Gestational Hypertension: Your Health Risks Don’t End with Delivery

Your blood pressure was normal, maybe even a bit on the low side, throughout your first trimester of pregnancy. Now, in the midst of your second trimester, your blood pressure reading is high, and you’ve been diagnosed with gestational hypertension. 

May is High Blood Pressure Education Month, and our women’s wellness and obstetrics team at Panhandle Obstetrics and Gynecology in Amarillo, Texas, is shining a spotlight on gestational hypertension, or high blood pressure that develops in the second half of pregnancy. 

Normal blood pressure during pregnancy

The term blood pressure (BP) refers to the degree of force (low, normal, or high) that your blood exerts against your arteries, or the blood vessels that transport oxygen-rich blood from your heart and lungs to the rest of your body.

What BP numbers measure 

Your BP reading consists of two measurements: The first number (systolic pressure) is the amount of force your blood exerts on your arteries as your heart beats; the second number (diastolic pressure) shows the force of your blood when your heart rests between beats. 

BP is normal when it’s lower than 120/80; it’s high when it’s at or over 130/80.

How pregnancy affects BP

Pregnancy is called “nature’s stress test” because of the higher demands it places on your cardiovascular system. Your blood volume increases significantly, making your heart work harder. This alone could lead to higher BP. 

But luckily, another physiological change of pregnancy provides protection: A surge of pregnancy hormones (progesterone, relaxin) causes the walls of your blood vessels to relax, effectively lowering or normalizing your BP despite the increased blood volume. 

In a typical pregnancy, BP actually tends to be on the low side for the first two trimesters, usually reaching its lowest point by week 28. Then, it increases gradually through week 40, reaching pre-pregnancy normal levels by delivery. 

When gestational hypertension develops

High BP is very common in the United States, affecting about half (48%) of adults. Some women have the condition before the start of their pregnancies, or develop it early on. This is called chronic hypertension. 

When you develop high BP in the second half of pregnancy (week 20 or later), you have gestational hypertension. This diagnosis means your blood pressure is at or above 140/90, but your other organs aren’t yet affected. Gestational hypertension risk is higher when:

• It’s your first pregnancy
• You’re carrying multiples 
• You’re younger than 20
• You’re older than 40
• You’re of Black ethnicity

Having obesity, diabetes, kidney disease, an autoimmune disorder, or a history of gestational hypertension in a previous pregnancy also increases your risk.

Prenatal risks of gestational hypertension

Gestational hypertension carries significant health risks — for you and your baby — during pregnancy and childbirth. High BP can reduce blood flow to the placenta, making it hard for your baby to get enough oxygen and nutrients in the womb. This can cause:

• Slow fetal growth
• Low birth weight 
• Premature birth 
• Fetal demise (stillbirth) 

It can also lead to placental abruption, a potentially life-threatening condition where the placenta separates from the uterine wall and causes heavy bleeding. Should high BP levels start to affect your organs (e.g., kidneys, liver, heart), the problem becomes a very serious condition called preeclampsia.

When high BP isn’t well-managed during pregnancy, you’re more likely to need pre-term labor induction and/or a C-section delivery. 

Continuing health risks in postpartum life

The higher your BP numbers, the greater the associated maternal and fetal health risks. Luckily, early diagnosis and proper management by you and your obstetrics care team can go a long way in keeping you and your baby healthy. 

In many cases, gestational hypertension doesn’t harm the mother or the baby and resolves on its own within 6-12 weeks of childbirth. Unfortunately, that’s not the end of the story: The effects of high BP during pregnancy can linger — even for a lifetime — leading to:

• Postpartum hypertension that persists for many weeks
• Postpartum preeclampsia, even weeks after childbirth
• An increased lifetime risk of chronic high blood pressure
• A much higher lifetime risk of heart disease and stroke

Women who develop gestational hypertension have double the risk of developing future heart disease compared to pregnant women with healthy BP levels. This risk is even higher for those who have pre-term delivery due to hypertension. 

Routine postpartum follow-up care is vital for ensuring timely intervention to protect your health. As time goes on, preventive care and heart-healthy living are just as vital for both you and your child. Babies born to mothers with high BP are more likely to develop high BP themselves and also have a higher lifetime risk of dying from heart disease. 

Expert obstetrics care 

Our team can help you navigate every aspect of your gestational hypertension diagnosis, from effective blood pressure control through pregnancy and delivery to postpartum monitoring and resources for long-term preventive cardiovascular health management. 

To learn more, call 806-359-5468 to schedule an appointment at Panhandle Obstetrics and Gynecology today.