The Rising Tide of Preeclampsia
Updated: Aug 10
Anne Wallen is a respected figure in women’s health with over 30 years of experience and is a leading voice on global change in maternity care, particularly for those at greatest risk.
Preeclampsia remains one of the most serious complications of pregnancy and one of the leading contributors to maternal and infant morbidity and mortality worldwide. Along with obstetric hemorrhage, infection, thromboembolic disease, and cardiomyopathy, hypertensive disorders of pregnancy account for a substantial proportion of maternal deaths. Even when not fatal, preeclampsia can lead to stroke, placental abruption, acute kidney injury, pulmonary edema, liver dysfunction, disseminated intravascular coagulation (DIC), fetal growth restriction, medically indicated preterm birth, and lifelong cardiovascular disease for the mother. The tragedy is that many cases develop gradually, with warning signs that can be recognized if mothers and their support teams know what to look for.
Unfortunately, the problem is worsening. According to the Centers for Disease Control and Prevention's newly released National Vital Statistics Report, the rate of hypertensive disorders of pregnancy has increased dramatically over the past decade. More than one in ten women giving birth in the United States now experience gestational hypertension or preeclampsia, representing an increase of more than 70 percent since 2016. Researchers note that maternal age and obesity alone do not account for the rise, indicating that the causes are likely multifactorial and deserving of much deeper investigation.
As maternity professionals, educators, and advocates, we should certainly pay attention to these statistics. But rather than responding with fear, we should respond with knowledge.
Beyond the blood pressure cuff
"Preeclampsia is far more complex than just elevated blood pressure." It is a multisystem disorder involving abnormal placental development, endothelial dysfunction, immune system alterations, systemic inflammation, vascular changes, oxidative stress, and impaired maternal cardiovascular adaptation. While medicine has made remarkable advances in recognizing and managing severe disease, our healthcare system often remains focused on identifying complications after they begin rather than maximizing maternal wellness before they occur.
Fortunately, there is growing recognition that improving maternal health before and throughout pregnancy matters.
Evidence supports optimizing chronic medical conditions before conception, maintaining appropriate prenatal care, managing diabetes and chronic hypertension, encouraging regular physical activity, obtaining sufficient sleep, reducing tobacco exposure, and identifying women who may benefit from interventions such as low-dose aspirin based on established clinical guidelines. These measures cannot eliminate every case of preeclampsia, but they represent meaningful opportunities to reduce risk and improve overall pregnancy health.
Nutrition is more than calories
"One of the most overlooked aspects of prenatal care is nutritional education." Pregnancy dramatically increases physiological demands on nearly every organ system. Blood volume expands by approximately 40 to 50 percent. The placenta becomes a metabolically active organ requiring substantial nutrient delivery. Maternal kidneys, liver, cardiovascular system, endocrine system, and immune system all adapt to support the developing baby.
"These remarkable changes require adequate nutritional reserves." Research has associated poor dietary quality with increased inflammation, insulin resistance, vascular dysfunction, and metabolic disease, factors that are also implicated in hypertensive disorders of pregnancy. While no single nutrient prevents preeclampsia, evidence suggests that a balanced diet rich in high-quality protein, fruits, vegetables, whole grains, healthy fats, and appropriate micronutrients, especially a complex of methylated B vitamins along with adequate magnesium, supports maternal cardiovascular and metabolic health. Addressing deficiencies when identified, promoting hydration, supporting healthy blood sugar regulation, and encouraging individualized nutrition planning are all practical ways to strengthen maternal wellbeing.
At MaternityWise International, we believe nutrition deserves to be discussed long before labor begins, not as a restrictive set of rules, but as one of the foundational ways families can nourish both mother and baby. Since doulas are influential throughout their client families’ journeys through pregnancy, birth, and postpartum, and are able to spend much more time prenatally educating and supporting them through these changes, they have the opportunity to make a profoundly positive impact.
Lifestyle matters because physiology matters
Modern pregnancy exists within an increasingly demanding environment. Chronic stress, inadequate sleep, highly processed foods, sedentary lifestyles, environmental exposures, financial insecurity, and limited access to nutritious foods all influence maternal physiology. Although none of these factors alone explains preeclampsia, together they create a landscape in which inflammation, metabolic dysfunction, and cardiovascular strain may become more likely.
Supporting maternal health therefore requires a broader conversation, and doulas are in a fantastic position to have that conversation. They can get to know the client’s current status, give advice, educate, and support healthy changes as needed.
