Hearing the words "high blood pressure" during pregnancy can feel a little unsettling. The good news? Gestational hypertension is relatively common, and with close monitoring and the right care, most pregnancies go on just fine. Knowing what the numbers mean, understanding the warning signs, and keeping up with prenatal visits can help you stay one step ahead and focus on what matters most: taking care of yourself and your growing little one.
There's a reason your blood pressure gets checked at every prenatal visit. While many pregnancy symptoms announce themselves loud and clear, high blood pressure often has no obvious signs.
In many cases, a one-time high reading is nothing to worry about. But if your blood pressure stays elevated after 20 weeks of pregnancy, your provider may diagnose you with gestational hypertension, a condition that affects about 6 to 8% of pregnancies.[1]
Here's what you need to know about gestational hypertension, including what causes it, how it's diagnosed, and how your provider can help keep you and your baby safe and healthy.
What is high blood pressure?
High blood pressure — also called hypertension — is when blood exerts too much force against your blood vessels and arteries. Here's what that means in relation to your blood pressure reading:[2]
- The first number your doctor reads is the "systolic" (or top) number. This is the pressure against your arteries when your heart pushes the blood out.
- The second number you hear is the "diastolic" (or bottom) reading, which is the pressure when the blood is flowing back to your heart.
What is considered normal blood pressure during pregnancy?
Normal blood pressure is considered to be 120/80 or lower.
What is gestational hypertension?
You'll likely be diagnosed with gestational hypertension if:[3]
- You're at least 20 weeks pregnant
- You have a systolic blood pressure reading of 140 or higher
- You have a diastolic number of 90 or higher
Also called pregnancy-induced hypertension, it usually disappears after delivery.
After her blood pressure was 136/92 at her 32-week checkup, What to Expect Community mom catlover 2223 shares: "I’ve never had blood pressure that high before … My doctor is sending me home to log my blood pressure twice a day for two weeks. If my blood pressure is high on my next visit, we will do labs and diagnose with gestational hypertension."
Keeping track of pregnancy symptoms, appointments, and questions for your provider can feel like a lot. Download the What to Expect app to stay organized with week-by-week pregnancy updates, personalized guidance, and a place to keep all those "Is this normal?" moments in one spot.
How is gestational hypertension different from chronic hypertension?
If you had high blood pressure before getting pregnant, or if you get a high blood pressure reading before 20 weeks of pregnancy, you likely have chronic hypertension.
Your doctor will monitor you closely, since chronic hypertension puts you at higher risk of preterm delivery and preeclampsia, and your baby at risk of low birth weight.
What is considered low blood pressure during pregnancy?
If you're generally feeling well, nothing is really too low, within reason. But blood pressure that's abnormally low, which is called hypotension, is represented by a systolic reading lower than 90 or a diastolic number of 60.[4] It can lead to dizziness and fainting.
What causes gestational hypertension?
It's not clear what's behind every case of gestational hypertension, but risk factors include:
- Having a history of long-term high blood pressure or chronic kidney disease
- Having type 1 or 2 diabetes
- Carrying twins or multiples
- Being Black
- Being younger than 20 or older than 40
- Being obese
Another cause of an above-normal blood pressure reading may be a case of "white-coat hypertension" — a pretty common phenomenon (even if you're not expecting), where blood pressure temporarily spikes because you get nervous or worried in medical settings.
"I tend to get so nervous when I go to the doctor. My blood pressure is always higher at the doctor’s office. But I go home and my blood pressure is fine because I’m relaxed," shares Community mom ajj52.
Still, if your doctor notices your blood pressure is above 140/90 on two separate visits, whether you're just anxious when that cuff is placed on your arm or you have one of the above-mentioned risk factors, they'll likely diagnose you with gestational hypertension.
What are the symptoms of gestational hypertension?
One of the tricky things about high blood pressure when you're pregnant is that you likely won't notice any symptoms — you may not know your blood pressure is high until you get a reading.
What are possible complications of gestational hypertension?
High blood pressure taxes the blood vessels, which in turn decreases blood flow to the liver, kidneys, brain, heart, lungs, uterus and placenta. When gestational hypertension isn't under control and the placenta isn't getting enough blood, fewer nutrients and oxygen make it to your baby, which can slow your baby's growth.
Gestational hypertension can also morph into preeclampsia, a condition that occurs in up to 8% of pregnancies. It puts you at greater risk of:
- Premature delivery
- Fetal growth restriction
- Placental abruption
- Eclampsia
In the worst of cases, preeclampsia can lead to stillbirth, seizures, and stroke. Therefore it requires very close monitoring and treatment.
If you're diagnosed with gestational hypertension, be mindful of the symptoms of preeclampsia:
- Severe swelling in your hands, face, or ankles that doesn't go away
- A headache that doesn’t respond to medication
- Vision changes, including blurred or double vision
- Sudden weight gain unrelated to eating
- Abdominal pain, particularly in the upper abdomen
Can you track your blood pressure at home during pregnancy?
Yes, you can track your blood pressure at home when you're pregnant. While it's important to keep up with your prenatal appointments, a home blood pressure monitor can give you extra peace of mind between visits.
If you have high blood pressure or are at risk for pregnancy-related blood pressure issues, checking your readings at home can help you stay on top of your health and play an active role in your care. Ask your health care practitioner which monitor they recommend, and have them show you how to use it correctly so you can get the most accurate readings.
How is gestational hypertension managed?
Managing a case of high blood pressure in pregnancy usually involves:
- Taking medication such as low-dose aspirin to help prevent preeclampsia. Some types of medication for high blood pressure aren't safe during pregnancy, but your provider will prescribe a medication that's safe for you and your baby.[5]
- Sleeping on your left side to keep the pressure off of your inferior vena cava, the vein that carries blood from your lower extremities to your heart.
- Keeping in close contact with your health care practitioner, since lifestyle changes such as weight loss and reducing salt intake can't help with a high reading the way they can when you're not pregnant. In fact, high blood pressure in pregnancy is rarely lifestyle-related and should always involve regular medical check-ins.
- Potentially delivering your baby early, around 37 or 38 weeks — or when diagnosed if you're past that point — to reduce the risk of complications for you or your baby.
"Went to my 36-week appointment and BP was 178/110," says Community member ash16245. "... I have officially earned a diagnosis of gestational hypertension. Since I'm diagnosed with that, they are inducing me at 37 weeks."
You may have elevated blood pressure for six to eight weeks after your baby is born, so your provider will continue to monitor you in case of complications. Importantly, preeclampsia can worsen in the weeks immediately after delivery, and if you notice worsening symptoms, get evaluated immediately.
High blood pressure during pregnancy isn't that unusual, and fortunately it's very treatable. If you attend all of your prenatal care visits and follow your doctor's advice, there's a good chance you'll go on to have a healthy pregnancy and delivery. The key is catching any changes early, so don't hesitate to speak up if something feels off.
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