Patient perspectives, facilitators, and barriers to care in hypertensive disorders of pregnancy

Background Hypertensive disorders of pregnancy (HDP) are leading causes of maternal morbidity and mortality, especially among populations who are underserved by the healthcare system. However, little is known about how patients experience and navigate HDP within the context of healthcare and social systems. Methods This qualitative study explored the perspectives of patients diagnosed with HDP to better understand barriers, facilitators, and the influence of social determinants on their care. Five virtual focus groups were conducted with 20 patients who had experienced a pregnancy complicated by HDP within the last three years. Transcripts were analyzed using directed qualitative content analysis. Coding and theme development were informed by a multidisciplinary research team and a patient advisory panel. Results Participants described varied reactions to their HDP diagnosis, ranging from fear and denial to confusion due to overlapping symptoms with comorbidities. Key care facilitators included personalized and accessible care, frequent monitoring, and emotional support from providers. Barriers included difficulties adjusting to medications, life stressors that interfered with adherence, limited health literacy and other adverse social determinants, and inconsistent communication from care teams. Conclusions Patient experiences with HDP highlight the need for more personalized and contextually responsive care strategies. Addressing systemic barriers and incorporating patient perspectives into care delivery may strengthen trust, improve adherence, and enhance outcomes for women at increased risk for hypertensive complications during pregnancy.