High Blood Pressure During Pregnancy
Some women have high blood pressure during pregnancy. This can put the mother and her baby at risk for problems during the pregnancy. High blood pressure can also cause problems during and after delivery.1,2 The good news is that high blood pressure is preventable and treatable.
High blood pressure, also called hypertension, is very common. In the United States, high blood pressure happens in 1 in every 12 to 17 pregnancies among women ages 20 to 44.3
High blood pressure in pregnancy has become more common. However, with good blood pressure control, you and your baby are more likely to stay healthy.
The most important thing to do is talk with your health care team about any blood pressure problems so you can get the right treatment and control your blood pressure—before you get pregnant. Getting treatment for high blood pressure is important before, during, and after pregnancy.
Complications from high blood pressure for the mother and infant can include the following:
- For the mother: preeclampsiaexternal icon, eclampsiaexternal icon, stroke, the need for labor induction (giving medicine to start labor to give birth), and placental abruption (the placenta separating from the wall of the uterus).1,4,5
- For the baby: preterm delivery (birth that happens before 37 weeks of pregnancy) and low birth weight (when a baby is born weighing less than 5 pounds, 8 ounces).1,6 The mother’s high blood pressure makes it more difficult for the baby to get enough oxygen and nutrients to grow, so the mother may have to deliver the baby early.
- Make a plan for pregnancy and talk with your doctor or health care team about the following:
- Any health problems you have or had and any medicines you are taking. If you are planning to become pregnant, talk to your doctor.7 Your doctor or health care team can help you find medicines that are safe to take during pregnancy.
- Ways to keep a healthy weight through healthy eating and regular physical activity.1,7
- Get early and regular prenatal careexternal icon. Go to every appointment with your doctor or health care professional.
- Talk to your doctor about any medicines you take and which ones are safe. Do not stop or start taking any type of medicine, including over-the-counter medicines, without first talking with your doctor.7
- Keep track of your blood pressure at home with a home blood pressure monitorexternal icon. Contact your doctor if your blood pressure is higher than usual or if you have symptoms of preeclampsia. Talk to your doctor or insurance company about getting a home monitor.
- Continue to choose healthy foods and keep a healthy weight.8
- Pay attention to how you feel after you give birth. If you had high blood pressure during pregnancy, you have a higher risk for stroke and other problems after delivery. Tell your doctor or call 9-1-1 right away if you have symptoms of preeclampsia after delivery. You might need emergency medical care.9,10
Your doctor or nurse should look for these conditions before, during, and after pregnancy:1,11
Chronic hypertension means having high blood pressure* before you get pregnant or before 20 weeks of pregnancy.1 Women who have chronic hypertension can also get preeclampsia in the second or third trimester of pregnancy.1
This condition happens when you only have high blood pressure* during pregnancy and do not have protein in your urine or other heart or kidney problems. It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after you give birth. However, some women with gestational hypertension have a higher risk of developing chronic hypertension in the future.1,12
Preeclampsia happens when a woman who previously had normal blood pressure suddenly develops high blood pressure* and protein in her urine or other problems after 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia.
Preeclampsia happens in about 1 in 25 pregnancies in the United States.1,13 Some women with preeclampsia can develop seizures. This is called eclampsia, which is a medical emergency.1,11
Symptoms of preeclampsia include:
- A headache that will not go away
- Changes in vision, including blurry vision, seeing spots, or having changes in eyesight
- Pain in the upper stomach area
- Nausea or vomiting
- Swelling of the face or hands
- Sudden weight gain
- Trouble breathing
Some women have no symptoms of preeclampsia, which is why it is important to visit your health care team regularly, especially during pregnancy.
You are more at risk for preeclampsia if:1
- This is the first time you have given birth.
- You had preeclampsia during a previous pregnancy.
- You have chronic (long-term) high blood pressure, chronic kidney disease, or both.
- You have a history of thrombophilia (a condition that increases risk of blood clots).
- You are pregnant with multiple babies (such as twins or triplets).
- You became pregnant using in vitro fertilization.
- You have a family history of preeclampsia.
- You have type 1 or type 2 diabetes.
- You have obesity.
- You have lupus (an autoimmune disease).
