Heart Health in Pregnancy: Protecting Two Hearts
By Dr Nabila Laskar — published September 2026.
Pregnancy places unique demands on a woman's cardiovascular system. Understanding these changes and recognising potential risks is crucial for the health of both mother and baby. Let's explore how to navigate heart health during this special time.
The Heart's Amazing Journey During Pregnancy
Pregnancy is a truly remarkable time, and your body undergoes incredible adaptations to nurture new life. One of the organs that works hardest during this period is your heart. It’s an amazing journey, but it also means your heart faces extra demands. As a consultant cardiologist, I often explain to my patients that understanding these changes is the first step in ensuring a healthy pregnancy for both mother and baby.
Think of your heart as a super-efficient pump. During pregnancy, its workload increases significantly. Your body needs to supply blood not just to you, but also to your growing baby via the placenta. This means your heart has to pump more blood, faster.
Key facts:
- • Your blood volume increases by 30-50% during pregnancy.
- • Your heart rate typically rises by 10-20 beats per minute.
- • Your heart pumps 30-50% more blood per minute by the second trimester.
- • These changes put extra strain on a healthy heart.
These physiological shifts are completely normal and your body is designed to handle them. However, for some women, especially those with pre-existing heart conditions or who develop new issues, these changes can present challenges. It's vital to monitor your heart health closely throughout your pregnancy journey.
Normal Changes vs. Warning Signs
Given the significant changes, it's common to experience some new sensations that might otherwise be concerning. For example, you might notice your heart beating a little faster, or feel slightly more out of breath after activity. These are often normal physiological responses to pregnancy.
However, it's important to distinguish between these normal adaptations and potential warning signs that might indicate an underlying issue. Being aware of what's typical and what's not can help you communicate effectively with your healthcare team.
Normal Pregnancy Symptoms
- • Mild shortness of breath with exertion
- • Occasional, mild heart palpitations (feeling your heart beat)
- • Swelling in feet and ankles (oedema)
- • Feeling lightheaded or dizzy when standing up quickly
- • Fatigue
Potential Warning Signs (Seek Medical Advice)
- • Severe or sudden shortness of breath at rest or when lying flat
- • Persistent chest pain or pressure
- • Frequent or prolonged heart palpitations accompanied by dizziness or fainting
- • Swelling in hands, face, or sudden, significant swelling in legs
- • Rapid weight gain
- • Fainting spells
- • Feeling dizzy or weak even when resting
- • Coughing up blood
If you experience any of the warning signs, it is crucial to contact your midwife, GP, or obstetrician immediately. Early detection and management are key to preventing complications.
Managing Risk: Who Needs Extra Care?
While most women with healthy hearts navigate pregnancy without major issues, certain factors can increase the risk of cardiovascular complications. Identifying these risks early allows your medical team to put a tailored care plan in place, often involving specialist input from a cardiologist.
Women who might require additional monitoring or cardiology assessment include those with:
- Pre-existing heart conditions: such as congenital heart disease, heart valve issues, or previous heart attacks.
- High blood pressure (hypertension): especially if it was present before pregnancy or develops early on.
- Diabetes: both type 1 and type 2 diabetes increase cardiovascular risk.
- Obesity: a higher BMI can place extra strain on the heart.
- Preeclampsia or gestational hypertension in a previous pregnancy: these can be indicators of future cardiovascular risk.
- Family history of heart disease: particularly if there's a strong family history of early-onset heart conditions.
- Autoimmune diseases: conditions like lupus can affect heart health.
If any of these apply to you, don't panic. The good news is that with careful planning and monitoring, many women with these conditions can have healthy pregnancies. It's all about proactive management.
Your Cardiology Care Plan During Pregnancy
If you're identified as needing specialist cardiac care during pregnancy, your journey will involve a collaborative approach between your obstetrician, midwife, and a cardiologist. This team will work together to ensure the best outcomes for you and your baby.
1. Pre-conception Counselling
Ideally, this starts before you even get pregnant. We'll assess your heart condition, discuss potential risks, and optimise any medications. This allows for informed decisions and preparation.
2. Regular Cardiac Assessments
Throughout your pregnancy, you'll have more frequent cardiology appointments. These may involve echocardiograms (ultrasound of your heart), ECGs, and blood tests to monitor your heart's function and adjust treatment as needed.
3. Medication Review
Many heart medications are safe in pregnancy, but some are not. We'll carefully review and adjust your medications to ensure they are safe for both you and your baby, often switching to alternatives if necessary.
4. Labour and Delivery Planning
We'll work with your obstetrician to create a delivery plan that minimises stress on your heart. This might involve recommendations for pain management, position during labour, and monitoring during and after birth.
5. Postpartum Follow-up
The first few weeks after delivery can still be a challenging time for your heart as your body adjusts. We'll provide continued monitoring and support to ensure a smooth recovery and long-term heart health.
Communication is paramount. Don't hesitate to ask questions and voice any concerns you have throughout this process.
Lifestyle Choices for a Healthy Heart (and Pregnancy!)
Whether you have an existing heart condition or a perfectly healthy heart, embracing a heart-healthy lifestyle is beneficial for everyone during pregnancy. These habits not only support your cardiovascular system but also contribute to a healthier pregnancy overall.
What kind of exercise is safe during pregnancy?
Generally, moderate exercise like walking, swimming, prenatal yoga, or cycling on a stationary bike is safe and encouraged. Always discuss your exercise routine with your GP or midwife, especially if you have a medical condition.
How can I manage stress?
Stress can impact heart health. Techniques like mindfulness, meditation, gentle yoga, adequate sleep, and spending time with loved ones can be very helpful. Don't be afraid to ask for support.
Are there any specific foods to focus on?
A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats (like those found in oily fish, avocados, and nuts) is ideal. Limit processed foods, excessive salt, and sugary drinks.
Remember, pregnancy is a marathon, not a sprint. Taking care of yourself is taking care of your baby.
When to Seek Specialist Help
It's essential to trust your instincts. If something doesn't feel right, or if you're experiencing any of the warning signs discussed earlier, don't delay in seeking medical advice. While your midwife and GP are your first point of contact, there are times when a direct consultation with a private cardiologist can offer peace of mind, a quicker diagnosis, and a tailored management plan, especially if you have complex or concerning symptoms.
- • If you have a known heart condition and are planning pregnancy or are already pregnant.
- • If you experience new or worsening chest pain, severe shortness of breath, or frequent fainting.
- • If your GP or obstetrician has recommended a specialist cardiac assessment.
- • For a second opinion or comprehensive cardiac evaluation.