Study finds respectful care key to outpatient care for pregnancy-related hypertension

Hypertension is a leading cause of death and complications among U.S. pregnant and postpartum women. In hospitals, providers use an intervention called the Severe Hypertension During Pregnancy and Postpartum Patient Safety Bundle to recognize and treat the condition. Yet many women with severe high blood pressure in pregnancy are treated in an outpatient setting instead. A Maternal Health Community Implementation Program (MH-CIP) research team led by the University of North Carolina at Chapel Hill examined the barriers and facilitators to integrating the Bundle into outpatient care.

“From data instrument creation to data collection, patient perspectives and community voices were integral to understanding the facilitators and barriers to Bundle implementation. Additionally, community engagement was a vital component in defining respectful care and understanding what respectful care means and looks like from different perspectives.” Implementation Science Communications, January 2025

Community voices were leveraged throughout the process, including in interviews with providers and focus groups with patients. Participants were identified through a partnership with a system of federally qualified health centers in rural North Carolina. This setting allowed researchers to capture the unique perspectives of rural providers, as well as rural patients, who have higher rates of hypertensive disorders of pregnancy.

The idea of “respectful care” emerged as a key theme. Respectful care was identified as central to the successful recognition and treatment of severe hypertension in pregnancy in outpatient care. This includes effective communication between provider and patient. 

During the study, the inpatient Bundle was revised to incorporate the concept of respectful care, further signaling its significance in improving outcomes for pregnant women with hypertension across care settings.

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