Hypertension in Pregnancy Change Package

What Is the Hypertension in Pregnancy Change Package (HPCP)?

The 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). It presents an evidence-informed listing of process improvements with accompanying tools and resources that outpatient clinicians and care team members can implement as they provide care to pregnant and postpartum women and women of reproductive age with a focus on early identification, optimal management, and prevention of complications of hypertension in pregnancy.

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.
Join the Million Hearts® Action Forum

The Million Hearts® Hypertension in Pregnancy Action Forum provides an opportunity for clinical, public health, and community-based partners to exchange best and promising practices, identify solutions to common obstacles,

and share resources related to improving hypertension management during and after pregnancy.

Please register for the 2025 Action Forums here.

  • Feb 11, 2025 (2:00 PM ET – 3:00 PM ET)
  • May 13, 2025 (2:00 PM ET – 3:00 PM ET)
  • Aug 14, 2025 (2:00 PM ET – 3:00 PM ET)
  • Nov 12, 2025 (2:00 PM ET – 3:00 PM ET)

For more information about the Action Forum, please send an email to MillionHeartsHPAF@cdc.gov.

The purpose of the HPCP is to help outpatient clinicians put more efficient and effective systems in place to care for patients with hypertension in pregnancy. It is meant to serve as a menu of options from which practices can select specific interventions to improve diagnosis and management of hypertension in pregnancy.

The HPCP is broken down into four focus areas:

Key foundations; equipping care teams; population health management; individual patient supports.

How Should We Use the HPCP?

Start by bringing together a team of clinicians, administrators, and other interested parties to discuss the aspects of hypertension in pregnancy that are most in need of improvement. The team can then select corresponding interventions from the HPCP that best address those issues.

Each strategy you choose should first be tested on a small scale (i.e., conduct “small tests of change”) to assess feasibility and allow the team to evaluate and adjust before instituting the change on a broader, more permanent scale.

We do not recommend that any practice attempt to implement all of the interventions at once, nor is it likely that all interventions will be applicable to your clinical setting.

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