- You are older than 40.
In rare cases, preeclampsia can happen after you have given birth. This is a serious medical condition known as postpartum preeclampsia. It can happen in women without any history of preeclampsia during pregnancy.14 The symptoms for postpartum preeclampsia are similar to the symptoms of preeclampsiaexternal icon. Postpartum preeclampsia is typically diagnosed within 48 hours after delivery but can happen up to 6 weeks later.9
Tell your health care provider or call 9-1-1 right away if you have symptoms of postpartum preeclampsia. You might need emergency medical care.9,10
*In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) updated the definition of chronic stage 2 hypertension to mean having blood pressure at or above 140/90 mmHg.15 The American College of Obstetricians and Gynecologists’ recommendations on hypertension in pregnancy predate the 2017 ACC/AHA’s guideline and definition of hypertension and stage 2 hypertension.
For more information about high blood pressure during pregnancy, see the following resources:
- Pregnancy Complications (CDC)
- Treating for Two: Medicine and Pregnancy (CDC)
- Heart Health and Pregnancyexternal icon (National Heart, Lung, and Blood Institute)
- Preeclampsia and Eclampsiaexternal icon (Eunice Kennedy Shriver National Institute of Child Health and Human Development)
- Pregnancy Complicationsexternal icon (Office on Women’s Health)
- Preeclampsia and High Blood Pressure During Pregnancyexternal icon (American College of Obstetricians and Gynecologists)
- High Blood Pressure During Pregnancyexternal icon (March of Dimes)
- Preeclampsia Foundationexternal icon
- American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancyexternal icon. Obstet Gynecol. 2013;122(5):1122–31.
- Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancyexternal icon. Best Pract Res Clin Obstet Gynaecol. 2011;25(4):391–403.
- Bateman BT, Shaw KM, Kuklina EV, Callaghan WM, Seely EW, Hernandez-Diaz S. Hypertension in women of reproductive age in the United States: NHANES 1999-2008external icon. PLoS ONE. 2012;7(4):e36171.
- Callaghan WM, Creanga AA, Kuklina EV. Severe maternal morbidity among delivery and postpartum hospitalizations in the United Statesexternal icon. Obstet Gynecol. 2012;120(5):1029–36.
- Creanga AA, Berg CJ, Ko JY, Farr SL, Tong VT, Bruce FC, et al. Maternal mortality and morbidity in the United States: where are we now?external icon J Womens Health (Larchmt). 2014;23(1):3–9.
- Macdonald-Wallis C, Tilling K, Fraser A, Nelson SM, Lawlor DA. Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: findings from a prospective cohortexternal icon. 2014;64(1):36–44.
- Centers for Disease Control and Prevention. Treating for two: medicine and pregnancy. Accessed May 22, 2019.
- Liu Y, Croft JB, Wheaton AG, Kanny D, Cunningham TJ, Lu H, et al. Clustering of five health-related behaviors for chronic disease prevention among adults, United States, 2013. Prev Chronic Dis. 2016;13:160054.
- Mayo Clinic. Postpartum preeclampsiaexternal icon. Accessed May 22, 2019.
- Matthys LA, Coppage KH, Lambers DS, Barton JR, Sibai BM. Delayed postpartum preeclampsia: an experience of 151 casesexternal icon. Am J Obstet Gynecol. 2004;190(5):1464–6.
- Centers for Disease Control and Prevention. Data on selected pregnancy complications in the United States. Accessed May 22, 2019.
- American College of Obstetricans and Gynecologists. Preeclampsia and high blood pressure during pregnancyexternal icon. Accessed May 22, 2019.
- S. Preventive Services Task Force. Screening for preeclampsia: U.S. Preventive Services Task Force recommendation statementexternal icon. JAMA. 2017;317(16):1661–67.
- Bigelow CA, Pereira GA, Warmsley A, Cohen J, Getrajdman C, Moshier E, et al. Risk factors for new-onset late postpartum preeclampsia in women without a history of preeclampsiaexternal icon. Am J Obstet Gynecol. 2014;210(4):338.e1–8.
- Whelton PK, Carey RM, Aronow WS, Casey DE Jr., Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelinesexternal icon. 2017;71(6):e13–115.