How to Navigate a Hypertensive Disorder in Pregnancy

A high-risk pregnancy can leave you feeling like you’re walking on pins and needles. You’re most likely to be diagnosed with a hypertensive disorder in pregnancy if you:

• Pregnant with more than one baby
• Older than age 35
• Actively smoking
• Using recreational drugs and/or alcohol
• Had previous high blood pressure during pregnancy
• Don’t have a maternal fetal medicine (MFM) specialist

Care from a Maternal-Fetal Medicine (MFM) Specialist

When it seems like your pregnancy may be riskier, how do you enjoy your pregnancy and advocate for your health and the health of your baby? This is a great question. Having risk factors means you may have to see your pregnancy care provider more often, or you may need to regularly see a MFM specialist as they specialize in supporting high-risk pregnancies.

When you have a higher risk pregnancy, it’s important that you can see these types of specialists and attend all of the appointments. Together, it’ll be a team effort to maintain you and your baby’s health, and to prevent more serious complications from occurring.

Pregnancy and High Blood Pressure Concerns

Blood pressure (BP) is a measure of how hard the blood pushes against your blood vessel walls when your heart beats to pump blood through your body. If your blood pressure becomes high, your baby may not get enough blood and oxygen through the placenta. One way to ensure you’re managing your health and baby’s health well is to ask to be seen by a MFM specialist. You may be asked to take medicine to manage your blood pressure. Alert your pregnancy care provider if your blood pressure becomes greater than 140/90.

Blood Pressure Medications

There are different types of medications that may be prescribed to help you manage a healthy blood pressure. Beta-blockers can slow your heart rate to decrease your blood pressure. Vasodilators open blood vessels, they prevent the muscles from tightening, and the walls in the arteries and veins from narrowing. These medications allow blood to flow more easily through the vessels and into the placenta. This means the heart doesn’t have to pump as hard thereby lowering your blood pressure.

Preeclampsia Warning Signs

During pregnancy, always call your pregnancy care provider or 911 if you experience:

• A headache that won’t go away
• Sudden swelling in your hands, face, feet, or ankles
• See spots or have vision changes
• Have difficulty breathing or catching your breath
• Sense upper right abdominal pain
• Feel severe anxiety or confusion

Any one of these symptoms together with a high blood pressure reading are considered preeclampsia. Preeclampsia usually occurs at 20 weeks gestation or after and can potentially lead to kidney and heart problems. It can also lead to worsening conditions like eclampsia (seizures) and stroke. Your pregnancy care provider can monitor your blood work and blood pressure, and you can track your baby’s movements daily. An important note is that preeclampsia can also occur up to six weeks postpartum.

Self-Advocacy

As a nurse, I’m passionate about empowering you to ensure your high blood pressure is managed well, even if the information is scary.

• Ask your pregnancy care provider for your blood pressure readings at each visit, and keep a log so that you can track your numbers and report any readings if outside your normal range to your pregnancy care provider
• Limit salt in your food
• Avoid pre-packaged and fried foods
• Take supplements such as iron, vitamin D and/or calcium that can improve your baby’s growth and brain development for their first year of life

Experts recommend a daily low-dose aspirin during pregnancy to prevent preeclampsia, and for individuals with any of the following risk factors:

• History of preeclampsia
• Chronic high blood pressure (hypertension)
• Type 1 or 2 diabetes
• Carrying more than one baby
• In vitro conception
• Being a Black or Indigenous woman who may experience discrimination due to historical health inequities

Prenatal Visits and Plan Early

A calendar full of prenatal appointments can seem overwhelming.

• For each healthcare visit, write your questions down or save in a mobile app, and take the time you need to ask all of them so that you make the most of your time with your pregnancy care provider and MFM specialist.
• If you work, talk with your health benefits representative and ask if you qualify for an intermittent leave of absence, and what benefits will cover you and your baby before, during and after birth.
• Build your birth and postpartum plans so you’re prepared if your health worsens, and you need to give birth sooner.
• Know that you may need to birth early if your blood pressure remains high, and this may mean your baby may spend some time in the neonatal intensive care unit.
• Order a breast pump from your insurance carrier so that you have it early and ready to use should you need to pump your colostrum to feed to your newborn to promote their growth and immunity.

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AUTHOR

LaShea Haynes