3 Ways to Care for Your Heart During Pregnancy

Pregnancy triggers many changes to the body, but there's one that may surprise many women.

A hidden change is that the heart has to pump, on average, nearly 50 percent more blood by the end of pregnancy than it did before pregnancy, and then it has to quickly go back to "normal operations" after delivery.

While most pregnant women's hearts tolerate these changes well, pregnancy can serve as a "stress test" on the heart that can cause new heart disease in patients who have not had heart problems previously, and can make existing heart issues more difficult to manage.

Here are some startling facts about heart problems during pregnancy:

Cardiovascular disease complicates up to 4 in 100 pregnancies.
People who are Black have a much higher risk of dying during pregnancy or soon afterward. Their risk is tripled compared with people who are Hispanic or white.

What types of heart conditions may arise?

The most common heart conditions seen in pregnancy are related to high blood pressure conditions in pregnancy (preeclampsia and gestational hypertension), irregular heart rhythms (arrhythmias), and the heart muscle not squeezing strongly enough (heart failure).

At the Duke Birthing Center, doctors care for patients who enter pregnancy with high blood pressure, heart defects that were present since birth and acquired heart disease (people who have developed heart disease such as an irregular rhythm or heart attacks).

What do these conditions mean in the long term?

While heart conditions can make pregnancy more complex to manage, high-quality care from experts in caring for pregnant people with heart disease can make all the difference in ensuring a safe, happy ending for mother and baby.

After pregnancy, people who have experienced heart-related pregnancy complications are oftentimes at higher risk of heart issues later in life. Knowing this risk can help a patient receive preventive care after pregnancy, to reduce the risk of heart problems for decades to come.

Tip #1: If you have had heart problems and are thinking about pregnancy, speak to your health care provider and consider meeting with a cardiologist and a maternal-fetal medicine specialist before becoming pregnant.

Many patients who become pregnant with an existing heart condition can have safe, successful pregnancies, but meeting prior to pregnancy with experts will allow you to review any potential complications with pregnancy, ensure that the medications you take would be recommended in pregnancy, and preview how your pregnancy care might proceed.

Tip #2: Ask your health care provider if low-dose aspirin therapy is right for you.

For many patients with risk factors for high blood pressure-related complications of pregnancy such as preeclampsia, taking a baby aspirin every day has been shown to prevent complications.

Your healthcare provider can review your health history with you and recommend whether low-dose aspirin should be part of your pregnancy care plan.

Tip #3: If you are pregnant and concerned about your heart, let your healthcare provider know!

Symptoms of pregnancy and symptoms of heart disease sometimes overlap -- for example, many pregnant people experience shortness of breath and swollen legs at the end of pregnancy.

While most patients who have symptoms during pregnancy do not have heart disease, it is important to let your healthcare provider know about new symptoms and concerns, so that they can help you decide together whether further treatment is needed.

Some symptoms to look out for include suddenly worse fatigue, fainting, chest pain, shortness of breath, trouble breathing when lying down, palpitations and sudden swelling in the legs.

Heart disease and pregnancy

If you have heart disease and are planning a pregnancy, now is the time to talk with your healthcare provider. It is important to know your risks and the best ways to manage your heart condition while you are pregnant. If your pregnancy was unplanned, it’s also very important to talk with your provider right away so that he or she can evaluate your risk for complications. As a result, your heart disease medications may change to make them safer for pregnancy, Cleveland Clinic notes.

Even if you don't have heart disease, talking to your doctor will be an important way to learn how unexpected heart issues can affect pregnancy.

Here are some tips to managing heart disease during pregnancy, according to the Cleveland Clinic:

Attend your medical appointments. You’ll likely receive care from an obstetrician and a cardiologist. Be sure to keep all your appointments and follow-ups. You may need regular testing (including echocardiograms) to check your heart function.
Avoid excess weight gain. Ask your provider how much weight is safe for you to gain during pregnancy.
Avoid stress. As much as possible, avoid situations that cause you emotional upset. Also, find relaxation strategies that make you feel calm. Prenatal yoga classes may be helpful if your provider says they’re OK for you.
Eat a heart-healthy diet. Follow your provider’s guidance on foods to eat and foods to avoid. In general, try to limit your intake of sodium, sugar, saturated fat and trans fat.
Exercise safely. Your provider will tell you how often to exercise and which types of exercise are safe for you. Be sure to follow their guidance closely. You may need to avoid activities that put too much strain on your heart.