Hypertension in pregnancy

Today’s blog is about high blood pressure or hypertension in pregnancy. While I am a huge advocate for home birth, women who have hypertension in pregnancy are safest birthing in the hospital. The development of hypertension is one of the most common reasons women risk out of home birth care prenatally.  6-9% of all women develop this during pregnancy, but that number has increased significantly over the last 20 years.

Factors that increase risk of hypertension in pregnancy

Women in the U.S. are now frequently delaying having children until their 30s and even 40s. Our cardiovascular systems are more susceptible to hypertension in pregnancy after 35, due to the physical stress of pregnancy and aging vessels. Many women are also entering pregnancy overweight or obese, a big change from 15-20 years ago, and another risk factor for hypertension. Other risk factors include diabetes in or before pregnancy, race (Southeast Asian, Hispanic, Native American, African American), pregnancy with twins/multiples, and having your first baby.

What can you do to decrease your risk?

  • Start pregnancy at a normal weight or body mass index (BMI) of <30 prior to conception. There are calculators online, where you plug in your weight and height. Talk to your midwife about evidence based ways to lose weight if that is indicated.
  • Focus on only gaining the amount of weight that is appropriate for your BMI.
  • Consider planning your pregnancies before you are 35 years old.
  • While regular exercise in pregnancy does not directly prevent hypertension in pregnancy, it can keep you within your weight gain goal.
  • Eat foods high in magnesium daily. This includes almonds/cashews/brazil nuts, dark leafy greens, dark or at least 70% chocolate, lentils, and seeds. There is some evidence that magnesium can slightly reduce the blood pressure of adults with hypertension. You could also take a magnesium supplement in pregnancy if you have risk factors for GHTN.
  • Early research indicates that beetroot juice and hibiscus tea, both high in nitrates, may slightly decrease your blood pressure. This may be helpful for women whose blood pressure is increasing at the end of pregnancy or who are hovering on the edge of chronic hypertension. Consult your provider before you try these options.
  • If you have what is called white coat hypertension, or high blood pressure only when at your provider’s office, talk to your provider about monitoring your pressures at home, and how you should communicate your levels to them. Here is a site to help you on your way. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20047889

I hope you have found this information helpful so that you can have a healthy pregnancy and uncomplicated birth. If you want more information about how to remain healthy in pregnancy, or utilize food and supplements safely and effectively, start by reading my post on choosing a prenatal vitamin http://thrivemidwives.com/best-prenatal-vitamins/.

Families Thrive Midwives

I loved the ease and convenience of using Thrive’s telehealth option. My daughter and I had developed a nasty case of thrush and with three kids and a busy schedule, I had no time to travel to an appointment to get it taken care of. Not to mention, it was a Saturday! In about 10 minutes, Kari had asked me the necessary questions, diagnosed the problem and had a prescription sent to my local pharmacy. It could not possibly have been easier. Thrive definitely has a patient for life!


As a doula practicing for 20 years, I can attest that the physical, emotional, informational and midwifery care that Kari provides is truly phenomenal. She cares so deeply about the families that she serves, which is evident in the countless births I have attended with her. From the moment you meet Kari, her knowledge about and trust in normal birth is infectious. On top of all of that she has an amazing sense of humor! As a doula, it is a joy to watch her hold space for all of the fortunate families that have entrusted her with their care.

−Jessie, doula

When I think about who I trust to deliver my baby, my mind automatically says, Kari. In 2015 I delivered my first son in a local hospital, and the tender care and attention I received from Kari during labor, delivery and post postpartum, I knew I wouldn’t be able to find in anyone else. The amount of respect you have between the boundaries of culture and medicine manifests itself in your practice, as I witnessed it during my first delivery. You place your patients wants and needs before yours. You are there any time of the day or night via phone, email or text message. During the hard times of struggle and when my life caused me stress, I turned to you to help me get back on track to improve or maintain my health. When I was going through my miscarriage, I trusted in your expertise and wisdom. Even though I was far away from home when it occurred, you made me feel comforted as I knew you were just one call away. When I think of you Kari, it brings tears to my eyes to have known such a wonderful person and knowing my family trust you whole heartily. What I can say about you is endless. Thank you for all you do.


I have known and practiced with Kari for a long time, and trust her implicitly to provide top-notch care for her patients. She stays current in evolving research regarding women’s health and demonstrates a growing knowledge base regarding use of supplements and herbal therapies. Kari is also really innovative in providing care in low resource settings, such as international health.

−Robyn, MD

Kari’s care is exceptional! Not only does she provide stellar whole woman care, she listens and truly forms a bond with each of her clients. Never feel like a number or meet an impersonal provider again. Kari takes the time to get to know you and your family’s health needs and provides you with the tools and knowledge to make well-informed and practical health choices. Thank you, Kari, for being my advocate!


Kari provides a one-of-a-kind blend of compassion, attention to detail and well researched medical knowledge. She believes strongly that pregnancy and birth is a natural process for most women, recommending both natural remedies and evidence-based Western medicine when it was indicated.


I am so impressed by how Kari keeps up with current research. You can rest assured that the care you get at Thrive will be rooted in the latest evidence and tailored to your needs. Kari is a strong communicator and will be your advocate. I will gladly refer families seeking home birth, gynecological care, and intrauterine insemination to Thrive Midwives.

−Emily, nurse-midwife

Kari is extremely knowledgeable, her clinical judgment and decision making are spot on, she is easy to talk to, and has a comforting and peaceful presence.


Kari offers the perfect balance of medical knowledge and personal care, while also trusting a woman’s body and addressing overall wellbeing. She believes that women’s bodies know what they’re doing. She helps you believe that, too.