High Blood Pressure Before or in Early Pregnancy

Author: Dr. Vrolijk   |   Updated: August 23, 2025   |   Disclaimer   |   Review Process   |   References

Author: Dr. Vrolijk   

Updated: August 23, 2025   

Disclaimer   |   Review Process   |   References

Have high blood pressure and are pregnant or planning to get pregnant? Wondering what this means for your baby? Not sure what steps to take next?

This page explains what high blood pressure means for you and your baby, what you can do at each stage of pregnancy, and when to get help.

What Is Hypertension Before & During Pregnancy?

Hypertension is when your blood pressure is high most of the time. Usually you’ll take your blood pressure at home to figure out if you have chronic hypertension. Multiple readings let us know how high blood pressure is most of the time. One reading can be high from things like stress or even having to go to the bathroom. Learn more about what can raise your blood pressure numbers.

You can have chronic hypertension before you get pregnant or that starts in early pregnancy (before 20 weeks). This is different from gestational hypertension. Chronic hypertension is not caused by pregnancy and won’t go away after you give birth. Learn more about gestational hypertension here.

Whether you’re thinking about getting pregnant or already are pregnant, you can protect yourself and your baby by taking care of your blood pressure.

How Is It Diagnosed?

  • You have hypertension before you get pregnant → Learn about how hypertension is diagnosed
  • You have 2+ readings that are 140/90 or higher during early pregnancy (before 20 weeks)

Blood pressure naturally goes down a little during the second trimester. But this doesn’t mean your hypertension has gone away.

Why Taking Care of Your Blood Pressure Helps

For Your Baby

  • Supports healthy growth
  • Helps them stay in the womb until they’re ready
  • Supports normal heart development

For You

  • Keeps your blood sugar stable during pregnancy
  • Increases your chances of vaginal delivery when possible
  • Reduces risks during and after birth
  • Lowers your chance of developing preeclampsia

The Types of High Blood Pressure During Pregnancy

Chronic hypertension (this page): High blood pressure you had before pregnancy or that starts early (before 20 weeks)

Gestational hypertension: High blood pressure that starts after 20 weeks
→ Read more about gestational hypertension

Preeclampsia: High blood pressure plus other symptoms that need immediate treatment
→ Read more about preeclampsia

What You Can Do

It’s never too late to get care. Find your current stage below to see what you can do now. 

Things You Can Do at Any Stage:

  • Track your blood pressure – If you don’t have a monitor at home, talk to your care team. They might be able to help you get one. Your health insurance might pay for one too.
  • Ask your doctor about your medicine – Keep taking it until you talk to them, so your blood pressure doesn’t get too high. They’ll help you make a plan to keep you and your baby healthy.
  • Try to eat less salt – Salt raises blood pressure. Watch out for processed foods, since they tend to have a lot of salt.
  • Try to stop smoking and vaping – If you smoke or vape, ask your doctor about ways to help you stop. Most people need help.
  • Stay in touch with your care team – Let them know if you’re having trouble making it to appointments, getting your medicine, or getting healthy food. They may be able to help.

Talk to your doctor before trying. They can help you have the healthiest pregnancy possible. Your doctor can:

  • Make sure your medicines are safe for pregnancy
  • Help you create a plan to control your blood pressure
  • Help you take care of any other health problems

Things you can start today:

Remember: These changes are hard for most people. Be patient with yourself. Any time you make a healthy change is a win.

Track your blood pressure and share your readings with your doctor. If you don’t have a monitor at home, ask your care team about getting one. Some health insurance companies will pay for them too.

Make a doctor’s appointment to:

  • Get blood and urine tests to check how your body is handling pregnancy
  • See if your medicines need to be changed
  • Ask about healthy changes for you and your baby
  • Make a blood pressure monitoring plan

Tell your doctor about:

  • Your blood pressure readings from before pregnancy
  • Past pregnancy problems
  • Any medicines or supplements you take

Track your blood pressure and share your readings with your doctor. If you don’t have a monitor at home, ask your care team about getting one. Some health insurance companies will pay for them too.

 

Make regular doctor’s appointments to:

  • Get blood and urine tests to make sure your body is staying healthy
  • Have ultrasounds to make sure your baby is growing well
  • Ask your doctor about any medicines you might need
  • Let your doctor know about any concerns or changes

Talk to your doctor about:

  • Whether you should take low-dose aspirin
  • How often you should check your blood pressure
  • Safe exercise and diet

Track your blood pressure and share your readings with your doctor

More frequent doctor’s visits to:

  • Watch your baby’s growth more closely
  • Check for signs of preeclampsia → Learn more about preeclampsia
  • Make a plan for delivery
  • Ask your doctor about when you should get help right away
  • Learn about what to expect during delivery

For 6 weeks after giving birth:

  • Keep checking your blood pressure
  • Write down your numbers
  • Call your doctor if the top number is over 140 or the bottom number is over 90 on 2 or more readings

