{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:11:56Z","timestamp":1790737916586,"version":"4.1.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hypertensive disorders are a leading cause of mortality and morbidity during pregnancy. Despite multiple national and international clinical guidelines and a plethora of research in the field of optimising management, there has been limited research describing the perspectives and experiences of pregnant women with the management of hypertensive disorders of pregnancy (HDP). Understanding these perceptions and experiences is imperative to the optimisation of HDP management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A qualitative study involving face-to-face, in-depth interviews were undertaken with 27 pregnant women diagnosed with and being treated for HDP to explore their perspectives of and experiences with clinical management. Written consent was obtained individually from each participant, and the interviews ranged from 16 to 54\u2009min. Inductive codes were generated systematically for the entire data set. Line-by-line analysis was then performed and nodes were created within NVivo, a qualitative data management software. Data collection was continued until thematic saturation was reached. Thematic analysis was employed to interpret the data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three major descriptive themes were discerned regarding the women\u2019s perspectives on and experiences with the management of HDP: attitudes towards monitoring of HDP, attitudes and perceptions towards development and management of complications, and perceptions of pregnant women with chronic hypertension. Trust in the hospital system, positive attitudes towards close blood pressure monitoring as well as self-monitoring of blood pressure, and a realistic approach to emergency antenatal hospital admissions contributed to a positive attitude towards monitoring of HDP. Women with prior experiences of HDP complications, including pre-eclampsia, were more confident in their clinical management and knew what to expect. Those without prior experience were often in shock when they developed pre-eclampsia. Some women with chronic hypertension displayed limited understanding of the potential risks that they may experience during pregnancy and thus lacked comprehension of the seriousness of the condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The clinical management experiences of pregnant women with HDP were varied. Many women did not feel that they were well informed of management decisions and had a desire to be more informed and involved in decision-making. Clear, concise information about various facets of HDP management including blood pressure monitoring, prescription of the appropriate antihypertensive agent, and planning for potential early delivery are required<jats:bold>.<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1186\/s12913-021-07320-4","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T11:03:22Z","timestamp":1638443002000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Pregnant women\u2019s experiences with the management of hypertensive disorders of pregnancy: a qualitative study"],"prefix":"10.1186","volume":"21","author":[{"given":"Amyna","family":"Helou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kath","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnson","family":"George","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"7320_CR1","volume-title":"Maternity Care in Australia","author":"Royal Australian and New Zealand College of Obstetrians and Gynaecologists","year":"2017","unstructured":"Royal Australian and New Zealand College of Obstetrians and Gynaecologists. Maternity Care in Australia. 1st ed; 2017.","edition":"1"},{"issue":"2","key":"7320_CR2","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.ajog.2016.09.076","volume":"216","author":"S Roberge","year":"2017","unstructured":"Roberge S, Nicolaides K, Demers S, Hyett J, Chaillet N, Bujold E. The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis. Am J Obstet Gynecol. 