High blood pressure

If you have ongoing (chronic) high blood pressure and are taking blood pressure medicine, talk to your health professional before becoming pregnant (or as soon as you learn you are pregnant). Some high blood pressure medicines are dangerous to your fetus.

If you have high blood pressure during pregnancy, take steps that will help control your blood pressure:

• Go to all of your prenatal checkups. It is important to monitor your blood pressure because a dangerous increase in blood pressure can occur without symptoms. You may also want to keep track of your blood pressure readings at home.
• If you smoke, quit smoking. This helps decrease your blood pressure and improve your fetus's growth and health.
• Do not gain an excessive amount of weight during your pregnancy. Talk to your health professional about how much is healthy for you to gain.
• Get regular mild exercise during pregnancy. Walking or swimming several times weekly can be healthy for you and your developing fetus. Because high blood pressure may reduce the oxygen supply to the placenta and fetus, the National Institutes of Health recommends avoiding vigorous exercise if you have high blood pressure during pregnancy.⁹
• Reduce stress. Find time to relax, especially if you continue to work, are parenting small children at home, and/or have a hectic schedule.

By following general guidelines for a healthy pregnancy, you can help optimize your own and your baby's overall health and ensure that you are both in the best possible shape for handling the challenges of pregnancy, delivery, and recovery.

Expectant management for preeclampsia

If you develop signs of preeclampsia early in pregnancy, your doctor or nurse-midwife may prescribe something called expectant management at home, possibly for many weeks. This may mean you are advised to stop working, reduce your activity level, or possibly spend a lot of time resting (partial bed rest). Although partial bed rest is considered reasonable treatment for preeclampsia, its effectiveness is not proven for treating mild preeclampsia.²⁵ It is known, however, that strict bed rest for 3 days or more increases the risk of developing a blood clot in the legs or lungs (from about 1 in 1,000 to as high as 16 in 1,000).²⁶

Whether you are required to reduce your activity or have partial bed rest, expectant management severely limits your ability to work, remain active, take care of children, and fulfill other responsibilities. It may be helpful to follow some tips for dealing with bed rest.

You may be required to monitor your own condition on a daily basis. If so, you or another person (such as a trained family member or a visiting nurse) will:

• Monitor your blood pressure at home.

  High blood pressure: Checking your blood pressure at home

• Check your urine for protein.
• Check your weight. Before checking your weight, you should empty your bladder, take off your shoes, and wear about the same amount of clothing each time.
• Monitor fetal movements.

Keep a written record of your results, including the dates and times you checked. Take this record with you when you visit your doctor or nurse-midwife.