Maternal Heart Health with Dr. Shola Adekoya
Summary Paragraph
Pregnancy places unique demands on the heart, and many women experience changes before, during and after pregnancy that can impact cardiovascular health. Dr. Shola Adekoya answers commonly asked questions about maternal heart health.
Key Takeaways
- Pregnancy increases the heart's workload and can worsen existing conditions like high blood pressure, diabetes and obesity.
- The first year after delivery is a high-risk period because the body is readjusting and some women face barriers to follow-up care.
- Early conversations with a provider can help identify risks and protect both mother and baby.
How Pregnancy Affects the Heart
Heart-related complications are the leading cause of maternal health problems in the United States and many women experience changes during pregnancy and after delivery that can affect their heart. Dr. Shola Adekoya, a Cardiologist at the Florence Wormald Heart & Vascular Institute at St. Elizabeth, explains how pregnancy affects the heart, why some conditions go undiagnosed and what patients and families should know throughout pregnancy and postpartum.
How Do Conditions Before Pregnancy Affect Heart Risks During Pregnancy?
Preexisting conditions create what Dr. Adekoya describes as a "prototype that's already at risk." If high blood pressure, diabetes or obesity are not well managed before pregnancy, a woman enters pregnancy with these challenges already in place.
It is then possible that pregnancy can make them worse. Blood pressure tends to rise, insulin resistance increases and the heart works harder. Without careful management before conception, women face higher risks for complications that affect both mother and baby.
What Heart Conditions Can Develop or Worsen During Pregnancy?
Pregnancy can influence many types of heart conditions. Women born with congenital heart disease may have a harder time throughout it because of the changing demands on the body.
"Heart conditions that can develop or worsen over pregnancy span across the spectrum," says Dr. Adekoya. They can range from abnormal heart rhythms to coronary artery disease. Because pregnancy can affect the entire cardiovascular system, monitoring and communicating with your care team is very important.
How Does Pregnancy Put Extra Stress on the Heart?
Pregnancy is a physically demanding time. "Heart rate increases and the heart pumps more blood to support the mother, baby and placenta. It's a lot of stress physically and physiologically," Dr. Adekoya explains.
Stress hormones like cortisol also rise, making the heart work harder and putting the body into overdrive. Regular check-ins with your care team help catch small changes early to continue your pregnancy safely.
What Is Peripartum Cardiomyopathy, and Why Is It Often Diagnosed Late?
Peripartum cardiomyopathy is heart failure that develops toward the end of pregnancy or in the first few months after delivery. There must be no other cause of heart failure for this diagnosis to be considered.
Dr. Adekoya says it is often diagnosed late because its symptoms resemble common pregnancy symptoms. "If a woman told you she was short of breath or her legs were swelling, it can often be put off as signs of pregnancy," she says. Fatigue can also be mistaken for a normal part of pregnancy or new parenthood.
Why Is the First Year After Delivery Such a High-Risk Time for Heart Complications?
The first year postpartum places significant stress on the body. During pregnancy, mothers gain weight from both fluid and fat. After delivery, the body works to lose that extra volume and readjust fluid, which creates major shifts in how the heart pumps. "There is a lot of redistribution happening and the body is learning to adapt to these new changes," says Dr. Adekoya.
At the same time, follow-up appointments may be delayed or missed. Plus, some heart medications are not safe during breastfeeding, which means certain conditions may not be fully treated during that first year. Together, these factors create a vulnerable time for heart-related complications.
Why Are Black Women at Higher Risk for Heart-Related Complications During and After Pregnancy?
Black women experience heart related maternal complications at three to four times the rate of white women. Dr. Adekoya explains that the difference is tied to a combination of factors. Conditions like hypertension, obesity and hypertensive disorders of pregnancy are more common in the Black community, but there may also be cultural barriers.
"Socioeconomic factors such as access to healthcare also puts black women at a higher risk during pregnancy and postpartum," explains Dr. Adekoya. These overlapping challenges can affect a woman's ability to receive timely, consistent care.
Having open conversations with your provider about your risk and your needs can help ensure you receive the personalized care you deserve. You're not alone, and support is available.
When to Seek Care
If you have concerns about your heart health during pregnancy or after delivery, or if you have pre-existing risk factors, talking with a provider early can help protect both you and your baby. You don't need to wait until something feels wrong – our team is here to support you at any stage.
The St. Elizabeth Heart & Vascular team can guide heart care throughout pregnancy and the postpartum period. To schedule an appointment, call (859) 287-3045 or visit our website to learn more.
Medically reviewed by Shola Adekoya, DO, on 3/6/2026.
