Background: Antihypertensive drugs are used during pregnancy for both chronic hypertension and gestational hypertension. Methyldopa, labetalol and nifedipine are considered safe for the fetus during pregnancy and are therefore recommended in the Dutch guidelines. Objectives: To determine how often antihypertensive drugs are prescribed in pregnancy and whether recommended drugs are prescribed. Methods: Using IADB.nl, a database with prescription records of 500,000 people in the Netherlands we investigated the use of antihypertensive drugs of women in the 273 days before the birth of their child. Results: Antihypertensive drugs were used in 2.3% of the pregnancies. Of these 44% used a not recommended drug in the first trimester of pregnancy, 22% in the second trimester and 10% in the third trimester. Of the pregnant women with chronic hypertension 49% used a recommended drug already before the pregnancy, 23% stopped using antihypertensive drugs during pregnancy and 17% switched to a recommended drug. 10% used a not recommended antihypertensive drug during the whole pregnancy. Of the women who started an antihypertensive drug after the 20th week of pregnancy, probably the group with gestational hypertension, 94% used a recommended drug. Conclusions: In most pregnancies antihypertensive drugs were used which are recommended as safe for the unborn child by the Dutch guidelines. In the first trimester 44% used a not recommended drug. Of the women with chronic hypertension 10% continued using a not recommended drug. More information to and education of women with chronic hypertension in the fertile age, by GP's and pharmacists could decrease these percentages.