When I was pregnant with both of my children, my blood pressure was “textbook normal.” No complications, no red flags, nothing that signaled a problem was coming. But after giving birth, both times, everything changed.
With my first pregnancy, my blood pressure spiked so high at my postpartum visit that my doctor considered admitting me back into the hospital. At the time, I was shocked. Nobody had ever explained that high blood pressure after pregnancy is common, or why it happens. It wasn’t covered in my childbirth classes. My doctors didn’t bring it up during prenatal visits. I felt blindsided.
The American Heart Association recommends maintaining a blood pressure of 130/80 mm Hg or lower to support heart health.
By my second pregnancy in 2022, I thought I knew what to expect. But within a week of being home, I started having headaches. When I went to my doctor, my blood pressure was dangerously high. This time, I needed medication, and eventually, my dosage had to be doubled to lower my blood pressure. It took almost four months for my blood pressure to stabilize.
That’s why the American Heart Association’s new blood pressure guideline matters so much. One of the most important recommendations is that high blood pressure before, during, and after pregnancy must be monitored and treated quickly to reduce the risk of serious complications, including preeclampsia. This isn’t just about numbers, it’s about preventing strokes, heart failure, and long-term cardiovascular disease.
Here are a few things the new guideline highlights:
- During pregnancy: If you have ongoing high blood pressure, you should continue medication to keep your numbers lower than 140/90, as directed by your health care professional. This helps protect both mother and baby. Some people at risk may also be advised to take a low-dose aspirin daily to lower their chances of developing preeclampsia.
- After delivery: High blood pressure can develop for the first time after the baby is born, or it can persist after pregnancy. That’s why The American College of Obstetricians and Gynecologists (ACOG) recommends that if you have high blood pressure in pregnancy, you should get your blood pressure checked within the first three to 10 days after birth.
- At home: Using a home blood pressure cuff is one of the best ways to detect high blood pressure early. Writing down your numbers and sharing them with your doctor can make a huge difference. Of course, not everyone has easy access to a blood pressure cuff or the resources to get one, an important reminder of the need for affordable tools and equitable access to care.
- Long-term health: Having high blood pressure during or after pregnancy isn’t just a short-term problem. It also raises your chances of developing chronic high blood pressure and heart disease later in life. That’s why experts encourage checking your blood pressure at least once a year, even long after your pregnancy is over.
High blood pressure puts too many women at risk during and after pregnancy.
For Black women especially, this conversation is urgent. We are at higher risk for both hypertension and maternal complications, yet our symptoms are too often dismissed or minimized. While the guideline outlines best practices, the reality is that not all women have the same opportunity to receive care that is accessible, culturally responsive, and respectful.
I was fortunate: I’ve worked for the Heart Association for a decade, so I already knew the basics of how to take my blood pressure at home and how important it is to keep monitoring. Most new moms don’t have that background knowledge, and they deserve clear, consistent education, not just a prescription and a pat on the back.
That means strengthening Medicaid coverage, so all parents can access the postpartum checkups, medications, and monitoring that save lives. It means passing policies like paid family and medical leave (PFML), so new parents have the time to heal and attend critical follow-up appointments without risking their jobs or income. It means investing in programs that make home blood pressure monitors, community-based doulas, and culturally responsive care accessible to every family, not just those who can afford it.
No mother should be blindsided by high blood pressure after birth – and no family should have to navigate those risks without the full support of our health care system and public policies.
April Wallace is the National Strategy and Partnerships Sr. Manager for Voices for Healthy Kids, which powers the National Collaborative for Infants & Toddlers (NCIT). She has extensive experience leading national partnerships and health promotion programs. April earned her bachelor’s degree in health sciences from Howard University and a master’s degree in healthcare administration and education. A native of Detroit, she now lives in Prince George’s County, Maryland, with her husband and two sons.
