Hypertension in Pregnancy

In 2021 MNPQC hosted a statewide quality improvement initiative to improve the identification, treatment, and follow up of hypertension in pregnancy and the postpartum period. Information/resources on this work is found here.

These are a variety of resources provided by MPO/MNPQC and other organizations for healthcare providers and the public. Many links are provided by other organizations and are subject to change without notice.


US pregnancies affected by hypertensive disorders.


of maternal deaths in the US are attributed to severe maternal hypertension


of severe obstetric complications from Preeclampsia/Eclampsia

6% & 19%

(preterm births & medically indicated induced preterm births)

are the result of severe maternal hypertension

Hypertension in Pregnancy/Postpartum Patient Experience Survey

Blue Band Patient Experience Survey


Hypertensive disorders of pregnancy are increasing in incidence and are a leading cause of severe maternal morbidity(SMM). Timely treatment of hypertensive urgency is a well-understood best practice but can be challenging to operationalize consistently:

  • Hypertensive disorders of pregnancy affect 3-11% of all pregnancies.
  • Minnesota and national data demonstrate Black and Native American women are disproportionately impacted.
  • Other risk factors include hypertension prior to pregnancy, advanced maternal age, Type 1 or 2 diabetes, obesity, multiple gestations, and prior preeclampsia.
  • Hypertensive disorders of pregnancy are responsible for up to 17% of all maternal mortality in the US.
  • Neonatal outcomes are impacted.
  • The American College of Obstetrics and Gynecology endorses treating a hypertensive crisis within 60 minutes to reduce the risk for stroke and other adverse outcomes.

Aim: By Feb. 2023, we will develop reliable processes of  recognition and treatment of obstetric hypertension (HTN) during pregnancy and up to six weeks postpartum to reduce severe maternal morbidity (SMM) by 25% and achieve 80% or higher compliance of the HTN recognition tool and OB HTN emergency pathway.


  • 1. Assess individual health system barriers and facilitate solutions to implement hypertension treatment strategies.

  • 2. Assess provider knowledge of interventions to reduce hypertension including treatment disparities for Black and Native American women and offer education opportunities to increase provider knowledge.

  • 3. Introduce a standardized process for treatment of hypertension including standardized order set, medication treatment kit and/or discharge planning protocol.

  • 4. Identify methods to incorporate anti-racism into individual practice and organizational guidelines.

  • 5. Identify various methodologies to enhance patient education and engagement to increase early recognition and intervention.



Working Group

Bethany Sabol

Hypertension Initiative Co-Chair, MHealth Fairview

Dr. Sabol received her Obstetrics & Gynecology training at Oregon Health & Science University and completed her Maternal-Fetal Medicine training at Washington University in St. Louis. She is now full-time faculty at the University of Minnesota/MHealth Fairview. Her career focus is centered on hypertensive disorders of pregnancy and quality improvement and implementation science in obstetrics. She is currently receiving her Master’s in Patient Safety and Healthcare Quality from Johns Hopkins Bloomberg School of Public Health. Her experience with quality improvement started as a resident working on a multidisciplinary effort to improve communication and patient outcomes in the setting of unplanned cesarean deliveries. During her fellowship, to combat high postpartum readmission rates and to improve maternal outcomes, she implemented a postpartum home blood pressure monitoring system for all hypertensive patients delivered at that institution. She is eager and excited to work towards improving access, quality, and healthcare equity for birthing people in our state.

Melissa Bray

CentraCare / AWHONN MN Section

Melissa has been working in obstetrical nursing for the past 20 years at a variety of facilities, from the small community hospital, to a large urban obstetrical care unit. She has worked as a Charge RN, a circulator, scrub and assist in the OR. Her current work as a Nurse Clinician began in August of 2013 at CentraCare Health, St. Cloud Hospital. Melissa is a part of the Molnlycke Speaker’s Bureau. She is a former Perinatal Expert Consultant with the Minnesota Hospital Association (MHA), and serves on the MHA Perinatal Safety Committee. Melissa serves on the Minnesota Perinatal Quality Collaborative and the Maternal Mortality Review Committee through the Minnesota Department of Health. Melissa is a 2012 Graduate of Western Governors University with a Master’s in Nursing Education. She is a present member of ANA, AWHONN, MOLN, AORN, ASPAN and Sigma Theta Tau professional nursing organizations, and serves as the current AWHONN Minnesota state chair. She was featured in “The Call of Nursing” written by William Patrick.

