Patient perspectives on the clinical management of pregnancy-related hypertension: A qualitative data analysis

Hypertensive disorders of pregnancy (HDPs) are common pregnancy complications. The only curative treatment for HDPs is delivery. However, studies have shown that low-dose aspirin reduces the risks of HDPs.

The aims of this study were to elucidate barriers and facilitators to implementing evidence-based treatment to prevent HDPs from the patient perspective; and to characterize patient clinical experiences of the management of HDPs.

A cross-sectional qualitative study.

Six focus groups were conducted with 26 birthing people who were pregnant between 2017 and 2024 with a history of HDPs. Thematic analysis was conducted by three independent coders using an ethnographic approach.

Patient experiences of optimal versus suboptimal care were characterized by three main areas: counseling and communication practices; decision-making practices; and intentionality of care. Intentionality as a guiding principle resulted in detailed counseling and communication of symptoms, severity, evidence-based management options, and implications. Additionally, intentional communication practices supported patient-provider relationship building and increased shared decision-making.

Patient experiences emphasize the need for healthcare providers to adopt more intentional, personalized approaches to care. It is crucial to acknowledge existing power dynamics and take deliberate steps to ensure that care remains patient centered. An intentional approach enhances patient confidence in the care team, promotes greater patient activation, and supports uptake of preventive measures such as low-dose aspirin.