Heart disease in pregnancy: Collaborative care, delivering safer births

Cardio-obstetrics is a specialized area of medicine focused on caring for people with heart disease during pregnancy and after delivery. At UW Health and UnityPoint Health–Meriter, cardiologists and maternal-fetal medicine specialists work together to help you have the safest possible pregnancy experience.

Historically, women with heart disease who were pregnant or planning to become pregnant had to seek expert care by visiting a heart doctor in one place and a doctor specializing in complex pregnancies located elsewhere.

UW Health and UnityPoint Health–Meriter offer a collaborative approach to caring for patients that offers more coordination — a key to achieving better health outcomes. Our approach provides more seamless care throughout the entire journey, before, during and after pregnancy.

With us, you’ll sit down with doctors specializing in cardiology and complex pregnancy at the same time. We will listen to your concerns and work with you to develop a care plan that fits your unique situation. Our goal is to help you deliver a healthy baby while keeping a close eye on your heart, cardiovascular system and overall well-being.

A pregnant woman, with or without heart disease, produces significantly more blood to support development of the fetus. If you are pregnant and have heart disease, specialized cardio-obstetrics care can help manage risks for both you and your baby. Our cardio-obstetrics team provides coordinated heart and pregnancy care before conception, during pregnancy and after delivery.

If you fall into one of these categories, we are ready to help:

• You have a heart condition and want to become pregnant

• You have a heart condition and are pregnant

• You become pregnant and experience symptoms, which reveal heart disease you didn’t know about previously.

We see pregnant women with a wide variety of heart conditions, such as:

• Abnormal heart rhythms (arrhythmias)

• Aortic valve disease

• Cardiomyopathy

• Conditions that require the use of blood thinners

• Congenital heart disease (meaning you are born with it)

• Connective tissue disorders, such as Marfan Syndrome or Ehlers-Danlos syndrome

• Coronary artery disease

• Spontaneous coronary artery dissection (SCAD)

• Heart failure, including peripartum cardiomyopathy

• Heart valve disease

• High blood pressure (hypertension), including preeclampsia

• Pulmonary hypertension

Our experts will care for you throughout your entire pregnancy and recovery. If you live far from Madison, it might be possible to schedule some appointments by video.

What is cardio-obstetrics?

Cardio-obstetrics brings together experts in cardiology and high-risk pregnancy care to support people with existing heart disease or heart conditions that develop during pregnancy.

Establishing heart care before or early in pregnancy

Your visit will start with a thorough evaluation so our care team can understand your heart health and how best to support you during pregnancy.

You could receive:

• A detailed health review of your heart condition, medications and any past procedures

• Heart tests, such as an echocardiogram (ECG)

• A personalized risk assessment to understand how pregnancy might affect your heart

• A medication review to ensure everything you take is safe for pregnancy

• Guidance on healthy lifestyle choices, such as exercise, nutrition and blood pressure management

• Family planning and genetic counseling, if needed

If you're planning a pregnancy, this visit helps you prepare. If you're already pregnant, the team tailors these steps to your stage of pregnancy.

Ongoing monitoring and support during pregnancy

Throughout pregnancy, you’ll receive regular check-ins to help ensure both you and your baby are doing well.

Typical care could include:

• Regular visits with a cardiologist, which might range from once per trimester to more frequent appointments

• Repeat heart imaging to watch how your heart adapts

• Monitoring for symptoms like arrhythmias or changes in blood pressure

• Adjustments to medications as your needs change

• Visits with a maternal‑fetal medicine specialist for fetal growth checks and high‑risk pregnancy support

• Guidance on activity and exercise to keep your pregnancy safe and comfortable

Your care team works closely together, sharing information and creating a care plan that fits your unique needs.

Planning for delivery

As you approach the third trimester, your team will create a personalized delivery plan.

This plan could include:

• A recommended method of delivery — vaginal birth is often preferred unless there is a medical reason for a Cesarean.

• An anesthesia plan

• Monitoring strategies during labor, such as continuous heart monitoring

• Medication or blood thinner adjustments leading up to delivery

• Emergency preparedness plans to ensure your safety

Your team will walk you through all the details so you know exactly what to expect.

Postpartum care after delivery

The weeks after delivery are especially important for heart health. Your team will continue to support you through this period.

Postpartum care often includes:

• Monitoring in the hospital for 24–72 hours

• Early follow-up visits, usually within the first week or two

• Medication adjustments, including options safe for breastfeeding

• Long‑term heart care planning, including guidance for future pregnancies

• Contraception counseling to help you make informed decisions

Our goal for your pregnancy

We are here to support you through every phase of pregnancy and beyond. By combining heart and pregnancy expertise, our cardio-obstetrics team provides coordinated care throughout pregnancy, delivery and recovery, helping you and your baby receive the support you need every step of the way.

You will see members from our cardio-obstetrics team team, which is led by cardiologists and maternal-fetal medicine specialists.

Our clinic is located at the UnityPoint Health–Meriter Center for Perinatal Care in downtown Madison, Wis.