As part of this year’s National Women’s Blood Pressure Awareness Week (NWBPAW), public health experts from key agencies including the National Heart, Lung, and Blood Institute (NHLBI), the Centers for Disease Control and Prevention (CDC), and the Office of Disease Prevention and Health Promotion (ODPHP) gathered to address a critical and growing issue: hypertension, often dubbed the ‘silent killer,’ and its increasing toll on pregnant women—particularly Black and Hispanic women.

With the release of new resources and guidelines, NWBPAW aims to underscore the urgency of this crisis and advocate for immediate action to tackle the systemic inequities that exacerbate these health disparities. For too many women, the joy of motherhood is marred by the looming threat of hypertension-related complications, and tragically, the outcomes can be fatal.

The Growing Crisis: Hypertension in Pregnancy

Hypertension, or high blood pressure, is a major risk factor for life-threatening conditions like preeclampsia and eclampsia, which can lead to severe complications or death for both mother and baby. During the NWBPAW presentations, it was revealed that Black women are 60% more likely to develop hypertension during pregnancy than their white counterparts, while Hispanic women face significant barriers to accessing adequate health care, often resulting in undiagnosed or poorly managed high blood pressure​.

High blood pressure in pregnancy, also known as gestational hypertension, typically develops after the 20th week of pregnancy and can escalate rapidly if left untreated. Preeclampsia, a dangerous condition characterized by high blood pressure and damage to organ systems, primarily the liver and kidneys, affects 2% to 8% of all pregnancies and is among the most common pregnancy complications. These numbers paint a grim picture, yet they only scratch the surface of the deep-rooted inequities at play.

Behind the Numbers: Systemic Disparities in Maternal Care

The NWBPAW event highlighted several systemic factors contributing to the high rates of hypertension in pregnancy among Black and Hispanic women. Among them, socioeconomic inequality, racial bias in health care, and unequal access to prenatal care were the most commonly cited​

For many Black and Hispanic women, the barriers to receiving consistent, high-quality health care are insurmountable. According to data shared during the event, these women are more likely to live in maternal care deserts, areas where access to comprehensive maternal health care is limited or nonexistent. As a result, many women go without routine blood pressure monitoring, an essential tool in detecting hypertension early on. The consequences are often dire: without early detection, conditions like preeclampsia can go unnoticed until they become life-threatening.

Beyond geographical and economic barriers, implicit bias in the health care system also plays a significant role. Studies have shown that Black and Hispanic women are less likely to have their symptoms taken seriously by health care providers, particularly when reporting common signs of hypertension, such as swelling or severe headaches. These biases result in delayed diagnoses and treatment, putting both mothers and babies at unnecessary risk.

A Health Crisis Rooted in Bias

Several personal stories shared during NWBPAW underscored the human cost of these biases. One story, recounted by a speaker during the event, involved a young Black woman who repeatedly sought medical attention during her pregnancy, only to have her concerns dismissed. Her complaints of headaches and dizziness—both common symptoms of preeclampsia—were brushed off as typical pregnancy discomfort. Tragically, she developed eclampsia in her third trimester, resulting in a premature delivery and a prolonged hospital stay for both her and her baby.

These stories are not unique. Across the U.S., Black and Hispanic women face similar struggles as they try to navigate a health care system that too often fails to address their needs. As one speaker at NWBPAW remarked, “Our health care system is not just broken—it is failing entire communities of women.”

Real-Life Stories of Struggle and Survival

Behind the statistics are real women who have faced the terrifying reality of hypertension during pregnancy. One such woman is Susan Bodiker, whose personal story illustrates just how devastating this condition can be. As a first-time mother, Susan didn’t anticipate complications. “My pregnancy was basically unremarkable until the last month,” she recalls. But suddenly, her blood pressure began to spike. “My blood pressure started going up and up to numbers I had never seen before,” she shares, her shock still palpable. “I didn’t know it was possible.”

Despite feeling that something was wrong, Susan didn’t fully grasp the severity of her situation. After undergoing a cesarean section, she vividly remembers lying in her hospital bed, staring at the monitor displaying her dangerously high blood pressure. “It was 167 over something, and I thought that can’t be right,” she says. But it was all too real, and her doctors warned that she was at risk of a stroke.

