I'll echo everyone else and say this is sadly serious and with natural birth hopes it really stinks.
I planned a non-intervention hospital birth for my first, but after my bp went consistently into the 140/90s in week 36, my doctor decided to induce at 37 weeks. My little guy was growth-retarded, though, and along with other complications ended up spending 4 days in the NICU. I did, however, avoid an epidural despite the mag (magnesium sulfate / mgs04 - prevents seizures from PE and CAN have nasty short-term side effects of nausea, extreme muscle weakness, mental confusion... but some women have no problem with it, so it's not guaranteed to be horrible if your wife needs it, and if she does need it, it is life-saving.)
My second birth was much better, amazingly so, but I had all kinds of contingency plans if I needed more intervention. I'm also happy to talk to you or your wife more on email or phone - email me through the forum if you're not already at the hospital!
In general, I thought very hard about what was most important to me in the birth experience and how the necessary interventions might impact my birth hopes. You may have vastly different reasons for wanting a home birth, but I can share my experience and hope it gives you some ideas.
Healthy mom and baby are at the top of the list, which I know are #1 for you also. This is also #1 for the medical people. It was very hard but very important for me to remember that when they were doing things to me I didn't want!
After that, I needed as much information as possible about the complications and the medical treatment plan. Sometimes in PE even that is not possible because the doctors need to move very fast. Does your midwife have hospital privledges, or at least hospital training? I would want her along as a doula instead of a midwife, a support person to explain what is happening if the doctors and nurses don't have time.
I wanted to avoid an epidural and other interventions because I wanted freedom of movement. With high bps, I knew I might be confined to labor on my left side to keep blood flow to the baby. You can still use relaxation techniques in bed - it's harder, but it can be done! Sometimes an epidural is necessary to bring bp lower, out of stroke range. I wasn't thrilled with this possibility - but knew it might be life-saving.
I wanted to have immediate skin-to-skin contact with the baby. I did not get that with my first baby, partially because of my doctor. For my second baby, I emphasized to my doctor how important that was to me, always adding that if the baby needed immediate care, the baby's health was obviously my priority. Depending on baby's health and mom's health at the time of birth, I knew I might have no contact, or only a few seconds or minutes of contact. I emphasized my hopes to my doctor and had to trust that she would help meet my emotional need for contact only if safely possible.
I wanted to breastfeed. I pumped for 9 weeks before my firstborn learned to nurse, so I knew I could do that again - I just didn't want to. I let my doctor and nurses and nursery staff know my hopes, and had to trust they would help me if the baby's health meant breastfeeding would have to wait.
I would recommend making a very short list of birth hopes. Again, if you'd like to email me privately I can share more of what - *in my limited experience* - is likely to be possible or not possible. I did massive birth planning for #2, and have some specific suggestions [:)]:
start with a short sentence about 'our birth plans have changed, we know mom's bp is serious, we are very happy to be at this hospital to ensure a healhty mom and healthy baby.' Butter them up with how grateful you are for their excellent training and medical and individual care! Personally, I wouldn't mention your home-birth plans... Then, 'we know the seriousness of mom's condition. we hope the follow things may still be possible": I'd list 3-5. For *ME*, they were:
honest and complete information about complications and prognosis and treatment plan
please don't offer pain medicine, I will ask for it if I need it - I appreciate other coping advice!
prefer a natural tear to an episiotomy Ã¢â‚¬â€œ thank you for your help avoiding either!
immediate and continuous skin to skin contact with baby if mom and baby are healthy
if emergency separation is necessary, kangaroo care as soon as possible
finger feeding if supplementary formula or pumped breastmilk is necessary Ã¢â‚¬â€œ please teach us!
Well, I have 6 [;)]. Good luck. You have my sympathies and highest hopes for healthy mom and baby, and a happy birth experience would be icing on that cake!