Anne Walaszek

MNPQC Executive Branch

Anne Walaszek, MPH (Anishinaabe) is the Maternal and Child Health Quality Improvement Specialist in the Women and Infant Health Unit at the Minnesota Department of Health. In her role, she leads two quality improvement grants, the Perinatal Quality Collaborative and the Communities Collaborating to Prevent Girls Opioid Abuse. Ms. Walaszek has experience working at a national non-profit addressing cancer inequities within American Indian and Alaska Native communities. In this role, she provided leadership for a clinic and community health approach to develop and implement culturally tailored evidence-based interventions to effectively build capacity in health systems across Indian Country. Her public health experience reflects grant writing, program development, research and data management throughout her experiences at the Minnesota Department of Health Diabetes Program, Institute of Child Development at the University of Minnesota, and SAMHSA for their Child, Adolescent and Family Branch. She is a 2017 recipient of the Lou Fuller Award for Distinguished Service in Eliminating Health Disparities.


Susan Thompson Boehm

MPO Executive Director/Treasurer, MNPQC Co-Director

Susan has been a Clinical Nurse Specialist in Women’s Health for over 30 years. She has a long history with MPO as a volunteer, conference presenter, planning committee member, and has served on the Board of Directors. She is currently the MPO Executive Director and Co-Director of the Minnesota Perinatal Quality Collaborative (MNPQC).

She enjoys the outdoors, hiking and kayaking, and loves the solitude of their cabin in the Boundary Waters.

Todd Stanhope

MNPQC Faculty

Dr. Stanhope is a full-time OB/GYN hospitalist and medical director of Women and Children’s services at North Memorial Health Hospital. His clinical interests include hypertension, complex deliveries, and postoperative opioid prescribing. Prior to his current position, he provided contracted OB coverage at a number of facilities, high and low volume, in several states and completed two missions to South Sudan with Doctors Without Borders from which he gained invaluable experience learning the myriad needs and challenges different facilities and systems face.

Jane Taylor
Ed.D., Hospital & Health Advisor to Improvers and Learners.
Yvy Rivera-Chiauzzi
Enid Rivera-Chiauzzi MD is an Assistant Professor and Consultant in the Department of Obstetrics and Gynecology at Mayo Clinic Rochester. She is a full-time Laborist at the Family Birth Center at Methodist Hospital. Her primary areas of research are understanding healthcare worker experiences after adverse stressful events (Second Victim Experience) and understanding their experience after encounters with racism and discrimination at work. She is using this research to help healthcare workers thrive after such events through peer support. Her clinical areas of research include surgical site infections, patient and OBGYN physician experiences during COVID, and improve postpartum care. She is an instructor of the Emergencies in Clinical Obstetrics (ECO) course offered by (ACOG) and instructor of the Advanced Life Support in Obstetrics (ALSO) by AAFP. She is the Co-Director for the Peer Support Program Healing the Emotional Lives of Peers (HELP) at Mayo Clinic. She is the Physician/Scientist Chair for Somos Latinos Mayo Employee Resource Group.
Alina Kraynak


No bio at this time.

Angie Thompson

Mayo Clinic

Arielle Skalisky


Ari is an experienced labor and delivery nurse and newly Certified Nurse Midwife. She was born in Addis Ababa, Ethiopia and grew up in Hermantown, Minnesota. She graduated from The College of Saint Scholastica (BSN) in 2016, and most recently, The University of Minnesota (DNP) in 2020. Ari was involved in the Improvement of Neonatal Abstinence Syndrome Outcomes project and her interests include health disparities among minority women; adolescent health; perinatal mood disorders.

