Hypertension and Pregnancy

NEED TO KNOW
SPECIAL ISSUE: HIGH BLOOD PRESSURE
WORDS - Aarti Patel + Terri Fleming
ILLUSTRATION - Alexandra Folino

High blood pressure can often be brought upon by pregnancy, resulting in hypertensive disorders of pregnancy that include gestational hypertension and preeclampsia. These occur if a person’s blood pressure is greater than 140/90 or if they begin to experience spikes above their baseline readings 20 or more weeks into pregnancy. 

Gestational hypertension can sometimes lead to serious health problems, but most people will go on to have healthy deliveries and healthy babies. Preeclampsia is a dangerous form of high blood pressure that occurs 20 weeks or later in pregnancy, accompanied by protein in urine or other symptoms including chest pain and changes in vision. It can cause organ damage, most commonly to your liver and kidneys. Preeclampsia occurs in 5% to 8% of pregnancies, and often shows up earlier in Black people. Black people are also more than twice as likely to die from preeclampsia than white people. The causes of preeclampsia are not completely known, but certain factors can increase your risk, including: 

• Age under 20 or over 35

• A personal history of high blood pressure, preeclampsia, or autoimmune disorders

• First pregnancy 

• Being pregnant with twins, triplets, or more

• Diabetes

• Kidney disease

Many people do not experience any noticeable symptoms of preeclampsia, though some may experience severe headaches, blurry vision, and upper abdomen or chest pain. If you experience any of these symptoms, be sure to contact your doctor.

Common complications can include preterm labor and low birth weight for the baby. A serious complication can cause the pregnant person to have seizures, a condition called eclampsia. Preeclampsia can also cause long term complications, and can double a person’s risk of heart disease and stroke, even after giving birth. If you have experienced preeclampsia, it is important that you let your doctors know in the future so they can help monitor and reduce those risks. 

Preeclampsia is often resolved with the birth of the baby, so your provider may recommend induction or cesarean delivery. However, there is also a condition called postpartum preeclampsia that can develop after birth, typically within the first 48 hours, but even up to six or more weeks later. The symptoms are similar to preeclampsia during pregnancy but may be easier to miss while recovering from childbirth and caring for a newborn. 

Hypertension and preeclampsia can take a toll on your physical and mental health, and eclampsia can be life threatening for both the pregnant person and the baby. Early recognition and regular prenatal care is the best way to detect and prevent the serious problems associated with hypertensive disorders of pregnancy. Blood pressure should be measured at every prenatal visit. When urine is tested, ask your provider whether protein was detected, and how much. Be familiar with the symptoms associated with preeclampsia. If any of these symptoms occur after 20 weeks of pregnancy, inform your health care provider as early as possible.

In addition to high blood pressure readings, the following signs or symptoms could also signal a possible hypertensive disorder. If you are pregnant and experience any of these symptoms, be sure to contact your health care provider.