Antenatal care -Hypertension can be dangerous during pregnancy, commonly referred to as high blood pressure.
Your GP/midwife will take your blood pressure at all antenatal care appointments.
You should see hypertension and pregnancy specialist to discuss the risks and benefits of treatment if you are expecting and have a history of hypertension/high blood pressure.
Suppose you develop high blood pressure for the first time during your pregnancy. In that case, your healthcare professional will perform antenatal checks, usually a midwife trained in caring for pregnant women with high blood pressure.
What is high blood pressure?
Hypertension is classified into three levels:
Mild – if blood pressure ranges between 140/90 and 149/99mmHg (millimeters of mercury); may need routine checks during antenatal care but usually does not require treatment.
Moderate – if blood pressure ranges between 150/100 and 159/109mmHg.
Severe – if blood pressure ranges 160/110mmHg or higher.
Guidelines for hypertension in pregnancy
If you are already prescribed blood pressure medicine
If you’re already taking blood pressure medication and want to have a baby, consult your GP or specialist first. They may change your medication before you become pregnant.
Inform your healthcare provider right away if you discover you’re pregnant. They may need to change your medication right away.
While pregnant, some high blood pressure medications may adversely affect the placenta and your baby, reducing blood flow.
Your pregnancy appointments | antenatal care
Routine checks carried out during antenatal care ensure that your high blood pressure is not affecting your baby’s growth and to check for a condition known as pre-eclampsia. So attend all your antenatal care appointments.
Your GP or midwife will check your blood pressure and urine for protein. In addition, you may be offered a PlGF (placental growth factor) test after 20 weeks of pregnancy to rule out pre-eclampsia.
A woman’s blood pressure usually drops during the first half of her pregnancy. It means you might be able to stop taking your medication for a while. However, one should do this only under the supervision of a healthcare professional.
How to lower your high blood pressure
Maintaining an active lifestyle and engaging in daily physical activity, such as walking or swimming, can help keep blood pressure within normal limits. In addition, eating a well-balanced diet and limiting salt intake can help lower blood pressure.
However, there isn’t enough evidence to suggest that dietary supplements like magnesium, folic acid, or fish oils can help prevent high blood pressure.
Pre-eclampsia
Pre-eclampsia is a condition that develops in some pregnant women after 20 weeks.
It is usually a placental problem that causes your blood pressure to rise. If left untreated, pre-eclampsia can pose a serious threat to both you and your child.
Pre-eclampsia is more likely to happen
- If you had hypertension before becoming pregnant
- If you had pre-eclampsia in your previous pregnancy
- If your mother or sister had pre-eclampsia
Because high blood pressure can make you feel fine, attending your regular antenatal care check-ups is crucial for blood pressure and urine testing.
Pulmonary hypertension
Pulmonary hypertension during pregnancy is a rare condition. However, pregnant women with pulmonary hypertension are at a high risk of morbidity and mortality.
Multidisciplinary services should manage pregnancy and delivery with experience in managing both pulmonary hypertension and high-risk pregnancies if pregnancy occurs and termination is declined.
Labour and birth
Because high blood pressure can make you feel fine, attending your regular antenatal care checkups is crucial for blood pressure and urine testing.
If you’ve been taking antihypertensive drugs throughout your pregnancy, continue to do so during labor.
Your healthcare provider will examine your blood pressure every hour if you have mild or moderate hypertension during labor. Providing your blood pressure stays within normal ranges, you should be able to give birth naturally.
Every 15 to 30 minutes, your GP will check your blood pressure during labor if you have severe hypertension. Your doctors may also advise you to have your baby delivered via forceps, ventouse, or cesarean section.
They may check your blood pressure after the birth.
If you had hypertension before becoming pregnant, you might need to continue your prenatal checkups two weeks after your child’s birth.
Checkups after the birth
Suppose you developed hypertension while pregnant and are still taking medication after the birth. In that case, you should be offered a doctor’s appointment two weeks after you transfer from hospital care to community midwives or two weeks after your home birth.
It is to determine whether your treatment should be changed or discontinued.
Everyone with hypertension during pregnancy should be offered an appointment with a general practitioner or a midwife 6 to 8 weeks after their baby is born.
This appointment is separate from your 6-week postnatal check to check your blood pressure.
Breastfeeding
If you need to take hypertension medication, you should be able to breastfeed. However, if
necessary, your GP can modify your treatment.
Hypertension medications can enter breast milk at very low levels, and the amount consumed by babies is minimal.
Most medications are not tested during pregnancy or breastfeeding. Also, the manufacturer’s information contains no specific safety concerns or evidence of harm, so any disclaimers or warnings are purely for clarity.
Talk to your midwife or GP about breastfeeding if you’re taking medication.
About Nurturey
The PinkBook from Nurturey is a “digital substitute” for the NHS’s Red Book. Pregnant women and parents can use the PinkBook to access their child’s health records, view upcoming health checkups, and get trusted information about their stage in the parenting or pregnancy journey directly from the NHS. If you are pregnant and have concerns, you can use the Nurturey pregnancy app to book an appointment with your GP/midwife. You can also schedule appointments, reorder prescriptions, and communicate with your GP.
