Understanding the Risks: Postpartum Hypertensive Conditions in Black Women

Black women are disproportionately affected by postpartum hypertensive conditions, including preeclampsia, eclampsia, and HELLP syndrome. These conditions pose significant risks to mother and baby if not diagnosed and managed promptly. This page aims to provide an overview of these conditions, explain why Black women are at higher risk, and offer resources for better understanding and management.*

Preeclampsia

Definition: Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. It usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal.

Symptoms:

  • High blood pressure

  • Severe headaches

  • Changes in vision

  • Upper abdominal pain

  • Nausea or vomiting

  • Decreased urine output

  • Shortness of breath

Risks: Preeclampsia can lead to serious, even fatal, complications for both mother and baby if left untreated. The only cure is the delivery of the baby.*

Eclampsia

Definition: Eclampsia is a severe complication of preeclampsia, characterized by the onset of seizures. Eclampsia can occur before, during, or after delivery.

Symptoms:

  • Seizures

  • Loss of consciousness

  • Severe agitation

Risks: Eclampsia is a medical emergency. It can result in permanent damage to the mother's vital organs, including the brain, liver, and kidneys, and can be life-threatening if not managed promptly.*

HELLP Syndrome

Definition: HELLP syndrome is a life-threatening pregnancy complication usually considered to be a variant of preeclampsia. HELLP stands for Hemolysis (breaking down of red blood cells), Elevated Liver enzymes, and Low Platelet count.

Symptoms:

  • Fatigue or feeling unwell

  • Upper right abdominal pain or tenderness

  • Nausea and vomiting

  • Headache

  • Swelling

Risks: HELLP syndrome can cause serious liver damage, bleeding problems, and complications for both mother and baby. Immediate delivery of the baby is often required to prevent further complications.*

Why Are Black Women at Higher Risk?

  1. Structural Racism and Implicit Bias: Systemic inequalities and implicit biases within the healthcare system often result in Black women receiving poorer quality of care. This can lead to delays in diagnosis and treatment.

  2. Socioeconomic Factors: Black women are more likely to experience socioeconomic disadvantages, which can affect their overall health and access to prenatal care.

  3. Health Disparities: Black women are more likely to have chronic conditions such as hypertension and diabetes, which increase the risk of hypertensive disorders during pregnancy.

  4. Genetic Factors: There may be genetic predispositions that contribute to higher rates of these conditions among Black women.