Why This Matters
Let’s talk about something that doesn’t get enough attention — high blood pressure during and after pregnancy. Doctors call it “hypertensive disorders of pregnancy,” or HDP. It includes conditions like preeclampsia, eclampsia, gestational hypertension, and chronic high blood pressure that starts before or during pregnancy.
For Black women, HDP isn’t just a medical term — it’s a warning sign that too many of us are missing. Research shows that Black women are three to four times more likely to die from pregnancy-related causes, and many of those deaths are linked to blood pressure problems. That means your heart, your pregnancy, and your long-term health are all connected — even years after giving birth.
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What the Research Shows
Science has been precise for years, but the message hasn’t reached enough of us. Here’s what recent studies tell us:
1. HDP is more common than we think
A significant study from the Mayo Clinic found that when researchers tracked women—not just individual pregnancies—they discovered 15% of women experienced some kind of HDP in their lifetime (Garovic et al., 2020). That’s twice as high as what we usually hear. Why does that matter? Because most women are told, “If it didn’t happen this pregnancy, you’re fine.” But HDP can happen later, and those earlier blood pressure spikes can predict heart problems down the road.
2. Pregnancy is your first heart stress test
Researchers now call pregnancy a “window into future health.” Women who’ve had preeclampsia or gestational hypertension are twice as likely to develop heart disease or kidney disease later in life (Garovic et al., 2020). Think of pregnancy like your body running a marathon — it shows how well your heart, kidneys, and blood vessels handle stress. If you had high blood pressure during that time, it’s your body whispering: “Pay attention to me even after the baby’s here.”
3. Race and place matter — but not because of genetics
A 2024 review looked at Black women in high-income countries and found four main reasons we face higher HDP risk:
- Biology — Certain genes, vitamin D deficiency, and autoimmune issues like lupus play a part.
- Lifestyle — Family history, weight, and diabetes increase risk.
- Environment — Stress, poor air quality, and neighborhood conditions can raise blood pressure.
- Bias and barriers — Dismissed pain, lack of follow-up, and limited access to preventive carea_scoping_review_of_risk_factor….
Translation: It’s not that our bodies are weaker — it’s that our systems are overloaded.
4. Care too often stops at delivery
One of the biggest failures in maternal care is what happens after birth.
Many women never get their blood pressure rechecked after leaving the hospital. But the first six weeks postpartum are the most dangerous — when blood pressure can spike, seizures can happen, or heart failure can develop. The Mayo study found that women with HDP often went on to develop chronic high blood pressure within five years, and the risk for heart disease stayed high for decades (Garovic et al., 2020).
You wouldn’t walk away from a storm with your roof half-fixed — your heart deserves the same care.
What “Rooted in Violet” Teaches Us About This
At Rooted in Violet, we believe:
“Your body is the blueprint. You are the architect. Your doctors are the engineers. Together, you build your legacy.”
That means:
- You bring the vision — the voice, the lived experience, the goals for your health.
- They bring the science — the medicine, the treatment, the monitoring.
- Together, you design care that’s not just about survival — it’s about thriving.
So let’s walk through a protocol — a Rooted in Violet Self-Advocacy Plan — that you can follow before, during, and after pregnancy.
Step 1: Before Pregnancy — “Design Your Health Blueprint”
Before you even start trying (or as soon as you find out you’re pregnant), build your Health Blueprint.
Here’s what goes in it:
- Know your numbers: Write down your blood pressure, blood sugar (A1c), and cholesterol.
- Family history: Did your mom, aunt, or sister have preeclampsia or heart disease?
- Check vitamin D: Many Black women have low levels because darker skin makes it harder to absorb sunlight — and that can increase the risk of HDPa_scoping_review_of_risk_factor….
- Ask about “prenatal aspirin”: Doctors now recommend low-dose aspirin (81 mg) for women at risk. It can lower your risk of preeclampsia by 10–20%.
Self-Advocacy Tip:
“Can we talk about starting prenatal aspirin to help prevent preeclampsia? I’d like to know if I qualify.”
That one sentence can open the door to prevention.
Step 2: During Pregnancy — “Measure, Track, Speak”
Blood pressure isn’t something to check only at the doctor’s office.
You can — and should — check it at home.
Here’s how:
- Buy a home blood pressure cuff (make sure it’s validated for pregnancy).
- Sit with your feet flat, rest 5 minutes, then check twice — once in the morning, once at night.
- Write it down in your Health Blueprint or a notes app.
If your numbers are 140/90 or higher, call your provider.
If your blood pressure is 160/110 or higher, go to the ER.
The ROOT Framework™ — A Violet Self-Advocacy Tool
“Root your words in confidence.”
| Step | Meaning | Example Phrase |
|---|---|---|
| R – Reveal What’s Going On | State what’s happening right now. | “My blood pressure has been higher than usual this week.” |
| O – Offer Your Observations | Describe what you’ve noticed or tracked. | “I’ve had headaches and swelling in my feet.” |
| O – Outline What You Need | Say what you want to happen next. | “I’d like my medication reviewed or my pressure rechecked.” |
| T – Take Note of the Plan | Repeat back next steps for clarity. | “So I’ll come back Friday and call if symptoms get worse?” |
Quick Tips
- Use calm, steady tones — you’re not asking for a favor, you’re directing your care.
