Postpartum perspectives on navigating hypertensive diseases of pregnancy: a qualitative study

Hypertensive disorders of pregnancy (HDP) affect 1 in 7 pregnancies and is on the rise. It is the most prevalent complication during pregnancy and the most severe diagnoses are associated with one-third of maternal deaths. Many birthing individuals with a history of severe HDP are unaware of their increased risk for cardiovascular disease and even fewer report receiving cardiovascular-specific follow-up care. A qualitative descriptive interview study was undertaken. Ten women, diagnosed with HDP, were recruited from a large hospital system in Washington, D.C. Inductive and deductive coding techniques were used to complete a thematic content analysis. Analysis revealed the following overarching themes that characterized participants' experiences of gestational hypertension and preeclampsia: (1) Information about Diagnosis, (2) Logistics of Managing Diagnosis, (3) Emotional Burden and (4) Thoughts on Future Pregnancy. Participants recalled receiving varying amounts of information after an HDP diagnosis regarding their health during the current or future pregnancy, as well as any follow up cardiovascular care. The most prominent way to manage their diagnosis was medical management of blood pressure. Many participants described experiencing stress or anxiety around their diagnosis, but few related the diagnosis to their thoughts on future pregnancies. This study sheds light on the often-overlooked lived experiences of individuals with HDP, underscoring the importance of further exploration across the severity spectrum of HDP.