Can I have a baby if I have a congenital heart defect?

September 21, 2015

A woman is holding her hands over her chest. — For most adult congenital heart disease patients, successful pregnancy is possible.

More than 1 million adults in the United States are living with a congenital heart defect or congenital heart disease – a heart condition that is present at birth. Conditions that offered minimal hope just 50 years ago can be treated today because of advancements in heart care.

But many congenital heart defects aren’t fully cured by childhood procedures. Your condition should be monitored over the course of your lifetime, especially when you decide to start a family of your own.

For most adult congenital heart disease patients, successful pregnancy is possible. But there are risks you should assess before pregnancy, or as early in the pregnancy as possible.

Preparing for pregnancy

Your first step in pregnancy planning should be to connect with an adult congenital cardiologist to discuss how to keep your heart as healthy as possible.

I also recommend you schedule a pre-pregnancy appointment with a maternal fetal medicine specialist. Ideally, the same specialist will provide your obstetric care during pregnancy.

Here’s what you can expect at the pre-pregnancy appointment:
Your cardiologist also may recommend genetic testing to determine your baby’s risk for inheriting a congenital heart defect from you or your partner. The average risk for a baby to develop congenital heart disease is 0.5 percent to 0.8 percent. When a parent has congenital heart disease, the risk is approximately 4 percent to 7 percent.

An extensive check-up: Even if you feel fine, I want to prove it. Testing options become limited once you get pregnant, so planning ahead is important. We ask that both parents attend the visit so everyone is aware of the risks involved.
Changes to your medications: Your safety and your baby’s safety are our top priority. Some heart medications can harm babies in the womb, so we will likely change or adjust your medications throughout the pregnancy.
Recommended interventions: Depending on your condition, we may recommend a heart procedure before you try to conceive. For example, I may recommend a diagnostic heart catheterization to repair a hole in your heart or a balloon procedure to open a blocked valve.

Risks during pregnancy and delivery

Depending on your condition, your baby may be at risk for low birth weight, respiratory distress syndrome, or miscarriage. Our team of specialists will monitor your baby closely throughout the pregnancy.

We’ll also watch mom for arrhythmia and signs of stroke or heart failure. The mother’s heart works harder during pregnancy, so the amount of blood needed versus the amount the heart can pump must be monitored.

If possible, we’ll try to avoid a C-section delivery. Moms lose about double the blood during a C-section as compared with vaginal delivery – that could stress your heart and increase your risk of complications.

For a safer birth experience, we may plan for induced labor. Mom may also be asked to stay in the hospital for 72 hours after delivery so we can monitor heart rhythm and fluid management.

If you decide to have another baby later on, you should be evaluated again to review the risks. Remember, having an uncomplicated pregnancy does not mean the next one will be as easy.

Who should not get pregnant?

If a doctor has told you that you can’t get pregnant because of your condition, what he or she probably meant is that you shouldn’t get pregnant because you have a high-risk condition. Having an adult congenital heart defect will not physically prevent you from getting pregnant.

Certain conditions put you and your baby at higher risk for complications. If you have a high-risk condition, your doctor may advise you to avoid becoming pregnant. High-risk conditions include:
If you and your doctor have determined pregnancy is not a healthy decision for you, it is important for you to be on an effective birth control. Talk to your physician about which birth control option is best for you.

If you or your partner have a congenital heart defect, it’s important to plan ahead before you try to conceive. Though the risks are higher, our multidisciplinary team has walked many women with complex heart defects through successful pregnancies.

For more information about the resources we provide for parents-to-be with congenital heart defects, request an appointment here or call 214-645-8300.