Pregnant woman touching her belly and measuring her blood pressure in the kitchen.

PhD student aims to raise awareness of hypertensive disorders of pregnancy among Black Canadian women

5 February 2024

The impact of race and ethnicity on women’s cardiovascular health is at the heart of Deborah Baiden’s doctoral research examining hypertensive disorders of pregnancy among Black Canadian Women.

Baiden, a PhD candidate at the Lawrence Bloomberg Faculty of Nursing and a trainee member of the Canadian Women’s Heart Health Alliance has found throughout her research, studies indicating Black women in the US are five times more likely to die of hypertensive disorders of pregnancy, while in the UK, that number stands at around four times more likely, compared to non-Black pregnant women.

However, in examining the risk profile of Black Canadian women, Baiden found that literature was limited on this demographic and these types of hypertensive disorders of pregnancy among the Canadian population.

“It is my personal belief that no one should be at risk of losing their life while bringing another life into this world,” says Baiden. “This finding solidified for me why this work is important, because we don’t have this data on Black Canadian women, and yet we know from evidence in other countries that they are at a higher risk of complications and hypertensive disorders of pregnancy,” says Baiden.

Hypertensive disorders of pregnancy encompass a variety of conditions, including gestational hypertension which can occur after 20 weeks of pregnancy. It can also include preeclampsia, a condition in which the pregnant person’s blood pressure remains dangerously high, amplifying stress on the heart muscle and affecting the central nervous system which can result in seizures. It can also lead to pre-term birth or stillbirth.

Most of the time, hypertension in pregnancy resolves once the individual has given birth, but there is emerging research showing that women who experience hypertension in pregnancy can experience lasting negative effects on their heart health.

In addition to a family history of cardiovascular disease and a higher BMI (Body Mass Index), other factors have emerged as contributing to a high risk of hypertension in pregnancy, says Baiden. These include socio-economic status, lower income and educational level, and limited access to health care services especially for refugees or those without immigration status.

“We see a lot of newcomers to Canada experience a deterioration in their health status,” says Baiden. “Passing the medical examination as part of the immigration process might mean new Canadians are in good health when they arrive, but barriers to improving their socio-economic status including obtaining licenses to pursue their professions, can have a significant negative impact on their health status in the years that follow.”

Baiden also points to the role that gender and discrimination can play in relation to risk factors for developing hypertension in pregnancy, and how the culmination of factors around race, and socioeconomic status can leave women feeling that their concerns are brushed aside by health care providers and inhibit their ability to seek out care and support when they need it.

“This is why it is imperative that we understand who is at risk of developing hypertensive disorders during pregnancy, and how awareness and changes to the structure of care provided to women, especially Black women, can drive change in the area of cardiovascular disease,” says Baiden.

Baiden, with the support of her supervisor Professor Monica Parry, is currently conducting a mixed-methods study recruiting women over 18 years of age, of African descent from across Canada, who have a history of hypertension in pregnancy within the last ten years. She is also working with a patient partner, a woman of African descent with lived experience of hypertension in pregnancy, to ensure her research is co-designed with what matters to patients in mind.

“I’m looking forward to seeing what this study will reveal about the prevalence of hypertensive disorders of pregnancy among Black Canadians, but also how it will drive further research on this topic and inform culturally safe care practices that align with a long-term and rigorous strategy around cardiovascular health in women,” says Baiden.

Some of these strategies Baiden believes, should be taking a preventative approach that aims to provide greater awareness of cardiovascular disease and pregnancy related hypertension through community campaigns that provide knowledge in a culturally specific way, taking into consideration collective cultures and the importance of community engagement.

“Knowledge is power. When someone doesn’t have knowledge about a certain disease or prevention strategies, it is always dangerous,” says Baiden. “Making sure that knowledge is readily available and accessible in a way that populations understand and that is safe for them is key.”

Having recently received an inaugural Personnel Award for Black Scholars from the Heart and Stroke Foundation and Canadian Institutes for Health Research (CIHR), Baiden is hoping her research will help raise more awareness about pregnancy related cardiovascular diseases and create pathways to inform policy about how pregnancy care is being administered, especially among Black Canadians.

February 13 is Wear Red Day Canada, an awareness day created by the Canadian Women’s Heart Health Alliance to help drive changes in messaging around cardiovascular disease in women, that target more diverse populations and improve care for all Canadians. Learn more