Let’s Talk About Blood Pressure in Pregnancy
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In the medical environment– your blood pressure is checked at every prenatal appointment, throughout your labor AND during your postpartum stay.
‘High’ blood pressure readings are often a reason for a medical induction. Or starting certain medications.
Is there a REAL reason to be concerned regarding this ‘number’? Let’s review some important topics regarding blood pressure in pregnancy:
What is blood pressure?
How will you know if your blood pressure reading is accurate?
What are the dangers of high blood pressure while pregnant?
How can you advocate for yourself?
In my 7 years as a Registered Nurse and 4 years as a Certified Nursing Assistant, I have taken a LOT of blood pressure measurements. I’ve also seen a lot of false readings. And a lot of interventions that were not necessary.
photo by jamilahallencreative
In this article, and like always, I want to help you advocate for yourself while in the medical environment (and truly for the rest of your life). I hope that this information will help you make informed decisions for yourself.
What is blood pressure?
Blood pressure is the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to all other parts of your body.
Blood pressure does not stay the same all the time. The pressure may be ‘higher’ when you are exercising or exerting yourself. And it may be lower when you are resting or sleeping.
Blood pressure is measured using two numbers: systolic pressure and diastolic pressure.
The systolic pressure (or the first number) is when the heart is WORKING or beating and pumping blood. The diastolic pressure (the second number) is when the heart is RESTING in between beats.
Normal/Abnormal Blood Pressure Readings
Normal- numbers of/or less than 129/80 mm Hg (millimeters of mercury)
High- when blood pressure consistently is 140/90 mm Hg or higher
Hypertensive crisis- if your blood pressure readings suddenly exceed 180/120 mm Hg (this is typically a medical emergency)
How will you know if your blood pressure reading is accurate?
I always laugh when I go to my own prenatal appointments & the medical assistant wheels in the blood pressure monitor. Most of them look like they have been used since the 1980’s.
Even working in the hospital as a Registered Nurse, I have seen some REALLY questionable blood pressure monitors.
It is nice to have a good idea of what your blood pressure normally is before pregnancy & postpartum. That way you can have an idea of your ‘baseline’.
For example, my blood pressure is typically 90/50. I have had medical professionals ‘freak out’ because this number seems low. I reiterate that it is my baseline & I am having no symptoms. This is where advocating for yourself comes into play 🙂
THE ONLY TRUE WAY TO HAVE A 100% ACCURATE BLOOD PRESSURE READING IS TO USE A MANUAL CUFF, CALLED A SPHYGMOMANOMETER, AND A STETHOSCOPE TO LISTEN TO THE HEARTBEATS.
Sorry, I am screaming. But, every medical professional should know how to complete a manual blood pressure check.
Other ways you can make sure your blood pressure reading is accurate:
-Assure you are calm during the measurement
-Loud sounds (TV, talking, baby crying, etc) should be muted during the reading
-Your legs should be uncrossed with feet or legs resting
-Try to avoid caffeine intake at least 30 minutes before the reading
If/when your medical provider gets a blood pressure reading that seems high, or ESPECIALLY if they want to intervene….ask for a manual blood pressure to be completed. This will ensure they have the MOST accurate result & you can move forward feeling good about the accuracy of the number.
What are the dangers of high blood pressure while pregnant?
Medical professionals check your blood pressure often throughout pregnancy. What are they checking for?
They are typically checking to make sure a few different complications aren’t developing….
Gestational Hypertension:
This is when you develop high blood pressure (typically after 20 weeks of pregnancy) and your organs aren’t affected.
Gestational Hypertension typically poses no risk to the pregnant mother & fetus.
Medical professionals will just keep a close eye on your blood pressure readings as well as any symptoms you may be having.
Continuous high blood pressure over time can pose certain risks so they will want to make sure the number is controlled.
Preeclampsia:
This is a condition that begins during pregnancy, usually after the 20th week. The symptoms may not present themselves until after delivery, or the postpartum period.
The symptoms of preeclampsia can be: high blood pressure, protein in the urine (detected my labratory tests), swelling (legs, hands, face, entire body), liver and/or kidney issues, headaches, and visual disturbances.
A severe & dangerous complication of preeclampsia is seizures or stroke. This is referred to as eclampsia and medical professionals want to intervene before any of these complications occur.
According to Harvard Health “experts are still not entirely sure what causes preeclampsia, but recent research has provided some good clues. Preeclampsia occurs when the placenta does not anchor itself as deeply as expected within the wall of the uterus during the first trimester”.
As you can see there are a few complications that come from having ‘high blood pressure’. When medical professionals are taking an ACCURATE blood pressure reading (a few different readings to be sure), listening to any symptoms a mother is experiencing, and treating each patient as an INDIVIDUAL there can be a few reasons for intervening.
How can you advocate for yourself?
It is 100% normal for your blood pressure to fluctuate during pregnancy. Your heart works a little harder, there is a higher volume (amount) of blood in your system, and your blood vessels relax more than usual while you are pregnant. These changes help support your growing body while supplying blood and nutrients to the fetus.
The first step to advocating for yourself, in my option, is educating yourself! Especially if you’re giving birth in a hospital environment. Education is the best thing you can equip yourself with.
Having knowledge of terms & a general knowledge helps you ask the right questions if the time should come.
The second step is not being afraid to ask for what you need. For example, if your blood pressure reading comes up ‘high’--asking for a manual blood pressure reading (or multiple) to assure the numbers are accurate.
Or asking for the medical professional to wait until you feel calm & relaxed to check your blood pressure.
The third step in advocating for yourself is remembering it is YOUR body. There are no ‘rules’ when it comes to the decisions you make. They are yours.
This means you are truly in control & your medical team with working WITH you. Not the other way around.
And if you don’t feel seen, heard, or comfortable with the medical team you are working with you can ALWAYS find someone new. Or ask to be seen by someone else.
It is important to be aware of the signs and symptoms of high blood pressure during pregnancy. Symptoms of high blood pressure may include:
- Headaches
- Blurred vision
- Swelling of the hands and feet
- Shortness of breath
- Nausea or vomiting
- Upper abdominal pain
Medical Professionals should always approach caring for you & your pregnancy individually. They should never place you into a box with ‘everyone else’ or think of you as a ‘number’. Unfortunately, this happens often in the medical environment.
Advocating for yourself can be difficult in the beginning, but I promise you it is SO worth it. Ask for clarification. Ask all the questions. And if you ever have a ‘high’ blood pressure reading you now know how to make sure it is accurate!
References
LeWine , H. (2023, June 27). Preeclampsia and Eclampsia. Harvard Health. https://www.health.harvard.edu/a_to_z/preeclampsia-and-eclampsia-a-to-z