Women’s Postpartum Experiences of Hypertensive Disorders of Pregnancy: A Qualitative Study of Barriers and Enablers to Healthy Lifestyle Behaviours

TL;DR

This study explores how women with pregnancy-related high blood pressure manage healthy lifestyles after childbirth, identifying barriers and support factors for better long-term heart health.

Contribution

The study provides novel insights into postpartum experiences of women with HDP and identifies enablers for promoting healthy lifestyle behaviors.

Findings

Women face challenges like physical recovery and emotional processing after HDP.

Support and tailored guidance are crucial for encouraging healthy lifestyle changes.

Financial stability and prior healthy behavior experience influence postpartum health outcomes.

Abstract

Public health relevance—How does this work relate to a public health issue?
HDP markedly increase long-term cardiovascular risk, making postpartum lifestyle support a key public health priority.Women’s experiences reveal behavioural and system-level factors influencing their ability to adopt healthy behaviours.

HDP markedly increase long-term cardiovascular risk, making postpartum lifestyle support a key public health priority.

Women’s experiences reveal behavioural and system-level factors influencing their ability to adopt healthy behaviours.

Public health significance—Why is this work of significance to public health?
The study identifies modifiable barriers to recommended lifestyle behaviours during a critical prevention window.Findings highlight enablers that can inform targeted, woman-centred interventions.

The study identifies modifiable barriers to recommended lifestyle behaviours during a critical prevention window.

Findings highlight enablers that can inform targeted, woman-centred interventions.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Clinicians should provide clear risk communication, tailored guidance, and coordinated postpartum follow-up.Policies and research should support accessible, culturally appropriate resources to reduce long-term cardiovascular risk.

Clinicians should provide clear risk communication, tailored guidance, and coordinated postpartum follow-up.

Policies and research should support accessible, culturally appropriate resources to reduce long-term cardiovascular risk.

Background: Hypertensive disorders of pregnancy (HDP) have significant implications for women’s long-term health, including at least a twofold increased lifetime risk of cardiovascular disease (CVD). The Blood Pressure Postpartum (BP2) Study was a three-arm randomised trial evaluating follow-up and lifestyle behaviour change strategies during the first year after HDP. Methods: This qualitative sub-study, embedded within the BP2 Study, explored women’s experiences of life in the first year following HDP. Semi-structured telephone interviews were conducted with 34 women, approximately 10–12 months postpartum. Interviews were transcribed verbatim and a thematic analysis was undertaken. Results: Participants reflected on their experiences post-HDP; three major themes were identified: Navigating life with a newborn, The value of support, and Processing and Moving forward. Some women felt informed and empowered to make positive lifestyle changes; others were still processing their HDP experience and/or feeling overwhelmed by the demands of early motherhood. Responses were influenced by their HDP experience, available support, prior experience with healthy behaviours, and financial stability. Conclusions: The findings highlight that postpartum women who experienced HDP face unique challenges, including physical recovery, emotional processing, and intensive infant care. It often takes time for these women to begin prioritising their own health, as they navigate these challenges. The insights generated from women’s experiences suggest that flexible, accessible, and individually tailored support may facilitate postpartum health, promote lifestyle change, and help reduce long-term CVD risk.

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