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.
Ruth X had a special arrangement in her first pregnancy with her doctors which meant she was allowed to monitor her own blood pressure at home. She took part in the BuMP study in a following pregnancy.
Ruth X had a special arrangement in her first pregnancy with her doctors which meant she was allowed to monitor her own blood pressure at home. She took part in the BuMP study in a following pregnancy.
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.
Philippa talked about the difficulties of fitting in blood pressure monitoring as part of the BuMP study when she was pregnant and after she gave birth.
Philippa talked about the difficulties of fitting in blood pressure monitoring as part of the BuMP study when she was pregnant and after she gave birth.
And what about after the baby was born, did you find it easier or harder to manage?
Harder. Much harder. Much harder. I had a, the service on my phone that would remind me if I hadn’t done it. It didn’t remind me to do it. It would remind me if I hadn’t done it but I’d put my own timers on my phone right the way through so I would remember on Monday, Wednesday and Friday to do the set times. But then after the birth, I do remember several times when the alarm on my phone would go off and I’d think, right, I need to do that and then suddenly something else would happen, the baby would need a feed, need a change, be sick, my older child would need something else and kind of an hour would pass and then I’d get a reminder and think, oh, I forgot to do it again and, by that point, it was too late in the day.
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”.
Towards the end of her pregnancy, Kat had some high blood pressure readings. She contacted her midwife and said it was reassuring to be able to check her blood pressure herself whenever she wanted.
Towards the end of her pregnancy, Kat had some high blood pressure readings. She contacted her midwife and said it was reassuring to be able to check her blood pressure herself whenever she wanted.
Yeah, there was, towards the end it did go, for me, very, quite high. I mean, generally, it wasn’t very high but for me for it was it was very high and I did have did have concerns, at that stage, so I did contact my midwife and that was really good reassurance. I found that really, really helpful because you can think, because I felt fine but if you’ve got high blood pressure, and I did it a couple of times extra just to make sure it wasn’t just that one time and it was a bit high but there wasn’t there wasn’t anything to worry about, which was good, but it was really nice to have that reassurance.
But you can check and you can do additional ones as well additional readings. To help out, so yeah, that was good.Taking part in the BuMP study made Ruth Y more aware about her health in pregnancy, which she saw as a good thing.
Taking part in the BuMP study made Ruth Y more aware about her health in pregnancy, which she saw as a good thing.
What preeclampsia was and how it would manifest itself and what it would result it.
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.
Amy didn’t like having her blood pressure checked. Through the BuMP study, she was able to monitor it herself at home. This meant that she could relax a bit and get more accurate results.
Amy didn’t like having her blood pressure checked. Through the BuMP study, she was able to monitor it herself at home. This meant that she could relax a bit and get more accurate results.
Put any needles in front of me, that’s fine, but show me a blood pressure monitor and, for some completely bizarre and unknown reason, I just would want to run away. So it always was a little bit elevated but that would be the top figure rather than the bottom figure, generally, that was elevated.
So I’d have to have it done maybe three times with a bit of a sit down and a quiet and a relax in between. And then it kind of brought it down to normal, so yes, I have had high blood pressure readings before and I have then had to have it kind of done repeatedly to check that it was fine.
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