Susan’s story doesn’t end there. Even after the immediate danger passed, the impact of hypertension lingered. “From that day, 32 years later, I had high blood pressure,” she reflects. The long-term effects of hypertension became a constant in her life, something she wishes she had been more informed about. “I didn’t know what it was doing to me, and I didn’t know the questions to ask.”

Her experience underscores a common theme for many women—particularly Black and Hispanic women—who often put their own health on the back burner. “So much of your mind is focused on the baby,” she says. “Women don’t think about themselves. We are the caretakers of the world… but it’s not just about your baby; it’s about you.” Susan’s call to action is clear: “Ask for help, ask to be seen, and insist on being seen.”

The Policy Response: A Path Forward

According to new data released during NWBPAW, less than one in four women with hypertension during pregnancy have their blood pressure adequately controlled, leaving millions of women at risk. For Black and Hispanic women, the problem is even more pronounced. Fewer than 50% of Hispanic women eligible for hypertension medication are receiving it. These disparities reflect deep-rooted inequities that must be addressed through policy changes and improved access to care.

At the heart of the NWBPAW discussions was a clear message: policy changes are urgently needed to address the systemic issues driving maternal health disparities. The Black Maternal Health Momnibus Act of 2021 remains a key legislative effort, aiming to improve maternal outcomes by increasing funding for community-based programs, improving data collection, and addressing the role of racism in maternal health care.

Additionally, advocacy groups are calling for the expansion of Medicaid to provide coverage for postpartum care for up to one year after childbirth. This would ensure that women who develop hypertension during pregnancy continue to receive care after delivery, which is essential for managing long-term cardiovascular risks. Long-term monitoring is crucial as women with a history of pregnancy-related hypertension are at a significantly higher risk of developing chronic hypertension later in life​

Recommendations for Combating Hypertension in Pregnancy

NWBPAW experts presented several key recommendations for reducing the risks of hypertension during pregnancy, particularly among women of color:

  • Enhanced Screening and Early Detection: Health care providers should implement comprehensive blood pressure screening protocols for all pregnant women, particularly in high-risk groups. Routine blood pressure monitoring at every prenatal visit can detect potential issues early before they escalate into life-threatening complications​.
  • Self-Monitoring Tools: During the NWBPAW presentation, experts emphasized the importance of self-monitoring blood pressure at home. They recommended using blood pressure monitors validated by organizations such as the American Heart Association, ensuring that the cuff size is appropriate, and following the latest guidelines to ensure accurate readings. Regular self-monitoring allows women to stay vigilant between visits and alert health care providers if issues arise.
  • Culturally Competent Care: Providers should be trained to offer culturally competent care that addresses the linguistic and socioeconomic needs of Black and Hispanic women. This includes ensuring that patients’ concerns are validated and taken seriously.
  • Community-Based Outreach Programs: Expanding community outreach programs in underserved areas can play a critical role in educating women about hypertension and the importance of prenatal care. These programs should be designed with input from the communities they serve and include bilingual education materials​.
  • Long-Term Cardiovascular Monitoring: The risks of hypertension do not end after childbirth. Health care providers should offer long-term cardiovascular monitoring for women who experienced hypertensive disorders during pregnancy to prevent future cardiovascular complications​.

A Call to Action

The insights and data shared during NWBPAW make it clear: addressing hypertension in pregnancy is not just a medical issue but a social justice imperative. The disproportionate impact on Black and Hispanic women demands systemic changes to ensure that all women receive equitable access to care and treatment.

As public health experts continue to push for more equitable care, it’s clear that a comprehensive, community-centered approach is needed. This includes improving early hypertension screenings, enhancing health care provider training, expanding Medicaid coverage, and enacting stronger policies to address health care disparities. By focusing on prevention, early intervention, and equitable access to care, we can reduce the risks posed by this silent killer and save the lives of countless women and their babies.

For more information on the resources and expert recommendations shared during National Women’s Blood Pressure Awareness Week, visit WomensHealth.gov.