Most women with chronic hypertension have good pregnancy outcomes, but these women are at increased risk for pregnancy complications, as compared with the general population. The risk of an adverse outcome increases with the severity of hypertension and end-organ damage.2 Furthermore, some antihypertensive agents carry risks in pregnancy and should be discontinued before conception.3 Since nearly 50% of pregnancies in the United States are unplanned,4 it is important to counsel women of reproductive age who have hypertension regarding such risks as part of routine care.