High Blood Pressure Means High Risk in Pregnancy

High blood pressure during pregnancy, also known as maternal hypertension, affects close to 15 percent of all pregnancies in the U.S.

Maternal hypertension can be serious and can endanger the life and well-being of both you and the baby. Some complications of high blood pressure during pregnancy require treatment in the hospital:

Preeclampsia: Pregnancy-related high blood pressure that puts stress on the heart and other organs such as the liver, kidneys, lungs, and eyes
Eclampsia: Seizures caused by high blood pressure during pregnancy
Strokes: Interruption of blood flow to the brain, resulting in weakness and permanent disability
Placental abruption: Separation of the baby’s blood supply (placenta) from the wall of the womb
Premature delivery: The need for the baby to be born earlier than expected, before growth and development are completed in the womb

High Blood Pressure and the Risk of Dying During Pregnancy

You can develop high blood pressure during pregnancy even if you’ve never had it before. When that happens, it’s called gestational hypertension. When you’ve already had high blood pressure before you become pregnant, it’s called chronic hypertension. Both types of high blood pressure raise your risk of dangerous complications during and immediately after pregnancy.

A 2022 study by the Centers for Disease Control and Prevention found that between 2017 and 2019, about one third of people in the U.S. who died during labor had high blood pressure. Most of them had developed it during pregnancy.

The danger of dying from a complication related to high blood pressure is greater if you’re over the age of 45 and/or medically obese, according to a Rutgers study. In addition, Black people, who are more likely to have high blood pressure-related health problems due to structural racism, are at particularly high risk of dying during pregnancy from a high blood pressure-related cause.

So it’s extremely important to understand what you can do to reduce your risk of high blood pressure-related complications before, during, and after pregnancy — especially if you already have high blood pressure, or your risk of having it is high.

Before Getting Pregnant

If your blood pressure tends to be high in the first place, do everything you can to maintain a healthy body weight and stay physically active. Talk to your pregnancy care provider about the safety of your medications during pregnancy and how to keep your high blood pressure under control.

Take care of your mental health and take action to reduce your stress level. Stress and anxiety can contribute to high blood pressure and have been linked to gestational hypertension.

Sleep deprivation and sleep apnea can also play a role in hypertension. So if you’re not getting enough sleep or don’t feel well rested in the mornings, talk to your doctor about what you can do to improve your sleep.

Also, if you had preeclampsia in a previous pregnancy, your risk of having it again increases with future pregnancies. Please discuss your individual risk for preeclampsia with your provider.

While You’re Pregnant

If you get pregnant and you already have high blood pressure, make sure your provider knows about it. Follow their advice and attend all your scheduled checkups.

You can also check your blood pressure regularly by yourself using a home monitor. If it starts going up above your normal blood pressure range, it’s much better to know sooner than later. Your provider can help you keep it under control. A blood pressure monitor may be at least partially covered by your health insurance; check with your insurer.

Keep eating healthy foods and monitoring your weight. That can help reduce your risk of developing hypertension or having it get worse.

If you’re an Independence Blue Cross (Independence) member, take advantage of our free Baby BluePrints® Maternity Program, which provides personal support throughout your pregnancy and after giving birth. Registered nurses who specialize in pregnancy-related care and are available by phone 24/7 can help you with any questions or complications you may experience.

Preeclampsia

Watch out for signs of preeclampsia, including:

Nausea and vomiting
Headaches
Eye problems such as blurry vision, light sensitivity, or dark spots in your vision
Belly pain
Swelling in your hands and face
Shortness of breath
Generally feeling unwell

Some of these symptoms — like nausea and vomiting — can happen in a normal pregnancy. But if you notice a sudden change, it’s better to get yourself checked out by a health professional.

Placental Abruption

Placental abruption is most likely to happen in the third trimester. This complication is very serious and can be life threatening to you or your baby.

Symptoms can include:

Vaginal bleeding
Belly and/or back pain
Tenderness or stiffness in your womb
Contractions, often very close together
Decreased movement by the baby

If you notice any of these symptoms, seek medical attention right away to find out if you need hospitalization. Your provider may recommend medicine to control your blood pressure, and a different medicine to help your baby’s lungs mature in case early delivery becomes necessary.

If the abruption is severe, or threatens you or your baby’s health, you’ll need an immediate delivery — most likely by cesarean section (C-section). When in doubt, call 911 immediately.

After Delivery

Preeclampsia can still happen after your baby is born — usually in the first 48 hours after delivery, but sometimes even up to six weeks or later. So, tell your provider immediately if you develop any symptoms. You may need emergency medical care.

Stroke can happen any time blood pressure is not controlled before, during, or after pregnancy. Even if the high blood pressure developed as a result of the pregnancy, strokes are still possible twelve or more weeks after delivery. Watch out for sudden:

Numbness in your face, an arm, or a leg, especially on one side of your body
Confusion, trouble speaking, or trouble understanding others
Vision problems
Loss of balance or coordination
Severe headache with no known cause

If you think you may be having a stroke, call 911 immediately so an ambulance can get you to the emergency room. Minutes count!

If you experience gestational hypertension, you may end up having chronic hypertension after your pregnancy. This is something you should work with your primary care provider to manage, because it can put you at higher lifetime risk of heart, brain, eye, and kidney disease. It can also lead to more high-risk pregnancies in the future.

And please pay attention to your emotional health. People who experience high blood pressure during pregnancy are more likely to experience depression, anxiety, and post-traumatic stress disorder after delivery. And these mental health conditions can become very dangerous to both you and your newborn child.

To help ensure your ongoing safety, Independence is working with Axia Women’s Health to support continued blood pressure monitoring during and after pregnancy using mobile apps. We’re also working with Penn Medicine and the Center for Digital Health to develop a chatbot that would provide 24/7 assistance to new mothers during the “fourth trimester.”

In addition, Independence covers services from Cayaba Care for eligible members who have certain risk factors, to help them stay healthy during and after pregnancy.

High blood pressure can cause problems during and after pregnancy. But working with your doctor to monitor and control your blood pressure, and knowing what warning signs to watch for, can help you and your baby stay healthy.