Postpartum Hypertension: High Blood Pressure After Birth

Did you know that high blood pressure affects up to 28% of new mamas?

Postpartum hypertension can become an issue in the days after you give birth, even if high blood pressure was never a problem for you during pregnancy.

Lots of cases of postpartum hypertension resolve themselves in the first days of the baby’s life, but there are still some warning signs that everyone should know.

Here, we’ll look at what causes postpartum hypertension, how it’s treated, and the symptoms you should never ignore.

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Normal postpartum blood pressure

A normal blood pressure reading for new mamas is the same as for any other healthy adult – below 120/80mmHg.

Side note: If you’ve ever wondered what your BP reading means, the first number is the pressure in your artery while your heart muscle contracts (squeezes). The second number is the pressure when your heart muscle is relaxed between beats. It’s all measured in mmHg, or millimeters of mercury, in reference to the traditional instruments where doctors took the readings from a mercury tube.

Is it normal to have high blood pressure after pregnancy?

Yes, as we saw above, it’s quite common to have high blood pressure postpartum.

A high reading is anything over 140/90 mmHg. At that point, your doctor will start discussing options for getting it down.

Anything over 160/110 mmHg is considered an emergency, and that’s much rarer.

By the way, if you’re checking your blood pressure at home and notice that it’s trending high, you should mention it to your doctor straight away.

You’ll usually be checked for hypertension after you give birth and then again at your six-week checkup. But if you know that your BP is elevated, you shouldn’t wait until your next appointment before getting advice.

Why does postpartum hypertension happen?

So what causes postpartum hypertension? There are several reasons:

Pain

No surprise – being in pain raises your blood pressure.

Some pain relievers in the NSAID family (which includes ibuprofen) can also send your pressure up.

In fact, it’s such a common side effect that you probably won’t be offered NSAIDs if you have a history of high blood pressure.

Excess fluid

You had a lot of extra blood in your body while you were pregnant.

After you give birth, it hangs around until you essentially sweat the extra water out (postpartum night sweats, anyone?).

But the pressure in your arteries can rise a little while your arteries are still extra-full.

Sleep deprivation

New babies take a while to realize that daytime = playtime and night-time = sleep.

The first few weeks, while their circadian rhythm adjusts to the outside world, can be tough.

Sleepless nights put your body under stress, which can elevate your blood pressure.

General stress

Being a hospital inpatient? Pretty stressful.

Adjusting to life with a newborn? Not always as easy as it seemed in the books.

Even having visitors to meet the new baby can be really draining for new parents.

You’re a superhero, but you’ll probably need some time for all of this to feel normal. The stress of a brand-new routine can make hypertension worse.

A note on postpartum hypertension and breastfeeding

Breastfeeding and postpartum hypertension have never been linked.

Although it’s often tough to establish breastfeeding, it’s not enough to explain a case of postpartum hypertension.

If your high blood pressure is down to any of the factors above, you should hopefully be able to manage it at home until it returns to a normal level.

But you should never dismiss high blood pressure postpartum as just ‘one of those things’. That’s because there are some rare but serious conditions where hypertension is a main symptom.

Postpartum preeclampsia

Postpartum preeclampsia can happen between 48 hours and six weeks after you give birth.

It’s possible to develop preeclampsia even if your blood pressure was normal during your pregnancy checkups.

If you have a high blood pressure reading accompanied by any of the following symptoms, treat it as an emergency:

• Headaches
• Changes in your vision
• Pain in your upper abdomen
• Nausea and vomiting
• Difficulty breathing
• Sudden weight gain or swelling, especially around your face, hands, and feet
• Confusion
  Your doctor will check your blood pressure and look for protein in your urine to diagnose postpartum preeclampsia.

The condition is treatable, but it can lead to seizures if there’s a delay in treatment.

What causes postpartum preeclampsia?

The exact causes of postpartum preeclampsia are scientifically unknown.

Still, there are certain risk factors worth keeping watch for, such as:

• High blood pressure before pregnancy
• High blood pressure during pregnancy
• Obesity
• Diagnosis of diabetes (both types)
• Multiple babies e.g. twins
• Being under 20 years old or over 40 years old
• Family history of postpartum preeclampsia

HELLP Syndrome

HELLP stands for Hemolysis, Elevated Liver Enzymes, and Low Platelets.

It can also be referred to as atypical preeclampsia and is considered a more severe form of preeclampsia

Like preeclampsia, it can happen either in the final weeks of pregnancy or after you give birth. It can lead to severe anemia (iron deficiency) and organ damage.

The symptoms overlap a lot with preeclampsia. They also include:

• Shoulder pain
• Pain when breathing deeply
  These conditions are serious, but they are treatable, especially if they’re caught early.

That’s why it’s important that you and your loved ones can recognize the first signs and know when to get help.

How long does postpartum hypertension last?

When it’s ‘regular’ postpartum hypertension rather than a symptom of a more serious illness, your blood pressure should normalize within a few days.

Even if you need further treatment, hypertension should go away within 12 weeks.

If you have high blood pressure for longer, it’s more likely that you have chronic hypertension, and it simply wasn’t caught before you had all the extra medical attention that comes with pregnancy and a new baby.

How do you deal with postpartum hypertension?

Apart from stopping smoking, some of the best ways to control your blood pressure are:

• Eating a healthy postpartum diet
• Exercising when you can
• Unwinding at the end of the day
• Getting a good night’s sleep
  But that’s often a big ask when you’ve just had a baby.

If your blood pressure measures in at about 140/90 for 48 hours or more in the postpartum period, your doctor will usually intervene.

One such route is to prescribe ACE inhibitors—drugs that relax your blood vessels and bring your blood pressure down.

Alternatively, your doctor can prescribe Beta-blockers, which lower your heart rate.

There are questions around ACE inhibitors if you’re breastfeeding because the small amount that gets into your milk can affect your baby’s blood pressure too.

But this risk decreases as your baby grows. So, if you choose to breastfeed, you should have more treatment options as time goes on.

It's always best to speak to your doctor before taking these, regardless of what stage of pregnancy you're in.

They are the best allies for finding a solution that works for both you and your little one.