2017;216(2):110\u201320 e6.","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"7320_CR3","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1046\/j.0004-8666.2003.00061.x","volume":"43","author":"L Dunlop","year":"2003","unstructured":"Dunlop L, Umstad M, McGrath G, Reidy K, Brennecke S. Cost-effectiveness and patient satisfaction with pregnancy day care for hypertensive disorders of pregnancy. Aust NZ J Obstet Gyn. 2003;43(3):207\u201312.","journal-title":"Aust NZ J Obstet Gyn"},{"issue":"1","key":"7320_CR4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1111\/ajo.12253","volume":"55","author":"SA Lowe","year":"2015","unstructured":"Lowe SA, Bowyer L, Lust K, McMahon LP, Morton MR, North RA, et al. The SOMANZ guidelines for the Management of Hypertensive Disorders of pregnancy 2014. Aust NZ J Obstet Gyn. 2015;55(1):11\u20136.","journal-title":"Aust NZ J Obstet Gyn"},{"issue":"9694","key":"7320_CR5","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1016\/S0140-6736(09)60736-4","volume":"374","author":"CM Koopmans","year":"2009","unstructured":"Koopmans CM, Bijlenga D, Groen H, Vijgen SMC, Aarnoudse JG, Bekedam DJ, et al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks\u2019 gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet. 2009;374(9694):979\u201388.","journal-title":"Lancet."},{"issue":"10021","key":"7320_CR6","first-page":"848","volume":"387","author":"K Broekhuijsen","year":"2016","unstructured":"Broekhuijsen K, van Baaren GJ, van Pampus MG. Immediate delivery versus expectant monitoring for hypertensive disorders of pregnancy between 34 and 37 weeks of gestation (HYPITAT-II): a multicentre, open-label randomised controlled trial (vol 385, pg 2492, 2015). Lancet. 2016;387(10021):848.","journal-title":"Lancet"},{"issue":"1","key":"7320_CR7","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1161\/HYPERTENSIONAHA.117.10803","volume":"72","author":"MA Brown","year":"2018","unstructured":"Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive disorders of pregnancy ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72(1):24\u201343.","journal-title":"Hypertension."},{"issue":"2","key":"7320_CR8","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.preghy.2014.01.003","volume":"4","author":"LA Magee","year":"2014","unstructured":"Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P, Pr CHD. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertens. 2014;4(2):105\u201345.","journal-title":"Pregnancy Hypertens"},{"key":"7320_CR9","doi-asserted-by":"crossref","unstructured":"East C, Conway K, Pollock W, Frawley N, Brennecke S. Women\u2019s experiences of preeclampsia: Australian action on preeclampsia survey of women and their confidants. J Pregnancy. 2011. Article number 375653.","DOI":"10.1155\/2011\/375653"},{"issue":"1","key":"7320_CR10","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1186\/s12884-018-1980-1","volume":"18","author":"F Ouasmani","year":"2018","unstructured":"Ouasmani F, Engeltjes B, Haddou Rahou B, Belayachi O, Verhoeven C. Knowledge of hypertensive disorders in pregnancy of Moroccan women in Morocco and in the Netherlands: a qualitative interview study. BMC Pregnancy Childbirth. 2018;18(1):344.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"4","key":"7320_CR11","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1111\/j.1479-828X.2011.01312.x","volume":"51","author":"E Sawicki","year":"2011","unstructured":"Sawicki E, Stewart K, Wong S, Leung L, Paul E, George J. Medication use for chronic health conditions by pregnant women attending an Australian maternity hospital. Aust NZ J Obstet Gynaecol. 2011;51(4):333\u20138.","journal-title":"Aust NZ J Obstet Gynaecol"},{"issue":"5","key":"7320_CR12","doi-asserted-by":"publisher","first-page":"474","DOI":"10.3109\/02770903.2012.678024","volume":"49","author":"AS Lim","year":"2012","unstructured":"Lim AS, Stewart K, Abramson MJ, Ryan K, George J. Asthma during pregnancy: the experiences, concerns and views of pregnant women with asthma. J Asthma. 2012;49(5):474\u20139.","journal-title":"J Asthma"},{"issue":"9","key":"7320_CR13","first-page":"1408","volume":"20","author":"PI Fusch","year":"2015","unstructured":"Fusch PI, Ness LR. Are we there yet? Data saturation in qualitative research. Qual Rep. 2015;20(9):1408\u201316.","journal-title":"Qual Rep"},{"key":"7320_CR14","unstructured":"Microsoft Windows NVivo 10. [Available from: http:\/\/help-nv10.qsrinternational.com\/desktop\/concepts\/about_nodes.htm.] Accessed 21 Feb 2020."},{"issue":"2","key":"7320_CR15","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"VC Braun","year":"2006","unstructured":"Braun VC, V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u2013101.","journal-title":"Qual Res Psychol"},{"key":"7320_CR16","unstructured":"Preeclampsia Foundation 2021 [Available from: https:\/\/www.preeclampsia.org\/health-information]. Accessed 11\/02\/2021."