Blood pressure and pregnancy: One mom’s warning

One of the last things any new mom wants to learn after giving birth is that her health could be in jeopardy. The thought of not being able to enjoy life with your newborn, let alone live long enough to be in your children’s lives, can be disheartening for any parent.

For Christina Perry, age 33, this was an alarming possibility. But thanks to the proactive and caring clinicians who helped her during and after her pregnancy, she is able to look forward to healthier days with her growing family.

In January 2023, the La Mesa resident and not-for-profit agency professional delivered her first child, a daughter named Ava, at the Sharp Grossmont Hospital for Women & Newborns.

“I had a miscarriage before getting pregnant with Ava, and I also have a history of uterine fibroids, and a family history of diabetes,” says Christina. “Because of my medical history, I was excited but also anxious to find out I was pregnant.”

Certain women at higher risk of complications

Alison Ingram, manager of the Department of Obstetrics and Gynecology at Sharp Grossmont Hospital for Women & Newborns, says that certain medical conditions can put pregnant women, especially Black women, at higher risk for serious complications, including preeclampsia (high blood pressure during pregnancy) and gestational diabetes.

“Research demonstrates that hypertensive disorders of pregnancy remain one of the top two leading causes of maternal death across all racial and ethnic groups during pregnancy or within six weeks after delivery,” says Ingram. “And it is the leading cause of maternal death among Black women.”

Moreover, Chelsea Brauns, a nurse practitioner at the Postpartum Heart Health Clinic at Sharp Grossmont Hospital, further emphasizes that preeclampsia is one of the most common causes of maternal morbidity and mortality affecting 5% to 8% of all pregnancies in the U.S. The rate is 60% higher in Black women than their white counterparts.

Christina was diagnosed with gestational diabetes. On top of that, during a routine antenatal (before birth) testing appointment in her third trimester, clinicians also noticed elevated blood pressure readings.

“I worked with my care team to implement dietary changes — cutting out sugar and being strict on the amount of proteins and carbohydrates I could consume,” says Christina. “I also had to do insulin injections daily. That was probably one of the hardest parts during my pregnancy. But it was all for the safety of me and my baby.”

Not quite out of the woods

Christina delivered Ava via a scheduled cesarean section at 36 weeks without any complications. “That was uneventful,” says Christina. “I was more scared than I needed to be. Ava was perfect. Everything was good with her.”

Christina was discharged from the hospital two days after delivery. But her interactions with her care team continued.

“My doctors still referred me to the Postpartum Heart Health Clinic at Sharp Grossmont, just to be safe, since I had elevated readings while pregnant,” says Christina.

According to Brauns, the first few months after giving birth, known as the “fourth trimester,” can still pose potential after-pregnancy health risks for women.

“We place a huge amount of attention on all the health dangers during pregnancy that most women do not even think about potential health risks after they give birth,” says Brauns. “For most patients, they have been healthy their whole lives with normal blood pressure. However, we know that during their fourth trimester, women can develop high blood pressure up to 6 weeks after giving birth.”

Ingram adds that because of such risks, extra support for high-risk mothers is essential, even after they leave the hospital. “Enhanced postpartum surveillance for at-risk patients through referral to the Postpartum Heart Health Clinic is an essential part of our dedication to improving the comprehensive health of women at all stages of life,” she says.

Vital monitoring and treatment

Christina had her first clinic appointment a week after delivery. She says when she arrived, she was not aware of having any symptoms. “I felt fine — I was not even concerned about my blood pressure because when I left the hospital, it was fine,” she says.

However, during her visit, her first blood pressure reading was 180/110. So, they waited and took it again. “This time, it was not as high, but still too high,” Christina remembers.

Brauns says that high blood pressure after giving birth typically resolves in most women by 12 weeks postpartum with proper treatment and monitoring. Without proper treatment, women are at risk for stroke, seizure and even death.

“I did not know how close I was to having a stroke or seizure,” says Christina. “I thought because I had delivered the baby already, and my blood pressure was good, I was out of the woods. That was not the case. So I am really grateful my doctors referred me to the clinic.”

The clinic advised Christina to go immediately back to the Sharp Grossmont Hospital for Women & Newborns for further observation. She went straight to triage, was admitted and given medications to help decrease her blood pressure.

“Thinking back on it, everyone was calm,” Christina recalls. “I did not feel panicked. All of my health care providers were educating me every step of the way.”

Lifestyle changes to decrease risk

Brauns shares there are several medications that are proven to be safe both during and after pregnancy with breastfeeding mothers. She also encourages lifestyle changes to help lower blood pressure, such as eating a low-salt diet, healthy weight loss and regular exercise.

“It is important to work with patients to create a personal action plan with home monitoring, medications and lifestyle modifications to meet their blood pressure goals,” Brauns says. “Managing blood pressure requires a team effort by both patient and provider in order to reach success.”

Christina’s blood pressure readings normalized and the following day, she was able to return home to her family. She is still taking medications to keep her blood pressure stable and is continuing with virtual follow-up visits with the clinic. However, the goal is to eventually stop the medications.

“Pregnancy really magnifies what is good or bad about your health,” reflects Christina. “I’ve told my friends who want to get pregnant there are certain things you can do now to prepare to make sure you have a healthy pregnancy. Some things are hereditary, but there are a lot of ways we can take charge of our own health and outcomes. It has been an eye-opener for me.”

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