Hypertension living in pregnancy

Overview

High blood pressure (hypertension) in pregnancy means your blood pressure is higher than normal while you are pregnant. It's a condition that needs careful monitoring to keep both you and your baby safe.

Yes, high blood pressure is one of the most common health problems during pregnancy.

It can affect any pregnant woman, but is more common in first pregnancies, women over 40, those with a family history of high blood pressure, women carrying more than one baby, and those who were overweight before pregnancy.

Symptoms

Common symptoms

• Often there are no symptoms – high blood pressure is often discovered during a routine prenatal check.
• Some women may have headaches, blurry vision, or swelling in the hands, feet, or face.

Causes

Main causes

• Pregnancy-induced hypertension (high blood pressure that starts after 20 weeks of pregnancy)
• Chronic hypertension (high blood pressure that was present before pregnancy or that appears before 20 weeks)
• Preeclampsia (a more serious condition that includes high blood pressure and signs of damage to organs, often the kidneys)

Risk factors

• First pregnancy
• Age over 40
• Being pregnant with more than one baby
• Obesity before pregnancy
• Family history of high blood pressure or preeclampsia
• Pre-existing conditions like diabetes or kidney disease

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms above, call your local emergency number immediately.
• If your blood pressure reading is very high or you feel unwell, seek urgent care.

Book a routine appointment if:

• Attend all your prenatal appointments – your blood pressure will be checked at every visit.
• If you have been diagnosed with high blood pressure, you may need more frequent check-ups.

Diagnosis

High blood pressure is diagnosed by measuring your blood pressure with a cuff at your prenatal visits. A reading of 140/90 mmHg or higher is considered high during pregnancy.

Tests that may be done

• Blood pressure measurement at every prenatal visit
• Urine tests to check for protein (a sign of preeclampsia)
• Blood tests to check liver and kidney function
• Ultrasound to monitor your baby’s growth and fluid levels

What to expect at your appointment

If you are diagnosed with high blood pressure, your doctor or midwife will monitor you more closely. This may include more frequent appointments, home blood pressure monitoring, and extra tests to make sure you and your baby are doing well.

Treatment

Treatment focuses on keeping your blood pressure at a safe level to protect you and your baby. It often involves a combination of lifestyle changes and medication, if needed.

Self-care at home

• Get plenty of rest – lying on your left side can improve blood flow to your baby.
• Reduce salt in your diet – avoid processed foods and limit added salt.
• Stay active with moderate exercise as advised by your doctor, such as walking.
• Avoid alcohol, smoking, and illegal drugs.
• Monitor your blood pressure at home if recommended by your healthcare team.

Medical treatments

If lifestyle changes are not enough, your healthcare provider may prescribe blood pressure medication that is safe to take during pregnancy. The type and dose will be chosen carefully for you and your baby. Never stop or change medication without talking to your doctor.

When is surgery considered?

In severe cases of preeclampsia, early delivery of the baby (by induction or cesarean section) may be needed to protect both mother and baby. This decision is made by your healthcare team based on your health and your baby’s development.

Living with this condition

Living with high blood pressure during pregnancy means paying extra attention to your health. You will have more prenatal visits and may need to check your blood pressure at home. It’s important to follow your care plan and rest when you need to.

Lifestyle tips

• Take time to rest during the day – put your feet up and relax.
• Manage stress with deep breathing, gentle yoga, or talking to a friend.
• Avoid heavy lifting or strenuous exercise without your doctor’s approval.
• Keep a diary of your blood pressure readings and any symptoms to share with your healthcare team.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein. Limit salt, sugary drinks, and fatty foods. Gentle exercise like walking or swimming is often safe, but always check with your doctor first.

Mental health and emotional wellbeing

Being diagnosed with high blood pressure can feel worrying. It’s normal to feel anxious or stressed. Talk to your partner, family, or healthcare provider about your feelings. If you feel overwhelmed, ask about counselling or support groups for pregnant women.

Prevention

It is not always possible to prevent high blood pressure in pregnancy, but you can lower your risk by maintaining a healthy weight before pregnancy, eating well, staying active, and attending all prenatal appointments. If you already have high blood pressure, planning with your doctor before pregnancy can help.

Vaccines

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Screening programmes

Regular blood pressure checks at prenatal visits are the best way to detect and manage high blood pressure early.

Complications

If left untreated

• Preeclampsia – a serious condition that can harm organs like the liver and kidneys
• Eclampsia – seizures caused by severe preeclampsia
• Preterm birth – having the baby too early
• Low birth weight – the baby may be smaller than expected
• Placental abruption – the placenta separates from the womb too early

Long-term outlook

With regular monitoring and proper treatment, most women with high blood pressure during pregnancy have a healthy outcome for themselves and their baby. Your healthcare team will work with you to manage your condition and make the best decisions for your health. Many women’s blood pressure returns to normal after giving birth.

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