Pre-eclampsia and high blood pressure in pregnancy

Experiences of self-monitoring blood pressure in pregnancy as part of research

In addition to monitoring as part of routine medical care during pregnancy, some women had monitored their own blood pressure (self-monitoring or home-monitoring of blood pressure) using their own monitor at home or going into their GP surgery to use a monitor in the reception. Some women had checked their blood pressure only occasionally or as a one-off. Josie’s partner was medically trained and he sometimes took her blood pressure at home. Kate had a blood pressure monitor at home and used it once when she felt unwell during her pregnancy. 

Others had monitored their blood pressure more frequently. Some of the women we interviewed had taken part in a medical research study called ‘BuMP’ (‘Blood pressure Monitoring in Pregnancy’) which asked them to test their blood pressure in the morning and evening three times a week.
Adjusting routines to fit in self-monitoring

Some women found it easy to fit blood pressure monitoring into their normal routines. Others had to adjust their daily routines a little. The BuMP study asked women to check their blood pressure on three days each week, twice in the morning (five minutes apart) and twice in the evening (five minutes apart). Ruth X said this wasn’t “onerous” and soon became part of her normal routine. She dropped her first son off at school, checked her blood sugar (as she also had gestational diabetes) and blood pressure before going to work in the morning. Others found it more difficult to add blood pressure monitoring into their daily routines. For Ify, it was “hard work”. Women had different strategies. Some took their blood pressure monitors to work. Others preferred to leave theirs at home. Abigail worked from home quite often which made it easier to fit in blood pressure testing: “I could just put it on while I was sat down working”.

Some women found it hard to remember the days and times they were supposed to check their blood pressure. Philippa spoke about the frustration of getting to work and realising she hadn’t checked her blood pressure that morning and the monitor was at home. Some women had strategies to help them remember: setting alarms on their phones or computer calendars and making a chart. Some said their children were quite interested in the blood pressure monitor. Philippa’s two year old son wanted to know why she wasn’t talking when she used the machine and so she explained “[mummy is] just checking that the baby is okay”.

When daily routines changed—going away on holiday, having people visit, being in hospital (either for monitoring or the birth), starting maternity leave—it could become even more difficult to remember to take blood pressure readings on the ‘right’ days. Although the risk of developing pre-eclampsia continues for a few weeks after birth, almost everyone said it became much more difficult to monitor after their baby was born. Ruth Y said having a new baby at home means you “always have your hands full”. Women in the BuMP study were asked to keep checking their blood pressure for six weeks after birth. This was how Ruth X found out that a particular painkiller was making her blood pressure spike and she was then advised by her doctors to stop taking it.
Emotional impact of self-monitoring blood pressure

Looking for reassurance about their health was a key reason women self-monitored their blood pressure in pregnancy. It gave Sally “peace of mind”. Ruth Y said she found it “very reassuring and also very empowering” to be able to “take charge” of her health in this way. Some found it helpful being able to check their blood pressure whenever they wanted. Philippa and Amy both took their blood pressure when they had headaches (see section on signs and symptoms). However, blood pressure is only one piece of a jigsaw of symptoms. So, as Kat cautioned, it was important not to take self-monitored blood pressure results as “the be all and end all”: “there could be so many different factors that affect a certain reading and so it’s just good to be aware of that really”.
Women who went on to develop pre-eclampsia (or had done so in a previous pregnancy) were often more unsure about the emotional benefits of self-monitoring. Angela found checking her blood pressure could make her more anxious, which in turn made her blood pressure rise and worried her further. Vicki said self-monitoring was both good and bad – it was “nice to know that I could check myself” but also meant she was constantly reminded of the possible problems that could develop. But overall, Vicki felt it was better for pregnant women to know if there was a problem so they could get medical help sooner rather than later. 

Women had mixed experiences of giving their home-monitoring readings to health professionals. Kate had a high blood pressure reading but when she called the maternity ward, they said the monitor “must be faulty”. But the reading was correct and Kate was admitted to hospital a few hours later.

Some preferred taking their own blood pressure rather than a health professional doing it. Amy said “it’s like torture for me”, and she felt more comfortable at home. In contrast, Vicki thought her blood pressure was probably lower when it was taken during a stay in hospital as she was less busy and with “your feet up”. Most said they didn’t have a preference either way.


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