Get help right away if you have:

  • Sudden worse swelling of face or hands
  • Headache that won’t go away
  • Seeing spots or other problems with seeing
  • Pain in the top part of your belly
  • Pain in your shoulder that feels different than normal
  • Feeling like you’re going to throw up or throwing up (after you are pregnant 20 weeks or more)
  • Trouble breathing
  • Very high blood pressure (top number 160 or more or bottom number 110 or more)

Get Help if You Have:

  • Severe symptoms: Very high blood pressure (160/110+), trouble breathing, severe headache
  • Vision/neurological: Seeing spots, vision problems
  • Physical changes: Sudden face/hand swelling, unusual belly or shoulder pain
  • Other concerning signs: Persistent nausea/vomiting after 20 weeks, fast weight gain

Quick Answers

Not necessarily. Many people with chronic hypertension have vaginal deliveries. Your doctor will help you make the safest delivery plan based on:

  • Your specific situation
  • Your baby’s health
  • How well your blood pressure is controlled

With good medical care and blood pressure control, most people with chronic hypertension have healthy babies. Uncontrolled high blood pressure can cause problems like slow growth or early delivery. This is why regular check-ups and taking your medicine are so important.

Your healthcare team needs to watch you and your baby more closely. They’re checking to make sure:

  • Your blood pressure isn’t getting worse
  • Your baby is growing well
  • You’re not developing preeclampsia
  • Your medicines are working

About Medications

The most common ones used are labetalol and nifedipine. However, what’s safest for you depends on your body. This is why you should talk to your healthcare team. They will suggest a medication that keeps your blood pressure normal and protects you and your baby.

Many blood pressure medicines are safe while breastfeeding. These are options where the amount in breast milk doesn’t affect your baby. There are more options than during pregnancy, so your medication might change. You can ask your doctor or your child’s pediatrician.

Your blood pressure medication might need to be changed. Pregnancy changes like increased blood volume can affect what treatment you need. Contact your healthcare provider to let them know your blood pressure readings. They’ll help you make a plan.

About Lifestyle Changes

Focus on limiting salt (less than 1 teaspoon per day or 2,300 mg) and processed foods. You don’t need a perfect diet. Small improvements help. Ask your doctor if you have questions about specific foods. Every person is different.

Many people with high blood pressure can safely exercise during pregnancy. But check with your doctor first. They can tell you what type and how much is safe for your body.

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Related Guides

Gestational Hypertension

Find out what gestational hypertension is, what to expect, and ways to take care of yourself & your baby.

Preeclampsia

Learn what preeclampsia is, what symptoms to watch for, and when to get help right away during pregnancy.

Talking to Your Doctor about Medication Problems

Find ways to start conversations with your doctor about problems with your medication, including scripts to get you started.

August, Phyllis, and Arun Jeyabalan. “Preeclampsia: Prevention.” UpToDate, Vol, 2017, 1–23.

Battarbee, Ashley N., Rachel G. Sinkey, Lorie M. Harper, Suzanne Oparil, and Alan TN Tita. “Chronic Hypertension in Pregnancy.” American Journal of Obstetrics and Gynecology 222, no. 6 (2020): 532–41.

Kametas, Nikos A., Diane Nzelu, and Kypros H. Nicolaides. “Chronic Hypertension and Superimposed Preeclampsia: Screening and Diagnosis.” American Journal of Obstetrics & Gynecology 226, no. 2 (February 1, 2022): S1182–95. https://doi.org/10.1016/j.ajog.2020.11.029.

​Panaitescu, A. M., A. Syngelaki, N. Prodan, R. Akolekar, and K. H. Nicolaides. “Chronic Hypertension and Adverse Pregnancy Outcome: A Cohort Study.” Ultrasound in Obstetrics & Gynecology 50, no. 2 (2017): 228–35. https://doi.org/10.1002/uog.17493.

Sanusi, Ayodeji A., Rachel G. Sinkey, and Alan TN Tita. “Clinical Trials That Have Changed Obstetric Practice: The Chronic Hypertension and Pregnancy (CHAP) Trial.” Clinical Obstetrics and Gynecology 67, no. 2 (2024): 411–17.

​Society for Maternal-Fetal Medicine; Publications Committee. Electronic address: pubs@smfm.org. “Society for Maternal-Fetal Medicine Statement: Antihypertensive Therapy for Mild Chronic Hypertension in Pregnancy-The Chronic Hypertension and Pregnancy Trial.” American Journal of Obstetrics and Gynecology 227, no. 2 (August 2022): B24–27. https://doi.org/10.1016/j.ajog.2022.04.011.

Terwisscha van Scheltinga, Josien A., Ineke Krabbendam, and Marc E.A. Spaanderman. “Differentiating between Gestational and Chronic Hypertension; an Explorative Study.” Acta Obstetricia et Gynecologica Scandinavica 92, no. 3 (2013): 312–17. https://doi.org/10.1111/aogs.12061.

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