Hypertensive disorders of pregnancy (HDP) are one of the leading causes of maternal and fetal morbidity and mortality worldwide and complicates 8–13 % of pregnancy[1], [2]. Early identification of those who are at high risk of developing complications is a major challenge in low and middle income countries (LMICs), resulting in 99 % of maternal deaths from HDP in LMICs[1], [3], [4].

Close antenatal surveillance and timely interventions can prevent these adverse outcomes. Optimizing healthcare services to prevent and treat women with HDP is a necessary step toward achieving the Millennium development goal. Women with HDP need frequent surveillance for optimum control of blood pressure levels. As women with high blood pressure are advised more frequent antenatal visits for BP monitoring, it can be a source of anxiety to the patient, and be demanding in terms of time, transport costs, and work absence. It also has significant cost implications for setting with limited healthcare resources [5].

Home blood pressure monitoring (HBPM) which involves patients measuring their own BPs outside a clinical setting, has been effectively implemented in many high-income countries (HICs) and has successfully demonstrated good accuracy and adherence [6], [7]. HBPM allows more number of BP recordings to be obtained without any additional cost. The potential benefits of HBPM in pregnancy include early detection of preeclampsia (PE), convenience and reduced healthcare costs, as well as increased compliance and acceptance of monitoring [8], [9], [10], [11], [12].

However, the evidence regarding the efficacy and safety of HBPM during pregnancy in a low-resource developing country setting is limited [9]. The study was therefore planned with the objective of the comparison of the average BP records in women with HDP on HBPM and on standard care and also evaluated the adherence to HBPM in them. We also tried to find out the incidence of maternal and fetal complications in women on HBPM and those under BP monitoring by clinician.