Available online 20 September 2022

This qualitative study included interviews with pregnant women, their clinicians, and clinic observations.

Effective partnerships between women and clinicians underpinned the use of SMBP.

Uncertainty remained around home-clinic differences and translating this into clinical decisions.

SMBP is acceptable to hypertensive pregnant women and their clinicians.

Self-monitoring of blood pressure (BP) has been shown to be effective at improving BP control in the general population. The OPTIMUM-BP feasibility study was a prospective randomised controlled trial of self-monitoring of BP (SMBP) during hypertensive pregnancy.

To explore experiences, perceptions, and use of the OPTIMUM-BP self-monitoring intervention

Study design

Qualitative study within the OPTIMUM-BP feasibility trial. Semi-structured interviews with a purposive sample of pregnant women with chronic hypertension (n=24) and their clinicians (n=8) as well as 38 ethnographic observations of antenatal visits.

Women found self-monitoring of BP feasible and acceptable and were highly motivated and pro-active in their monitoring, reporting greater control and knowledge of BP and reassurance. Women’s persistence with SMBP was driven by a perceived need to safeguard the pregnancy, particularly among those taking antihypertensive medication. Clinicians also described the intervention as acceptable, though BP variability could cause uncertainty. Clinicians used different heuristics to integrate home and clinic readings. Observations suggested close working relationships between women and clinicians were key for confident integration of self-monitoring.

Self-monitoring of BP was acceptable both to pregnant women with hypertension and their clinicians. More research is needed to understand BP variability within pregnancy to help interpret and integrate home BP readings for improved BP management. Clinical pathways that use BP self-monitoring should aim to maintain the continuity of care and relationships that are valued and appear pivotal for the confident and safe use of self-monitoring in pregnancy.

Pregnancy

hypertension

self-monitoring

blood pressure

qualitative

ethnography

© 2022 The Authors. Published by Elsevier B.V. on behalf of International Society for the Study of Hypertension in Pregnancy.