},{"key":"7320_CR17","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1186\/s12913-015-0967-0","volume":"15","author":"PR Ward","year":"2015","unstructured":"Ward PR, Rokkas P, Cenko C, Pulvirenti M, Dean N, Carney S, et al. A qualitative study of patient (dis) trust in public and private hospitals: the importance of choice and pragmatic acceptance for trust considerations in South Australia. BMC Health Serv Res. 2015;15:297.","journal-title":"BMC Health Serv Res"},{"issue":"3","key":"7320_CR18","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1080\/13698575.2013.776017","volume":"15","author":"SB Meyer","year":"2013","unstructured":"Meyer SB, Ward PR. Differentiating between trust and dependence of patients with coronary heart disease: furthering the sociology of trust. Health Risk Soc. 2013;15(3):279\u201393.","journal-title":"Health Risk Soc"},{"issue":"5","key":"7320_CR19","doi-asserted-by":"crossref","first-page":"S160","DOI":"10.1016\/S0002-9378(02)70189-0","volume":"186","author":"ED Hodnett","year":"2002","unstructured":"Hodnett ED. Pain and women\u2019s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002;186(5):S160\u2013S72.","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"7320_CR20","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1080\/10641950701547549","volume":"26","author":"LA Magee","year":"2007","unstructured":"Magee LA, von Dadelszen P, Chan S, Gafni A, Gruslin A, Helewa M, et al. Women\u2019s views of their experiences in the CHIPS (control of hypertension in pregnancy study) pilot trial. Hypertension Pregnancy. 2007;26(4):371\u201387.","journal-title":"Hypertension Pregnancy"},{"key":"7320_CR21","doi-asserted-by":"publisher","unstructured":"Tucker KL, Sheppard JP, Stevens R, Bosworth HB, Bove A, Bray EP, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389. https:\/\/doi.org\/10.1371\/journal.pmed.1002389.","DOI":"10.1371\/journal.pmed.1002389"},{"issue":"3","key":"7320_CR22","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1111\/j.1524-6175.2006.04872.x","volume":"8","author":"G Ogedegbe","year":"2006","unstructured":"Ogedegbe G, Schoenthaler A. A systematic review of the effects of home blood pressure monitoring on medication adherence. J Clin Hypertens (Greenwich). 2006;8(3):174\u201380.","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"7320_CR23","doi-asserted-by":"publisher","unstructured":"Hinton L, Tucker KL, Greenfield SM, Hodgkinson JA, Mackillop L, McCourt C, et al. Blood pressure self-monitoring in pregnancy (BuMP) feasibility study; a qualitative analysis of women\u2019s experiences of self-monitoring. BMC Pregnancy Childbirth. 2017;17(1):427. https:\/\/doi.org\/10.1186\/s12884-017-1592-1.","DOI":"10.1186\/s12884-017-1592-1"},{"issue":"5","key":"7320_CR24","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1097\/HJH.0000000000002734","volume":"39","author":"KL Tucker","year":"2021","unstructured":"Tucker KL, Hodgkinson J, Wilson HM, Crawford C, Stevens R, Lay-Flurrie S, et al. Current prevalence of self-monitoring of blood pressure during pregnancy: the BUMP survey. J Hypertens. 2021;39(5):994\u20131001.","journal-title":"J Hypertens"},{"key":"7320_CR25","volume-title":"Adherence to long-term therapies: evidence for action","year":"2003","unstructured":"Sabate E, editor. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003."},{"issue":"3","key":"7320_CR26","doi-asserted-by":"publisher","first-page":"341","DOI":"10.3109\/10641955.2010.507851","volume":"31","author":"WB You","year":"2012","unstructured":"You WB, Wolf M, Bailey SC, Pandit AU, Waite KR, Sobel RM, et al. Factors associated with patient understanding of preeclampsia. Hypertens Pregnancy. 2012;31(3):341\u20139.","journal-title":"Hypertens Pregnancy"},{"key":"7320_CR27","doi-asserted-by":"crossref","unstructured":"Barlow JHHJ. Thornton S Women\u2019s experiences of hospitalisation with hypertension during pregnancy: feeling a fraud. J Reprod Infant Psychol. 2008;26(3):157\u201367.","DOI":"10.1080\/02646830701691384"},{"issue":"5","key":"7320_CR28","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1111\/resp.12773","volume":"21","author":"E Zairina","year":"2016","unstructured":"Zairina E, Abramson MJ, McDonald CF, Li J, Dharmasiri T, Stewart K, et al. Telehealth to improve asthma control in pregnancy: a randomized controlled trial. Respirology. 2016;21(5):867\u201374.","journal-title":"Respirology."