Simple practices such as regular movement, restorative sleep, hydration, stress reduction techniques, mindfulness, appropriate weight management, and emotional support contribute to healthier pregnancies. Equally important is ensuring that women feel heard, respected, and empowered to seek medical evaluation whenever something feels wrong.
A mother who understands her body is not "difficult." She is engaged in her own healthcare, and that is powerfully positive.
Recognizing the symptoms of preeclampsia that save lives
Education is most powerful when it prepares families to recognize danger early. Every pregnant woman should know that the following symptoms require prompt medical assessment:
Persistent or severe headache
Visual disturbances such as blurred vision or flashing lights
Right upper quadrant or epigastric pain
Sudden swelling of the hands, face, or eyes
Rapid weight gain caused by fluid retention
Shortness of breath
Elevated blood pressure
Decreased fetal movement
Far too often, these symptoms are minimized, dismissed, or attributed to "normal pregnancy." While many pregnancy discomforts are indeed benign, hypertensive disorders can progress rapidly. Timely evaluation can mean the difference between routine treatment and life-threatening complications.
The unique role of the doula
This is where professional doulas provide tremendous value. Doulas are not medical providers. They do not diagnose disease, prescribe treatment, or replace physicians or midwives. Instead, they become trusted educators, compassionate observers, skilled communicators, and consistent sources of support throughout pregnancy, birth, and the postpartum period.
Because doulas often spend significantly more uninterrupted time with families than any other member of the healthcare team, they are uniquely positioned to reinforce healthy habits, encourage prenatal attendance, facilitate informed conversations, and help parents recognize when symptoms deserve immediate medical attention. This is not practicing medicine. It is practicing vigilance, education, and compassionate support.
How MaternityWise helps change the trajectory
At MaternityWise International, we believe reducing maternal mortality begins long before an emergency room visit or labor admission.
Our curriculum intentionally prepares doulas to understand the physiology of pregnancy, the pathophysiology of hypertensive disorders, and the evidence-informed strategies that support healthier pregnancies. Students receive comprehensive education in maternal nutrition, hydration, appropriate weight gain, blood sugar balance, inflammation, sleep health, stress physiology, prenatal exercise, and the social determinants of health that influence pregnancy outcomes.
"Just as importantly, they learn professional accountability." Our doulas are taught never to dismiss concerning symptoms or reassure a client when medical evaluation is warranted. Instead, they learn to recognize red flags within their scope of practice, encourage immediate communication with physicians or midwives, reinforce adherence to clinical recommendations, document observations appropriately, and remain a calm, compassionate presence throughout the process.
We also teach something equally important: "Education is not about creating fear. It is about creating confidence."
When families understand why healthy nutrition matters, how lifestyle influences pregnancy, what symptoms deserve attention, and when to seek medical care, they become empowered partners in protecting maternal health rather than passive recipients of healthcare.
A shared responsibility
No single profession will solve the maternal mortality crisis. Physicians, midwives, nurses, dietitians, public health professionals, doulas, childbirth educators, policymakers, researchers, and families each hold an important piece of the solution.
Education alone cannot eliminate preeclampsia, but education changes behaviors. It improves communication. It strengthens partnerships between families and healthcare providers. It promotes earlier recognition of complications. It supports healthier pregnancies from the very beginning. Most importantly, it reminds every expectant mother that her body deserves nourishment, her concerns deserve to be heard, and her symptoms deserve to be taken seriously.
If we hope to change the future of maternal health, we must begin where lasting change always begins, with knowledge, compassion, accountability, and a commitment to helping families thrive long before complications arise.
Anne Wallen, Director and Founder of MaternityWise International
Anne Wallen is a respected figure in women’s health with over 30 years of experience and is a leading voice on global change in maternity care, particularly for those at greatest risk. She continues to educate and empower birth professionals in more than 20 countries, contributes to a variety of curricula, and shapes the future of maternal health through her impactful role as a speaker and mentor. Anne is the Director and founder of MaternityWise International, and her legacy lies in inspiring generational changes and elevating women's healthcare worldwide.
References:
American College of Obstetricians and Gynecologists. Gestational Hypertension and Preeclampsia. Practice Bulletin No. 222.
American College of Obstetricians and Gynecologists. Hypertension and Preeclampsia in Pregnancy.
Centers for Disease Control and Prevention. National Vital Statistics Reports. Births: Provisional Data for 2025. Volume 75, Number 4.
Centers for Disease Control and Prevention. Pregnancy Mortality Surveillance System.
American Heart Association. High Blood Pressure During Pregnancy.
The New York Times. Belluck, P. (July 29, 2026). High Blood Pressure in Pregnancy Has Surged in the U.S.
