Hypertension in Pregnancy – Guidelines, Resources, and Quality Improvement Tools

Hypertension in pregnancy, including chronic hypertension, gestational hypertension, and preeclampsia, is one of the leading causes of maternal and perinatal morbidity and mortality worldwide.  It is a leading cause of maternal morbidity and mortality and is associated with earlier onset of sustained chronic hypertension and increased incidence of cardiovascular disease and cardiovascular mortality. Because postpartum exacerbation of severe hypertension is common, the American College of Obstetricians and Gynecologists recommends that patients with severe hypertension during childbirth hospitalization be seen within 72 hours after discharge. 

The Hypertension in Pregnancy Change Package (HPCP) was developed in partnership with the American Academy of Family Physicians (AAFP), American College of Nurse-Midwives (ACNM), American College of Obstetricians and Gynecologists (ACOG), American College of Osteopathic Obstetricians and Gynecologists (ACOOG), American Medical Association (AMA), National Association of Nurse Practitioners in Women’s Health (NPWH), and the Society for Maternal-Fetal Medicine (SMFM).

On this page, you’ll find the Hypertension in Pregnancy Change Package, upcoming Action Forum opportunities, and curated resources from SMFM and our partners to help improve patient outcomes and reduce maternal morbidity.


Hypertension in Pregnancy Change Package

The HPCP is a practical, evidence-based quality improvement guide designed to help hospitals, clinics, and healthcare teams improve care processes for patients with hypertension during pregnancy and postpartum.

The HPCP is composed of change concepts, change ideas, and evidence- or practice-based tools and resources. 

Change concepts are general notions that are useful in the development of more specific ideas for changes that lead to improvement. 

Change ideas are specific, actionable ideas for changing a process. Change ideas can be rapidly tested on a small scale to determine whether they result in improvements in the local environment. 

Evidence- or practice-informed tools and resources listed with each change idea can be adapted or adopted in a clinical setting to improve identification and management of hypertension in pregnancy. 

This resource includes best practices, data collection tools, and implementation strategies to support better blood pressure management and early intervention.

Download the Change Package (PDF)


Action Forums & Quality Improvement Initiatives

SMFM hosts regular Million Hearts®Hypertension in Pregnancy Action Forumto bring together healthcare providers, quality improvement teams, and public health partners to share progress, discuss challenges, and implement evidence-based solutions.

These forums are part of a nationwide effort to reduce severe maternal morbidity and mortality caused by hypertensive disorders.

Upcoming Forum: Wednesday, November 12, 2025 from, 2:00 PM – 3:00 PM ET

For more information or any questions, please send an email to hypertension@smfm.org.


Organization   Resource
Society for Maternal-Fetal Medicine Society for Maternal-Fetal Medicine Special Statement: Quality metric for timely postpartum follow-up after severe hypertension
American College of Obstetricians and Gynecologists Gestational Hypertension and Preeclampsia
American College of Obstetricians and Gynecologists Chronic Hypertension in Pregnancy
California Maternal Quality Care Collaborative Improving Health Care Response to Hypertensive Disorders of Pregnancy Toolkit
California Maternal Quality Care Collaborative Low-Dose Aspirin (LDA) Campaign to Reduce Preeclampsia and Related Preterm Birth
Minnesota Perinatal Quality Collaborative Family of Measures, Stratify by race/ethnicity
Weill Cornell Medicine HTN QI: How to set up blood pressure flowsheet correctly
Duke University School of Medicine Management of Hypertension Guideline
Florida Perinatal Quality Collaborative Florida Hypertension in Pregnancy Toolkit
University Chicago Medicine STAMPP HTN: Systematic Treatment And Management of Postpartum Hypertension
Indiana Perinatal Quality Improvement Collaborative Preeclampsia Patient Education
Indiana Perinatal Quality Improvement Collaborative Ambulatory Preeclampsia Checklist
Indiana Perinatal Quality Improvement Collaborative Hypertension in Pregnancy-Ambulatory Readiness Assessment
ACOG District XII Cardiac Disease and Pregnancy
Illinois Perinatal Quality Collaborative Maternal Hypertension Grand Rounds
North and South Dakota Perinatal Quality Collaborative Hypertension Project 2021-2022: Learning Session 1
North and South Dakota Perinatal Quality Collaborative Hypertension Project 2022: Learning Session 2
Wisconsin Perinatal Quality Collaborative Aims/Goals Worksheet
Illinois Perinatal Quality Collaborative Illinois Maternal Hypertension Initiative Comprehensive Slide Set
Illinois Perinatal Quality Collaborative Mapping Tool Resources/Services in Hospital's Service Area to Address Patients' Social Determinants of Health
Illinois Perinatal Quality Collaborative Winnebago County resources
California Maternal Quality Care Collaborative CVD Risk Infographic
Wellspan Health Severe Hypertension Treatment and Follow-Up in Pregnancy and the Postpartum
Georgia Perinatal Quality Collaborative Cardiac Warning Watch Badge Buddy
Georgia Perinatal Quality Collaborative Cardiac Warning Watch Poster
CardioSmart Heart Health After Pregnancy
UConn Health Million Hearts® Self-Monitoring Blood Pressure (SMBP) Grant
Indiana Perinatal Quality Improvement Collaborative Blood Pressure Competency Checklist
Oklahoma Perinatal Quality Improvement Collaborative Preeclampsia Risk Assessment
Oklahoma Perinatal Quality Improvement Collaborative Provider Aspirin Decision Tree
Oklahoma Perinatal Quality Improvement Collaborative LDA Clinical Workflow
UNC Collaborative for Maternal and Infant Health Front Desk/Clinic Call Center Triage Flow Chart for Pregnant/Postpartum Patients with possible Severe Hypertensive Emergency
UNC Collaborative for Maternal and Infant Health OB Hypertensive Emergency Nifedipine Task Checklist
UNC Collaborative for Maternal and Infant Health Outpatient Hypertension Simulation Scenario
Jupiter Medical Center Medical Reconciliation Form
ACOG District II Oral Nifedipine Algorithm
Fort Health Care OB Hypertension
Northern Health Indigenous Health Cultural Safety, Respect and Dignity in Relationships
Baptist Health College Little Rock Plus Delta Debriefing Tool
American Medical Association Medication Management: Save Time by Simplifying Your Prescribing and Refill Process