May is 2021 Preeclampsia Awareness Month.  May 22 is World Preeclampsia Day.  Preeclampsia, or high blood pressure in pregnancy, affects approximately 5-8% of all pregnancies in the United States and is a leading cause of maternal mortality and morbidity.  The 2021 campaign’s theme is Beyond Pregnancy.  When a pregnant person experiences preeclampsia either during their pregnancy or after giving birth (which can happen even if preeclampsia was not present during the course of pregnancy) the impact of this serious disease lasts long after the birth and postpartum period are over.  A traumatic pregnancy experience like preeclampsia can cause anxiety, depression and even post-traumatic stress disorder during the pregnancy and after the birth.  New parents should be screened for these conditions by their providers and also use a self screening tool like the Edinburgh Postnatal Depression Scale in between visits.

This disease can affect a person’s emotional and physical health for their entire lifespan.  Over the course of their life, people who experienced preeclampsia during the childbearing year are at an increased risk of future cardiovascular disease and stroke in the future.  This connection has been documented since 2011, but awareness and acceptance of long-term health impacts on someone who had preeclampsia is not well recognized beyond obstetricians and cardiovascular physicians.

Long after the pregnancy is finished, preeclampsia survivors must continue to be their own advocates, becoming informed and educated on how to manage their health care going forward.

The Preeclampsia Foundation and the International Society of the Study of Hypertensive Disorders of Pregnancy (ISSHP) has created a downloadable tool called "My Health Plan Beyond Pregnancy" for people who have had preeclampsia to use with their health care providers.  It is advised that preeclampsia survivors develop a personalized health plan to mitigate their risk.  Consistent blood pressure checks should be planned frequently for anyone who had preeclampsia or gestational hypertension during or after birth.  Regular exercise can help reduce the risk of a cardiac related event in the future.

With the increase in tele-health visits during the COVID-19 pandemic, people are moving through their pregnancy and early postpartum visits with fewer in-person visits and fewer prenatal and postpartum visits overall.  The in-person appointment is a time where a provider can monitor and assess the parent’s blood pressure.  In my classes, I am noticing that as a result of less in-person contact and no instructions to monitor blood pressure at home, my students and clients are being identified as preeclamptic or gestational hypertensive later in their pregnancy then previous families who did all their visits in person before the pandemic.

Childbirth educators and other professionals who have contact with pregnant and postpartum families should advise their students and clients of the short and longterm risks of preeclampsia and gestational hypertension and encourage them to have their blood pressure monitored frequently.  If diagnosed, sharing the after pregnancy resource linked above can help to reduce longer term impacts on their cardiac health.  The Preeclampsia Foundation can be a resource for parents who may be facing this diagnosis, before, during and after their pregnancies.

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