Becky Gams

MHealth Fairview / AWHONN MN Section

Becky obtained a BSN at the University of Wisconsin Eau Claire and a Masters of Science from the University of Minnesota. She has over 30 years of obstetrical nursing experience at the bedside, as an education specialist and is currently an Advanced Practice Nurse Leader for the Women’s and Children’s Service Line at MHealth Fairview. She is certified as a Women’s Health Nurse Practitioner. Becky is one of the founding members of the Zero Birth Injury Initiative at MHealth Fairview, a perinatal safety initiative aimed at reducing preventable birth injuries to both mothers and newborns. She is the co-lead the ZBI Steering Committee and the ZBI leadership team for MHealth Fairview with Dr. Phillip Rauk. She is the recipient of the University of Minnesota Medical Center Visionary Nurse Leader Award in 2016.

Beth Elfstrand


Dr Elfstrand has been a practicing physician in Minneapolis for 26 years. She has served in leadership roles at Abbott Northwestern Hospital for over a decade and served on Alina pregnancy care council for many years and worked on multiple quality projects. She is serving as chair of ACOG in MN and go to several district and national meetings each year.

Cameron Berg

North Memorial

No bio at this time.

Cara Carter

University of Minnesota

No bio at this time.

Carrie Neerland

MHealth Fairview / MN ACNM

Carrie Neerland is an Assistant Professor in the University of Minnesota’s Nurse-Midwifery program and practices full-scope midwifery. Dr. Neerland has experience with quality improvement projects in maternity care, especially around reducing primary cesarean births. Dr. Neerland represents the Minnesota Affiliate of the American College of Nurse-Midwives.

Charles Snow

CentraCare Health

CJ is a board certified OB/GYN with broad experience in both rural and urban practice settings. He is currently employed as a OB laborist at St. Cloud Hospital and recently completed an MBA from St. Thomas.

Elizabeth Baldwin

Allina Health

Heather Brusegard

Family Advocate

Heather Brusegard, Special Assistant, US Federal Government. Heather grew up in St. Paul, Minnesota and graduated from the University of Minnesota with a degree in Child Psychology. Heather and her husband Derek reside in Brooklyn Park, Minnesota with their two children, Eleanor (5.5) and Scarlett (3). Heather delivered Scarlett twelve weeks early and has been actively involved with the NICU & antepartum community since.

Janyne Althaus

Essentia Health

Julie Shelton

Essentia Health

Julie Shelton DNP, APRN, CNS for the Birthplace/NICU at Essentia Health St. Mary’s Medical Center Duluth, MN. She has worked for 33 years as an RN at this facility. She has been the Education Coordinator at a critical access hospital, the Coordinator for our High Risk OB Clinic and our NICU Follow-Up Clinic. She is responsible for system initiatives and quality metrics. She provides education for staff surrounding High Risk OB and Critical Care Obstetrics.

Kathy Pfleghaar

CentraCare Health

No bio at this time.

Katie Linde


No bio at this time.

Kelly Drake

The Mother Baby Center • Abbott Northwestern Hospital MSN, RNC, C-ONQS, PHN
Clinical Program Specialist

Marijo Aguilera


Melanie Dixon

MHealth Fairview

Melanie is a OB GYN practicing with M Health Fairview Women’s Clinic in Burnsville, MN at Ridges Hospital. She attended medical school at the University of N.C.-Chapel Hill, and completed residency training at Mayo Clinic Graduate School of Medicine in Rochester, MN.

Michael Kassing


No bio at this time.

Sara Wiggins

Black Nurses Association

Shalana Bolton


Shalana represents the St. Cloud ETC as a nurse educator. She has been an ED RN for 15 years and an educator for the past 3. She has a passion for the OB population.

Sara Wiggins

Black Nurses Association

Sara has over 27 years of experience in the health care field. Her experience includes OB/GYN, and currently, work for a health plan and help navigate members through policies, claims, utilization processes, and coverage.

Tanya Melnik

MHealth Fairview

Tanya has worked in Obstetric Medicine since 2004. Her interest in hypertensive disorders of pregnancy resulted in collaboration with Preeclampsia Foundation and the first White Paper on preeclampsia and future cardiovascular risk. She holds Master’s degree in Patient Safety and has worked on several quality improvement projects in her organization.

Tony Pelzel

MHealth Fairview

Tony Pelzel, M.D. is a family medicine physician and the director of family medicine with obstetrics at HealthEast. He has over ten year’s experience providing maternity care and practicing primary care medicine in St. Paul.

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