For many years, medical experts have believed that it's not safe for women with cardiac problems to get pregnant. And while research shows that pregnancy and childbirth for women with congenital heart defects can still be especially risky, it’s not impossible — so long as expectant mothers are under careful supervision and their complex health conditions are properly managed. But, that’s not to say that carrying a child will necessarily be a breeze.
“For the majority of patients, the ability to conceive and carry a pregnancy to term will present little problem,” according to the American Heart Association. “For those with complex CHD, pregnancy may be associated with an increased risk compared with women with milder forms of CHD, regardless of whether they are clinically stable at the time of conception.”
As your heart essentially works overtime during pregnancy and your blood volume increases by 30 to 50 percent to nourish your growing baby — labor and delivery also intensifies this workload — those with heart conditions, depending on the severity, will need special care while they’re expecting, according to the Mayo Clinic.
As The Washington Post reported, one major risk is heart failure because “the heart simply may not be able to keep up with pregnancy’s demands.” Other risks include arrhythmia, both during and after pregnancy, and cerebrovascular events — episodes that affect blood supply to the brain such as a stroke or aneurysms — that contribute to the overall risk, according to the AHA.
While a treatment plan will depend on the nature and severity of each woman's congenital heart defect, doctors may recommend using a pacemaker, certain medication, bed rest, or even heart surgery before conception, according to the Mayo Clinic.
"It is critical that these patients be given counseling well before they get pregnant," Mary Canobbio, a cardiac nurse at UCLA and chair of the group that wrote the latest AHA recommendations, told The Washington Post. "If we don’t get the problems controlled before pregnancy, we potentially have a disaster."
Speaking with a doctor and a heart specialist is the first and most important step in getting pregnant for those with a complex health condition. But once they get the green light, they can help prevent further complications by seeing their health care provider as often as needed, taking medication as prescribed, and monitoring their weight as gaining too much can add stress on the heart. Asking lots of questions about what to expect can also help alleviate any anxiety because being in a relaxed state can make things much easier for both mom and baby.