The goal of this clinical trial is to learn if a telehealth hypertension group prenatal care program (Centering HER / HGPC-T) can improve blood pressure monitoring and aspirin adherence and help reduce early-onset preeclampsia in low-income, predominantly Black pregnant participants in Kansas who are <13 weeks gestation, age ≥18, and moderate or high risk for preeclampsia (USPSTF).

The main question[s] it aims to answer [is/are]:

Does Centering HER increase hypertension monitoring and aspirin compliance compared with usual doula care?

Is Centering HER feasible and acceptable, and what contextual factors influence implementation in community clinics?

The study will compare Centering HER (routine prenatal care + 7 doula-led 90-minute virtual group sessions with OB/GYN fellow oversight + Bluetooth BP cuff/scale ± Apple Watch) to usual doula care + routine prenatal care to see if the intervention improves monitoring/adherence and supports better BP-related outcomes.

Participants will:

• Be randomized 2:1 to Centering HER or usual doula care.
• Complete REDCap surveys at baseline, antepartum, and postpartum.
• If assigned to Centering HER, attend 7 virtual group sessions and self-monitor/report BP and weight using a Bluetooth BP cuff/scale (± Apple Watch), and keep a medication log if applicable.

Inclusion Criteria:

• English or Spanish speaking
• <13 weeks gestations
• >18 years old
• moderate or high risk for hypertensive disorders in pregnancy

Exclusion Criteria:

• less than18 years of age
• not receiving prenatal care
• not eligible for doula care
• no risk factors for hypertensive disorders in pregnancy

The study focuses on pregnant women, so females are included in the study.

The IPD will not be shared with other researchers outside of the study team to date. Currently the decision is undecided unless IRB approved to share with other researchers.