- Bring your Health Blueprint binder or notes app to keep your ROOT conversations logged.
- After each visit, summarize what was agreed upon in your own words (and if possible, message it through the patient portal).
Speaking in structure helps you stay calm — and it reminds your provider that you’re informed and involved.
Know your red flags
Call 911 or go to the ER if you experience:
- A severe headache that won’t go away
- Vision changes (blurry, flashing lights, dark spots)
- Pain under your ribs or on your right side
- Swelling of your face or hands that happens suddenly
- Shortness of breath or chest pain
- Blood pressure higher than 160/110
You are never overreacting by protecting your life.
Step 3: After Birth — “Close the Loop”
This is where too many women get left behind. Your baby has a pediatrician — but you still need care too. Here’s your postpartum timeline:
- 3–7 days after delivery: First blood pressure check.
- 10–14 days: Follow-up check or telehealth visit.
- 6 weeks: Full postpartum visit (and heart check).
If your doctor doesn’t offer these, ask directly:
“Can we schedule my blood pressure checks for the next three weeks? I want to stay ahead of any complications.”
You deserve proactive care — not reactive care.
After pregnancy, your heart is still in focus
Many women assume preeclampsia is “over” once the baby is born.
But research says the opposite:
- Women with HDP have a two times higher risk of developing chronic hypertension or heart disease later in life (Garovic et al., 2020, Incidence and….
- That means your OB visit should end with a warm handoff to a primary care doctor or cardiologist.
Ask for it. Make sure your story doesn’t stop at delivery.
Self-Advocacy Made Simple: Actionable Steps
This is your Rooted in Violet Self-Advocacy Routine — small, doable actions you can start today.
| Step | Action | Frequency |
|---|---|---|
| Check blood pressure | Use your home cuff. Write it down. | 2× daily if pregnant, 3× per week if not. |
| Track symptoms | Note swelling, headaches, or visual changes. | Daily |
| Take supplements | Vitamin D + prenatal vitamin if pregnant. | Daily |
| Ask 1 question per visit | “What can I do to lower my risk of high blood pressure?” | Every appointment |
| Schedule follow-ups | Before you leave the office, confirm your next visit. | Every visit |
| Bring your support person | They can help remember info or speak up. | Key visits |
| Document everything | Keep copies of test results and discharge papers. | Ongoing |
Real Talk: The Emotional Side of Advocacy
Advocating for yourself isn’t always easy.
It’s exhausting to speak up when you’re tired, vulnerable, or recovering from birth.
But remember — you don’t owe anyone silence when your life is on the line.
If a provider talks over you, try this:
“I hear you, but I need to finish my thought. What I’m experiencing is not normal for me.”
If you feel dismissed:
“Can you note in my chart that I requested a different evaluation or opinion?”
That’s calm, factual power.
It documents your voice and demands accountability.
Rooted in Violet Quick Checklist
- Know your numbers
- Track your symptoms
- Take “prenatal aspirin” if prescribed
- Attend postpartum BP visits
- Ask for a warm handoff to primary care
- Keep your Health Blueprint updated
Each of these steps builds the foundation for your health story — a story you write, not one written about you.
The Bigger Picture
Here’s what the experts — and Rooted in Violet — agree on:
- Blood pressure problems are preventable and treatable.
- Postpartum follow-up saves lives.
- Community and cultural connections matter.
- Health systems must listen to Black women — not lecture them.
Every podcast, Violet Sheet, and educational toolkit we produce will echo this same truth:
“When you know your numbers, you control your narrative.”
Closing Reflection
Your body is powerful, but power needs protection.
If your heart could talk, it would say:
“Don’t wait until I break down to check under my hood.”
So take the small steps now — the daily readings, the questions, the follow-ups — because every check-in is an act of love.
You are not a statistic.
You are a designer, and your health is the masterpiece.
References
- Baiden, D., Nerenberg, K., Hillan, E. M., Dogba, M. J., Adombire, S., & Parry, M. (2024). A scoping review of risk factors of hypertensive disorders of pregnancy in Black women living in high-income countries: An intersectional approach. Journal of Cardiovascular Nursing, 39(4), 347–358.
- Garovic, V. D., et al. (2020). Incidence and long-term outcomes of hypertensive disorders of pregnancy. Journal of the American College of Cardiology, 75(18), 2323–2334.
- JAMA Network (2022). Racial and Ethnic Differences in Hypertensive Disorders of Pregnancy and Associated Cardiovascular Risks. JAMA, 327(21), 2057–2069.
- NIH (2023). Hypertensive Disorders of Pregnancy and Long-Term Cardiovascular Outcomes. NIHMS-1828411.