Can people with high blood pressure have a normal pregnancy?

Yes. Most people with high blood pressure before pregnancy will have a normal pregnancy. But people with high blood pressure before pregnancy have a higher chance of having certain problems when they are pregnant. These might include:

• Preeclampsia – People with preeclampsia have high blood pressure and too much protein in their urine or problems with certain organs. Preeclampsia usually happens during the second half of pregnancy, and can be a dangerous condition. It can cause problems with a baby's growth in the mother's uterus. It can also affect the mother's liver, kidneys, blood, heart, eyes, and nervous system.

• Placental abruption – During pregnancy, the placenta is the organ that brings the baby nutrients and oxygen, and carries away waste. It is attached to the inside wall of the uterus. A placental abruption is when part or all of the placenta separates from the uterus before the baby is born. If this happens, the baby might not get enough nutrients and oxygen.

• Slowed growth of the baby – The baby can be small and not grow normally.

What should I do before trying to get pregnant?

Talk with your doctor. If you are taking blood pressure medicine and your blood pressure is well managed, your doctor might want to switch you to a different medicine that is safer during pregnancy.

If your blood pressure is not well managed, your doctor will work with you to treat it.

Will I have tests during pregnancy?

Yes. At each visit, the doctor or nurse will check your blood pressure and your baby's growth. You will also have tests to check your baby's health at different times during pregnancy.

Will I need to take medicine during pregnancy?

It depends on how high your blood pressure is.

When your doctor or nurse tells you your blood pressure, they will say 2 numbers. For instance, they might say that your blood pressure is "130 over 80." Your doctor will recommend medicine if:

• Your "systolic" blood pressure (the top number) is 140 or higher, or

• Your "diastolic" blood pressure (the bottom number) is 90 or higher.

If you do start blood pressure medicine or switch to a new medicine, your doctor will make sure that it is safe to take during pregnancy.

Your doctor might also tell you to take low-dose aspirin during your second and third trimesters of pregnancy (after 12 weeks). This can lower your risk of preeclampsia. Do not take aspirin, or any other medicines, unless your doctor or nurse tells you that it's safe.

What symptoms should I watch for during pregnancy?

Your doctor or nurse will talk to you about how to recognize signs of preeclampsia or placental abruption, or other problems, during pregnancy.

Call your doctor or nurse right away if:

• You don't feel your baby move as much as usual.

• You start having contractions. A contraction is when the uterus muscle squeezes. This can cause pain and make your belly hard.

• You have belly pain.

• You have bleeding from your vagina.

• You have any symptoms of preeclampsia. These can include:

  • Bad headache

  • Changes in vision, such as blurry vision or flashes of lights

  • Pain in the upper belly

Can I have a normal vaginal delivery?

Yes. Most people can have a normal vaginal delivery.

Will my baby be healthy?

Probably. If you have high blood pressure during pregnancy, you are more likely to give birth earlier than normal. That's because if you have preeclampsia, a placental abruption, or a baby that is small for their age, the doctor might need to deliver your baby early. But if your blood pressure is managed during pregnancy, chances are good that your baby will be healthy.

What will happen after I give birth?

Your doctor or nurse will continue to check your blood pressure. They will also have you come in for a blood pressure check, or check your blood pressure yourself at home, several days later. This is because blood pressure sometimes goes down right after giving birth but then rises again. If this happens, your doctor might recommend starting blood pressure medicine again (if you stopped during pregnancy) or changing your medicine.