Saving moms’ lives: The unique heart health risks new moms face and tips from a cardiologist for better health before, during and after pregnancy

Zuleyma Santos started having problems breathing shortly after her daughter’s birth.

More than two years later, Santos’s heart still can’t supply enough oxygen to her organs. She carries 10 pounds of batteries that power an implanted device to help her heart pump effectively.

The 37-year-old Los Angeles woman keeps a positive outlook as she waits for a heart transplant, and she urges others to “live every minute, and live in the moment.” 

Santos was diagnosed with peripartum cardiomyopathy, an uncommon form of heart failure that occurs during the last month of pregnancy or up to five months after birth – a time when a woman is keenly focused on the health of her baby. 

As National Women’s Health Week begins on Mother’s Day, May 8, the American Heart Association’s (AHA) Go Red for Women movement and its supporter, Huntington Hospital, encourage soon-to-be moms to pay close attention to their heart health as they prepare to welcome a child into the world.

Dr. Kristal Young, a cardiologist with Huntington Hospital in Pasadena, Calif., knows about heart health, but she learned even more when she was recently pregnant.

“When women are pregnant, it’s basically like putting yourself through a stress test,” she said. “Being pregnant requires your heart to pump 30 to 50 percent more than it’s used to – to support you and your growing baby. Your heart has to work harder.”

Typically, the heart begins a dramatic increase in pumping during the first trimester, and that pace tends to plateau by the third trimester, Young said.

Women, including pregnant women, have unique cardiovascular risk factors, according to the AHA. Studies compiled by the AHA show that cardiovascular disease (CVD) is the No. 1 killer of new mothers, as well as the leading cause of death for all women.

The four key risk factors for CVD-related maternal mortality are race/ethnicity, age, hypertension and obesity. Additionally, significant disparities in maternal care and outcomes persist across race, ethnicity, geography, income, and other sociodemographic factors.

Women of color, particularly Black and Hispanic/Latina mothers, American Indian and Alaska Native women have disproportionately higher rates of adverse outcomes related to cardiovascular diseases. These cardiovascular related adverse childbirth outcomes have increased in the U.S., widening racial and ethnic disparities. This poses a threat to women’s heart health during pregnancy and later in life, making it important that women understand how to care for themselves and their babies.

Pregnancy can lead to peripartum cardiomyopathy, stroke and heart attack. Other risks such as gestational hypertension, preeclampsia and gestational diabetes can increase a woman’s risk for CVD later in life.

Young noted that heart issues and other pregnancy health risks can increase with age, and some women in the United States are delaying getting pregnant. Younger women can have heart issues, as well.

Pregnant women need to establish a strong relationship with an obstetrician early on and maintain regular appointments, she said.

“Get a lot of good care to make sure you don’t have any risk factors,” Young said, adding that it’s important to identify any problems as early as possible so that adjustments can be made. She said she gets pregnant women referred to her for a number of cardiac issues.

“Prenatal care will really help identify people at risk early on,” she said. Pregnant women and new mothers also need to embrace a healthy lifestyle – eat nutritious food, find ways to be active and get enough sleep. Reducing stress and managing anxiety, as well as avoiding unhealthy habits like smoking, alcohol and illegal drugs are important.

“We want women to have a good experience with pregnancy,” said the 37-year-old cardiologist, who gave birth to her son in December. “I personally had a really good overall experience. You’re growing something inside of you. It’s phenomenal, women’s bodies are amazing. The adaptations women’s bodies undergo for pregnancy and delivery are incredible.”

Santos continues to undergo treatment to reduce her antibodies to receive a new heart and avoid organ rejection. Having lost her husband to cancer in March 2020, she vows to fight to survive for her children.

“Me and my LVAD are going to keep on going,” she said. “If it means I have to carry it, anytime, I will carry it. Once they tell me we have a heart, I will take it off gladly.”

For more information, visit GoRedforWomen.org’s Pregnancy and Maternal Health Hub.