Postpartum Preeclampsia: Why Blood Pressure Spikes After Birth

Following the physical ordeal of giving birth, all any new parent wants — and deserves — is the chance to rest their bodies and bond with their baby.

Alongside the sheer joy and excitement of welcoming your new arrival, you’re probably also worried about what happens next. As in: “OMG, now I have to actually take care of this little creature?” or “Will I ever get any sleep again?” That kind of stress is completely understandable.

Another equally understandable form of post-delivery stress arises if you’re also diagnosed with a complication like postpartum preeclampsia.

Postpartum preeclampsia is a rare but serious condition relating to high blood pressure and excessive protein in the urine that presents after giving birth. While it commonly appears within 48 hours after delivery, postpartum preeclampsia can occur up to six weeks after your baby is born. This condition can lead to strokes, seizures, and additional complications if not treated immediately.

Though similar, postpartum preeclampsia is a different condition from preeclampsia, which occurs during pregnancy (usually after the first 20 weeks).

If you are diagnosed with postpartum preeclampsia, the most important things to remember are a) it’s okay to be scared and b) this complication isn’t your fault.

Read on for our expert insights as to why blood pressure spikes after birth, and how postpartum preeclampsia is both monitored and treated.

Diagnosing postpartum preeclampsia

So why would someone’s blood pressure suddenly spike after giving birth?

Hypertensive disorders of pregnancy affect between 10-20% of pregnancies in the United States. While there are certain risk factors for postpartum preeclampsia — a history of chronic hypertension (aka high blood pressure), gestational hypertension (aka high blood pressure that presents typically during the later half of pregnancy), preeclampsia — “even completely healthy patients prior to delivery can be susceptible,” says Dorothy Bestoyong, DO, an OB/GYN based in Orlando, Florida.

Another potential cause of postpartum high blood pressure — which can lead to a postpartum preeclampsia diagnosis — is the rapid hormonal changes after childbirth. This can affect blood pressure regulation.

Most symptoms of postpartum preeclampsia are the same as preeclampsia:

• High blood pressure — 140/90 millimeters of mercury (mm Hg) or greater
• Excess protein in your urine (proteinuria)
• Severe headaches
• Changes in vision, including temporary loss of vision, blurred vision, or light sensitivity
• Pain in your upper belly, usually under the ribs on the right side
• Nausea and vomiting
• Shortness of breath
• Decreased urination

If postpartum preeclampsia is suspected, your healthcare provider will check your blood pressure, as well as perform a blood test (to check platelets and the function of your liver and kidneys). You will also need a urinalysis to check the urine for protein.

Differentiating between postpartum high blood pressure and postpartum preeclampsia depends on several factors, including “severe range blood pressures (>/=160/110), lab value changes (protein in urine, liver enzymes, low platelets, etc), persistent headaches, and severe fluid retention,” says Dr. Bestoyong.

Treating postpartum preeclampsia

If postpartum preeclampsia is left untreated, the condition can lead to even more frightening complications, including “long-term organ damage, stroke, blood clots, and even death,” warns Dr. Bestoyong.

Both postpartum high blood pressure and postpartum preeclampsia are treated similarly, says Dr. Bestoyong: “Optimally with IV magnesium and blood pressure medications (labetalol or nifedipine).”

Once on medication, you can expect your blood pressure to return to normal (no higher than 120/80 mm Hg) “typically within a few days to a few weeks depending on severity,” says Dr. Bestoyong. Since every case is different, she cautions that “sometimes blood pressure spike medications need to be continued up to six weeks after delivery.”

Other recommendations for people with postpartum preeclampsia include eating a healthy, low-sodium diet, exercising regularly, getting plenty of rest, lowering stress levels, and monitoring your blood pressure both at home and with your healthcare provider.

What you need to know about postpartum preeclampsia

One of the reasons why postpartum preeclampsia is so scary is that it’s a silent health condition for many people. You may not have had any signs or symptoms during pregnancy, and unless you’re regularly checking your blood pressure (which will happen while you’re still in the hospital after giving birth), you may not even be aware that something is wrong.

However, if you’re experiencing unexplained headaches, leg swelling, blurred vision, or abdominal pain, tell or call your healthcare provider immediately. You may also want to consider monitoring your blood pressure at home after you’ve been discharged from the hospital. Above all, make sure you discuss any concerns with your doctor.

“[Postpartum preeclampsia] is one of the causes of maternal morbidity and mortality,” reiterates Dr. Bestoyong. “Signs and symptoms should not be ignored. Don’t dismiss [them] and say it’s just due to stress or no sleep.” Also, she says, “Your blood pressure shouldn’t be persistently in the severe range even if [you have a postpartum preeclampsia diagnosis].”

The postpartum period is an exciting and stressful time for both new and experienced parents, but remember that your health should always be a priority. Your life may depend on it.

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Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist dedicated to reporting on women's health, parenting, mental health, TV, and pop culture. Her work has appeared in HuffPost, Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.