Is preeclampsia political? Yes.
Let's chat during Preeclampsia Awareness Month
No coverage from me today on the recent announcement re: the COVID vaccine and pregnant women from HHS and the non-medical experts. I just don’t have it in me. But suffice it to say: I disagree and stay tuned.
As May comes to a close, I want to talk about something that affects about 5-8% of pregnancies: preeclampsia. My guess is you’ve probably heard of it, but keep reading to learn that delivery is not the cure, it affects your health for the rest of your life, how Medicaid cuts will make this worse for hundreds of thousands of women, and my favorite advocacy organization.
I also want to say thank you to everyone who spread the word about “pregnancy exclusions” after I wrote about it in a recent Substack. So many of you have shared how you’re contacting your legislators about this…and how many of them didn’t even know it was a thing. This is how change starts!
-Dr. Jen
What exactly Is preeclampsia?
Preeclampsia is a pregnancy complication involving high blood pressure and signs that other organs—particularly your kidneys and liver—may be affected. It typically develops after 20 weeks and stems from problems with the blood vessels that supply the placenta. While the exact cause isn’t fully understood, factors such as immune system changes, genetics, and underlying health conditions can all play a role.
Key symptoms include:
Persistent headaches that don't respond to usual remedies
Vision changes like spots, flashing lights, or temporary vision loss
Upper abdominal pain under your right ribs
Sudden weight gain
Facial and hand swelling (not technically part of the diagnosis, but it makes us suspicious)
Reflux that is new or doesn’t get better with treatments like Tums
Important note: Many pregnant people with preeclampsia have no obvious symptoms, which is why we check your blood pressure at every prenatal visit.
Who's at higher risk?
First-time pregnancies, personal or family history of preeclampsia, chronic conditions like high blood pressure or diabetes, age under 20 or over 35, and carrying multiples all increase your risk. While these factors matter, preeclampsia can affect anyone.
Prevention: what actually works
For women at high risk, low-dose aspirin (81mg daily) starting between 12-16 weeks can significantly reduce preeclampsia risk. This doesn’t mean everyone should be on it—your doctor or midwife will use guidance from the table below to decide if it’s right for you:
Maintaining a healthy diet, staying active as approved by your doctor, and attending all prenatal appointments remain your best prevention strategies. Unfortunately, there's no guaranteed way to prevent preeclampsia entirely.
If you’re diagnosed with it
Management depends on severity and how far along you are. Milder cases might involve increased monitoring and blood pressure medication. More serious cases may require hospitalization, delivery, even if your baby would be premature.
While delivery resolves the immediate pregnancy-related risks, it's important to understand that delivery isn't a complete "cure" as many people think.
Postpartum Preeclampsia
Here's something many people don't realize: preeclampsia can show up for the first time or worsen after you have your baby. In fact, symptoms can appear up to 6 weeks postpartum, with most cases occurring within the first 48 hours after birth.
This is why your postpartum blood pressure checks are so important, and why you should never hesitate to call if you experience symptoms after going home with your baby.
It sticks with you for life
People who've had preeclampsia face increased lifelong risks for high blood pressure, cardiovascular disease, and having a stroke. This makes ongoing healthy lifestyle choices and regular medical care even more crucial. Your preeclampsia history is crucial information that all your future healthcare providers must know about.
Luckily the Preeclampsia Foundation has made a wonderful tool that I make sure my patients who’ve had the diagnosis leave the hospital with. What I like about it is that not only does it help them communicate their risk to their primary care doctor, but it also includes ways they can take control to have the healthiest recovery possible. Below is just one page from this document, which you can download here.
Preeclampsia is…political?!
Yep.
Proposed Medicaid cuts could have serious effects on women with preeclampsia, so these are some great talking points you can share with your conservative dad who loves this proposed Big Beautiful Bill (I like to call it the Death Bill).
Ask him if he’s thought about the following and how it could affect his daughter or future grandchild:
Many rural hospitals depend on Medicaid funding to keep their doors open. Without it, more hospitals will be forced to close, making it harder for women to access urgent care for pregnancy complications like preeclampsia.
Medicaid also covers essential screenings and prenatal care—services that are critical for detecting and managing preeclampsia early.
If funding is reduced, many doctors will be forced to stop taking patients on Medicaid or will close up shop entirely. This means fewer OBGYNs to provide care—even if you have private insurance.
Preeclampsia is already a higher risk for Black women, who are about 60% more likely to develop this compared to white women. Because Black women are more likely to rely on Medicaid for maternity care, proposed cuts would be especially deadly for this group.
Feel free to share this graphic to get the word out:
Let me know what your dad (or neighbor, or uncle, or Facebook group) says…
Q&A: Preeclampsia risk related to your weight?
Research shows that women who have a low BMI (body mass index) before getting pregnant are less likely to develop preeclampsia. The exact reasons are not fully understood, but it is thought that excess body fat may contribute to inflammation, problems with blood vessel function, and other changes that increase the risk of preeclampsia.
This does not mean you should practice restrictive eating when TTC or in pregnancy, though. If you’re not sure where you stand or feel like you need help, don’t hesitate to talk to your doctor or midwife who can give you the resources or referrals you need.
Want to get your question answered in the BBC newsletter? Send me a message and I’ll incorporate them into future newsletters! *no personalized medical advice*
Spotlight on the Preeclampsia Foundation
The Preeclampsia Foundation is a national nonprofit dedicated to improving outcomes for mothers and babies affected by preeclampsia and related hypertensive disorders of pregnancy. They provide vital education, support, and advocacy for patients and families, while also funding research and raising awareness among healthcare professionals.
Their work helps ensure that women, especially those in underserved communities, have access to the information and resources needed to recognize symptoms early and seek timely care.
As an OBGYN I love their website for both patients and providers alike—their “My Health Beyond Pregnancy” handout above is just one example.
Fun fact: I’m including some of their resources (such as the one below) in The Birth Book because I couldn’t think of a better way to convey the information from a source that I trust so much:
Want to support them? Share their info during Preeclampsia Awareness Month! They’ve got ready-made social media content here—I’ve sprinkled some into this newsletter. Sharing them could save a life.
Until next week,
Dr. Jen