},{"issue":"2","key":"7320_CR29","doi-asserted-by":"publisher","first-page":"92","DOI":"10.12968\/bjom.2019.27.2.92","volume":"27","author":"EKA Sheehan","year":"2019","unstructured":"Sheehan EKA, Kay L. Using a smartphone app to identify signs of pre-eclampsia and\/or worsening blood pressure. Br J Midwifery. 2019;27(2):92\u20139.","journal-title":"Br J Midwifery"},{"issue":"1","key":"7320_CR30","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.wombi.2019.06.002","volume":"33","author":"D Coates","year":"2020","unstructured":"Coates D, Goodfellow A, Sinclair L. Induction of labour: experiences of care and decision-making of women and clinicians. Women Birth. 2020;33(1):e1\u2013e14.","journal-title":"Women Birth"},{"issue":"1","key":"7320_CR31","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1186\/s12884-019-2687-7","volume":"19","author":"M Benton","year":"2019","unstructured":"Benton M, Salter A, Tape N, Wilkinson C, Turnbull D. Women\u2019s psychosocial outcomes following an emergency caesarean section: a systematic literature review. BMC Pregnancy Childbirth. 2019;19(1):535.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"5","key":"7320_CR32","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1007\/s10995-009-0518-6","volume":"14","author":"CH Chuang","year":"2010","unstructured":"Chuang CH, Velott DL, Weisman CS. Exploring knowledge and attitudes related to pregnancy and preconception health in women with chronic medical conditions. Matern Child Hlth J. 2010;14(5):713\u20139.","journal-title":"Matern Child Hlth J"},{"issue":"11","key":"7320_CR33","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1161\/CIRCULATIONAHA.113.003904","volume":"129","author":"EW Seely","year":"2014","unstructured":"Seely EW, Ecker J. Chronic hypertension in pregnancy. Circulation. 2014;129(11):1254\u201361.","journal-title":"Circulation."},{"key":"7320_CR34","doi-asserted-by":"crossref","unstructured":"Giorgione V, Ridder A, Kalafat E, Khalil A, Thilaganathan B. Incidence of postpartum hypertension within 2 years of a pregnancy complicated by pre-eclampsia: a systematic review and meta-analysis. BJOG. 2021;128(3):495\u2013503.","DOI":"10.1111\/1471-0528.16545"},{"key":"7320_CR35","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.midw.2017.01.004","volume":"46","author":"LM Roberts","year":"2017","unstructured":"Roberts LM, Davis GK, Homer CS. Pregnancy with gestational hypertension or preeclampsia: a qualitative exploration of women\u2019s experiences. Midwifery. 2017;46:17\u201323.","journal-title":"Midwifery."},{"issue":"1","key":"7320_CR36","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.wombi.2020.08.010","volume":"34","author":"I Garti","year":"2021","unstructured":"Garti I, Gray M, Tan JY, Bromley A. Midwives\u2019 knowledge of pre-eclampsia management: a scoping review. Women Birth. 2021;34(1):87\u2013104.","journal-title":"Women Birth"},{"key":"7320_CR37","doi-asserted-by":"publisher","unstructured":"Shanmugalingam R, Mengesha Z, Notaras S, Liamputtong P, Fulcher I, Lee G, et al. Factors that influence adherence to aspirin therapy in the prevention of preeclampsia amongst high-risk pregnant women: a mixed method analysis. PLoS One. 2020;15(2):e0229622. https:\/\/doi.org\/10.1371\/journal.pone.0229622.","DOI":"10.1371\/journal.pone.0229622"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-021-07320-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-021-07320-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-021-07320-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T22:53:05Z","timestamp":1673909585000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-021-07320-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["7320"],"URL":"https:\/\/doi.org\/10.1186\/s12913-021-07320-4","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"12 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from Mercy Health Human Research Ethics Committee Heidelberg-Melbourne (R12\/62) 08\/01\/2013, The Royal Women\u2019s Hospital Research and Human Research Ethics Committee Parkville-Melbourne (R13\/18) 12\/07\/2013 and Monash University Human Research Ethics Committee Clayton-Melbourne (CF13\/117) 18\/01\/2013. Informed written consent was obtained prior to each interview, which included permission to audio record the conversation and use quotations when anonymously reporting and publishing the results. All methods were carried out in accordance with relevant guidelines and regulations of the ethics committees.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1292"}}