Every pregnancy is as unique as the person experiencing it. As you become in tune with your body and yourself on the path towards expanding your family, be aware of the risk factors that might impact your pregnancy and health.
Due to a lifetime of navigating racism and sexism, Black women and birthing people experience negative health impacts (i.e. toxic stress) that can increase the risk of pregnancy complications. For Black women and birthing people, these elevated risks can lead to critical health issues for both birthing parent and baby.
Having a clear understanding of the challenges you may face is essential to advocating for yourself, being vocal about your needs and your experiences with your providers and support team.
Preeclampsia and hypertension are two of many conditions that Black women and birthing people are more likely to experience throughout pregnancy, when compared to other groups. These serious health conditions can contribute to a higher incidence of maternal death.
All of this can feel overwhelming, but knowing potential risks empowers you to advocate for the screening and care you deserve. Although, there is an elevated risk, this does not mean you can’t have a healthy pregnancy and baby.
High blood pressure or hypertension
Many women and birthing people have pre-existing health conditions that can lead to high-risk complications during pregnancy. High blood pressure or hypertension is a condition that disproportionately affects Black communities, with Black women being 46% more likely to experience the condition than any other group.
If you have hypertension before pregnancy or up to 20 weeks of pregnancy, this is called chronic hypertension. You should closely monitor your blood pressure and work with your providers to ensure that any maintenance medications you take are still the best choice during pregnancy. It’s okay to need different medication or a different dose during pregnancy. Some people find that their blood pressure changes during pregnancy. Even though they didn’t have high blood pressure before, they develop it after 20 weeks of pregnancy. Elevated blood pressure without protein in the urine or other symptoms of preeclampsia is called gestational hypertension.
Preeclampsia explained
Chronic hypertension and gestational hypertension can be monitored and managed during pregnancy. But sometimes, high blood pressure with additional symptoms develops. This can happen whether or not you had high blood pressure before. This is called preeclampsia. Based on how high the blood pressure is and the symptoms that develop, it is categorized into preeclampsia without severe features and preeclampsia with severe features. In rare cases one may develop seizures, a condition that is then called eclampsia.
Preeclampsia without severe features is high blood pressure in pregnancy with protein in the urine, and possibly other lab test changes. . Many birthing people may never feel any of the symptoms of preeclampsia with severe features, including severe headaches, unusual swelling, vision changes, upper abdominal pain and less frequent urination.
Preeclampsia without severe features may be similar in management to chronic or gestational hypertension, however preeclampsia with severe features needs more intensive treatment with medications to control high blood pressure and prevent seizures. Delivering your baby may also be the safest option when severe preeclampsia is diagnosed. This is true even if you are preterm.
What about diabetes?
Your body processes the food you eat into nutrients and energy. Diabetes occurs when your body cannot regulate the amount of glucose in your blood through its normal insulin production. Unlike Type 1 diabetes, which is generally diagnosed in childhood, or Type 2 diabetes, which can be diagnosed at any age, gestational diabetes presents during pregnancy.
As part of your pregnancy care, you will undergo initial glucose level screenings to ensure you are within a normal range. You will be asked to take the screening between the 24th and 28th week of pregnancy, unless you’re high risk and need to be screened even earlier. Most people have no symptoms of gestational diabetes, which is why screening is so important for everyone.
When gestational diabetes goes undiagnosed or untreated, there are serious risks to both you and your baby. Even though getting screening can be inconvenient and navigating care with gestational diabetes is hard, it’s essential for your short and long-term health.
Reviewed by the Ovia Health by Labcorp Clinical Team
Sources
- “Working Together to Reduce Black Maternal Mortality.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. April 9, 2021. https://www.cdc.gov/healthequity/features/maternal-mortality/index.html.
- Howell EA. Reducing Disparities in Severe Maternal Morbidity and Mortality. Clin Obstet Gynecol. 2018 Jun;61(2):387-399. doi: 10.1097/GRF.0000000000000349. PMID: 29346121; PMCID: PMC5915910.
- “High Blood Pressure during Pregnancy.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. May 6, 2021. https://www.cdc.gov/high-blood-pressure/about/high-blood-pressure-during-pregnancy.
- “Preeclampsia.” Mayo Clinic, Mayo Foundation for Medical Education and Research. March 19, 2020. https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745.
- “Gestational Diabetes.” Mayo Clinic, Mayo Foundation for Medical Education and Research. August 26, 2020. https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339#:~:text=Gestational%20diabetes%20is%20diabetes%20diagnosed,pregnancy%20and%20your%20baby’s%20health.
- “Racial/Ethnic Differences in Diabetes Screening and Hyperglycemia among US Women after Gestational Diabetes.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention. October 24, 2019. https://www.cdc.gov/pcd/issues/2019/19_0144.htm.
