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Many women experience changes in blood pressure during pregnancy. While high blood pressure, or hypertension, is a risk factor for various complications, such as preeclampsia and preterm birth, low blood pressure, or hypotension, can also pose certain challenges. Here we discuss what to do to lower blood pressure when pregnant and ways to handle low blood pressure during pregnancy.

Lowering Blood Pressure During Pregnancy

First of all, it’s important to recognize the difference between normal blood pressure, prehypertension, and hypertension. The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women have blood pressure below 120/80 mmHg. If your blood pressure is consistently higher than that, your health care provider may monitor you more closely, prescribe some medications, and recommend lifestyle changes.

Some ways to lower blood pressure during pregnancy include:

• Managing stress: try relaxation techniques such as deep breathing, meditation, yoga, or guided imagery to reduce stress and promote calmness.
• Eating a healthy diet: consume a variety of foods rich in nutrients and low in salt, sugar, and saturated fat. Focus on fruits, vegetables, whole grains, lean protein, and low-fat dairy products.
• Staying active: engage in moderate physical activity for at least 30 minutes on most days of the week. Walking, swimming, cycling, or prenatal yoga are good options.
• Avoiding tobacco and alcohol: smoking and drinking alcohol can raise blood pressure and harm the fetus.
• Taking medications as prescribed: if your doctor has prescribed antihypertensive drugs or other medications, follow the instructions closely and report any side effects or concerns.

Handling Low Blood Pressure During Pregnancy

Low blood pressure is generally less worrisome than high blood pressure, but it can still cause dizziness, lightheadedness, fainting, or falls that may harm you and your baby. Some common causes of low blood pressure during pregnancy include:

• Changes in hormones and blood volume: as your body adjusts to the growing fetus, your blood vessels may dilate and your blood pressure may decrease.
• Lying on your back: when you lie flat on your back, especially in the third trimester, the weight of the uterus and baby may compress the inferior vena cava, a major blood vessel that returns blood to the heart. This can decrease blood flow and lower blood pressure.
• Dehydration: not drinking enough fluids can lead to low blood pressure and other problems such as constipation, urinary tract infection, or preterm labor.

If you experience symptoms of low blood pressure during pregnancy, such as blurred vision, nausea, chest pain, or shortness of breath, notify your health care provider. Depending on the severity and underlying cause of your hypotension, he or she may recommend:

• Dietary changes: eating smaller, more frequent meals, avoiding high-carbohydrate or high-fat foods, and increasing your fluid intake can help stabilize your blood pressure.
• Position changes: avoid lying on your back, and try lying on your left side, which can improve blood flow to the fetus and your heart.
• Compression stockings: wearing special stockings that improve blood circulation in the legs and feet may reduce orthostatic hypotension, a type of low blood pressure that occurs when you stand up quickly.
• Medications: some medications, such as fludrocortisone or midodrine, can increase blood pressure and expand blood volume. However, they should be used only under careful supervision and as a last resort, as their safety and effectiveness during pregnancy are not fully established.

By following these tips, you can help manage your blood pressure and minimize any potential risks to yourself and your baby. Remember to discuss any concerns or questions with your health care provider.

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