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In a recent episode of the Healthful Woman podcast, “Hypertension during and after delivery,” Podcast host Dr. Nathan Fox and guest Dr. Samantha Do discuss hypertension during and after pregnancy, with a focus on high blood pressure that may emerge during labor and delivery.

Why Blood Pressure Matters in Labor

Hypertension, or high blood pressure, can develop at any point in pregnancy, but it is very common during labor. Dr. Fox shared, “You’re more likely to have high blood pressure in labor than you are the week or two before labor for some reason.” Dr. Do and Dr. Fox believe this could be due to uterine contractions or hormonal changes. Dr. Do shared, “2% to 8% of pregnancies have gestational hypertension or preeclampsia. Pregnancy-induced hypertension and chronic hypertension are on the rise in America.”

Types of High Blood Pressure in Pregnancy

Hypertension is categorized based on when it develops. Chronic hypertension occurs when blood pressure is elevated before pregnancy or before 20 weeks. Gestational hypertension occurs when high blood pressure begins in the second half of pregnancy. Preeclampsia is a more severe form of gestational hypertension with risks to the kidneys, liver, and clotting system. Each type carries its own risks, and the timing of your high blood pressure influences your management and monitoring strategies.

Managing Hypertension in Labor

For women in labor, blood pressure is monitored more closely. If your blood pressure becomes dangerously high at 160/110 mmHg or above, medications are recommended to lower it. Women who already take blood pressure medication before pregnancy usually continue those treatments during delivery. Dr. Do shared, “If the blood pressures are severely elevated, in the 160 or 110 range that we talked about, then they might need magnesium to decrease the risk of seizures that go with that pregnancy-induced hypertension.” While effective, magnesium can cause flu-like symptoms.

What Patients May Notice

Most women with high blood pressure in labor will not feel any different. Possible symptoms can include headaches, vision changes, and abdominal pain. Low blood pressure typically causes more discomfort, such as dizziness or nausea, after an epidural.

Postpartum Hypertension

Some women develop postpartum hypertension, which may occur days to weeks after delivery. This occurs while pregnancy hormones are still in the bloodstream. Mothers are advised to monitor blood pressure at home. Dr. Do shared, “Everyone who’s had high blood pressure in labor or delivery or postpartum should go home, checking their blood pressures twice a day at least, and having a sense of what’s normal for them and calling their OB provider if it’s higher than what’s normal for them.”

Learn More

If you are interested in learning more about high blood pressure in pregnancy, labor, and postpartum, listen to the full episode of the Healthful Woman podcast. For pregnancy related questions, contact Maternal Fetal Medicine Associates by completing the online contact form.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!