The blood pressure drops in early pregnancy, and stays low until the 3rd trimester when it may gradually rise again to help you circulate the increased blood volume you have late in pregnancy. 

Hypertension vs Preeclampsia:
What’s the Difference?

The average blood pressure range is between 110/70 and 120/80, although this varies a lot in pregnancy. If your blood pressure reaches 140/90 it is considered “pregnancy induced hypertension”.  Although gestational hypertension usually goes away after the birth, it may be an indication that you are at risk for hypertension later in life.  Hypertension can be caused by stress.  Some women get it simply because of underlying anxiety.  But in 7-10% of women, elevated blood pressure can be a part of a condition called pre-eclampsia.  We monitor blood pressure throughout pregnancy, and recommend some important strategies to support your healthy blood pressure.

If your blood pressure is above 140/90, we need to set up an appointment with a physician who can help us make sure everything is ok. Most of the time, a few changes to diet and implementing exercise and relaxation strategies can keep your blood pressure controlled. 

What effect does high blood pressure have?

Imagine what would happen if you use a high pressure hose to clean the screens on your windows.  The forceful water could bend the fine wires that make up the mesh of the window screen.  In a similar way, high blood pressure can cause damage to the mother’s kidneys, liver, and also to the placenta.  

Kidneys:  Kidneys have a filtration system in them that functions like a window screen.  High pressure blood can damage the filtration system, causing the filters to expand, reducing the amount of filtration.  We can see the amount of damage by doing a urine test to measure protein that passes into the urine. If your protein is in your urine, you aren’t getting the benefit of all that healthy nutrition.

Placenta:  The placenta attaches to the uterus with little fibers that resemble Velcro.  At high pressure, blood can cause damage to the connections, reducing the amount of nutrition and oxygen that travels across the placenta to the baby.  This can cause a wide range of consequences including restricting the baby’s growth.

What’s Our Plan?

We are a team.  If we have some concerns about your blood pressure, we will need to work together to support your health.

Our plan will include strategies to address your blood pressure from a few angles . .. Nutritional (food & supplements), Physical, and Emotional. Our plan also includes staying aware of your baby and your health and communicating a lot with your midwife team.

Nutritional Strategies

1.  Nutritional Consulting: Consult with our Homeopathic / Nutritional Counselor Niki Bisbee at Origin Wellness.  She will help determine if a nutritional approach can support your pregnancy.

2.  Protein: Eat 100+ grams of protein a day. At the heart of blood pressure issues is protein: how your body gets it, how your uses it, and how your baby benefits from it. Eating more protein helps your body make blood protein (albumin) which supports your blood vessels and eases the stress on your heart.

3.  Almonds:  7 raw organic almonds daily.  Almonds may reduce inflammation in the blood vessels.

4.  Healthy Nutrition: eat a clean diet with a variety fresh vegetables and clean sources of protein (meats, seeds, nuts, cheese). Try to eat vegetables and protein at every meal and snacks throughout the day.

5.  Hydration: ½ your body weight in ounces of water.  Add a pinch of sea salt to your water to improve hydration. Add fresh lemon to water to help prevent swelling.

Supplements

·    The Well Nut: There are some supplements at The Well Nut on Main Street. The health practitioner there may be able to help you find a supplement that will work specifically with your body. They carry 2 or 3 that may be appropriate.

• Milk Thistle:  Take 1000 mg of Milk Thistle tincture, spread out across the day (active ingredient silymarin)

• Calcium - Magnesium:  Take 1200 mg Calcium with Magnesium (less if you are getting protein from dairy).

• Low dose aspirin: Take a baby aspirin daily.  (DHA may be a suitable alternative, but studies indicate baby aspirin is more effective).

• ·Probiotics:  Daily  (Find a brand that has both Lactobacillus rhamnosus GR-1 & Lactobacillus reuteri RC-14 )

• Chlorophyll:  Up to 300 mg daily. Chlorophyll supports production of blood cells.

• Vitamin C:  1000 mg daily; divided. Vitamin C supports tissues and membranes

• Electrolytes: Add electrolytes to your water to help balance minerals in your body

Foods & Teas to incorporate

NORA Tea. Drink NORA tea (Nettles, Oat Straw, Red Raspberry and Alfalfa). Nettles and Alfalfa are traditionally known to support blood pressure. We have home-blended tea at the office. Pick some up when you' come to your next appointment.

• Yellow Dock Tea

• Dandelion Tea

• Pumpkin seeds

• Beans / Lentils

• Citrus Fruits

Physical - Exercise & Relaxation

• Exercise: Alternate between rest moderate exercise

• Meditation:: Begin a daily practice of relaxation / meditation.  Insight Timer is a good, free app that has guided relaxation scenarios that may help.

• Yoga: Yoga is a great practice that helps with stress management and also improved fitness. Bryne Boyer can help you customize a program that may help regulate your blood pressure and help manage stress triggers that make blood pressure raise even more.

Daily Observations:

• Fetal Kick Counts.  Please do standardized, fetal kick counts daily.  Be aware of your baby’s normal movements and contact your midwife if they change.  Read the handout “Fetal Kick Counts” for specific information about how to standardize them.

• Monitor Your Blood Pressure: Take your blood pressure at home in the morning and at night.  If you get a reading of 140/90 or greater, rest for 1 hour and take it again.  If it is still elevated, call your midwife.  Make sure you have been sitting still for at least 5 minutes.  Keep your feet flat on the floor.  Do not talk during the test.  Breathe slowly and stay totally relaxed.  Rest your arm on a supportive surface at about chest level while the test is being performed.

Call your midwife if you have:

• Swelling (“pitting edema”) legs, hands & face

• Headaches with Visual disturbance

• Pain in your upper abdomen

• Reduced fetal movement (Kick Counts)

If you have any of these symptoms with elevated blood pressure, your midwife will coordinate additional care and assessment. 

What Labs will I need?

• Comprehensive Metabolic Panel:  measures the current status of your kidneys and liver and levels of blood proteins. (Creatinine should be < 1.0)

• Complete Blood Count (platelets should be within normal limits)

• 24-hour Urine Catch.  (Protein < 300)

• Liver Panel (AST & ALT within normal limits)

• Biophysical Profile:  A Maternal Fetal Medicine physician will assess the health of the baby using a detailed ultrasound.

Sources:

ACOG.  Preeclampsia and High Blood Pressure During Pregnancy.  FAQ034 May 2018 

https://www.mamanatural.com/dates-during-pregnancy/