How pregnancy affects your heart

In short: Pregnancy makes your heart work harder: your blood volume rises, your pulse speeds up and your heart pumps more blood every minute to feed your baby. Mild breathlessness and tiredness are usually normal. Chest pain, a racing heart with dizziness, fainting, severe breathlessness or swelling in one leg are not, so go to hospital or call your doctor straight away. Heart problems can also start in the months after delivery, so keep watching for new symptoms then too.

Pregnancy is a beautiful journey, but it is also a powerful transformation for your body, especially your heart. As your baby grows, your cardiovascular system works harder than ever. And while many of these changes are normal and expected, there is a rising concern worldwide: maternal heart disease.

Your heart: The unsung hero of pregnancy

From the moment pregnancy begins, your body starts adapting in remarkable ways. One of the biggest changes? Your heart starts pumping more blood, almost 30% to 50% more by the time you are in your third trimester.

Here is what that means:

• Increased heart rate: Your pulse quickens to move blood efficiently to your uterus and placenta.
• Lower blood pressure (in early pregnancy): Blood vessels relax to accommodate the growing blood volume.
• Higher blood volume: To nourish both you and your baby, your body makes extra blood.
• Increased cardiac output: Your heart is working overtime to keep up with demand.

For most women, these changes are temporary and manageable. But for some, especially those with preexisting heart conditions or high-risk pregnancies, they can be dangerous.

The rising concern: Maternal heart disease

Heart disease has become a leading cause of pregnancy-related deaths worldwide. And it’s not just about having a preexisting condition; some women develop cardiovascular issues during or after pregnancy, even if they have always been healthy.

Common pregnancy-related heart concerns:

• Peripartum cardiomyopathy (PPCM): A rare form of heart failure that happens during the last month of pregnancy or up to five months postpartum.
• Preeclampsia and high blood pressure: Can lead to long-term heart problems if not managed.
• Gestational hypertension: Increases the risk of stroke, heart failure, and future cardiovascular disease.
• Heart arrhythmias: Pregnancy can trigger abnormal heart rhythms in some women.

Risk factors include:

• Age over 35
• Obesity or diabetes
• Family history of heart disease
• Smoking
• Autoimmune conditions
• Multiple pregnancies (twins, triplets)
• Sedentary lifestyle

Warning signs you should not ignore

While shortness of breath and mild fatigue can be normal during pregnancy, some symptoms signal something more serious.

Go to hospital or call your doctor straight away if you experience:

• Persistent or extreme shortness of breath
• Chest pain or pressure
• Rapid heartbeat (especially with dizziness)
• Swelling in one leg or sudden weight gain
• Fainting or near-fainting episodes
• Severe fatigue that interferes with daily life

Protecting your heart during pregnancy

The good news? With early care, many heart-related pregnancy complications can be managed or even prevented. Here is how you can prioritize heart health during pregnancy:

1. Start with a pre-pregnancy checkup

If you are planning to conceive, talk to your doctor, especially if you have a personal or family history of heart issues.

2. Track your blood pressure and weight

Use a digital BP monitor at home and monitor weight gain to stay within healthy limits.

3. Eat a heart-healthy diet

Choose whole grains, leafy greens, healthy fats (like nuts and avocados), and stay hydrated. Limit salt and sugar intake.

4. Stay active

Unless advised otherwise, walking, swimming, or prenatal yoga are safe ways to support your heart.

5. Manage stress

Deep breathing, meditation, and gentle stretching can help lower your heart rate and cortisol levels.

6. Do not skip prenatal visits

Your OB-GYN is not just checking the baby, they are monitoring your whole body, including your cardiovascular system.

Postpartum: Do not let your guard down

Many heart complications show up after delivery, during the “fourth trimester.” Stay in touch with your doctor, especially if you notice any new symptoms like chest tightness or swelling.

Pregnancy is a time when all eyes are on the baby, but your health matters just as much. Understanding how pregnancy affects your heart is the first step in preventing serious complications. Listen to your body, stay informed, and do not be afraid to speak up when something feels off.

Your heart is strong, and with the right care, it can carry you and your baby safely through this incredible journey.

Questions women ask

Does a mother's heart rate go up during pregnancy?

Yes. Your heart rate rises a little because your body makes extra blood and your heart has to move it to your uterus and placenta. Blood pressure often dips in early pregnancy as blood vessels relax. These changes are normal for most women.

Are palpitations during pregnancy normal?

A faster or stronger heartbeat now and then can be part of a normal pregnancy, but pregnancy can also trigger abnormal heart rhythms. Tell your doctor about palpitations, and go to hospital straight away if they come with dizziness, chest pain, breathlessness or fainting.

Is chest pain during pregnancy normal?

Heartburn can cause a burning feeling in the chest, but chest pain or pressure should never be ignored. Call your doctor immediately or go to hospital if you have chest pain, especially with breathlessness, a racing heart, dizziness or fainting.

What are the symptoms of peripartum cardiomyopathy?

Peripartum cardiomyopathy is a rare kind of heart failure in the last month of pregnancy or up to five months after birth. Signs include breathlessness that keeps getting worse, especially lying flat, swollen feet or legs, sudden weight gain, a racing heart and severe tiredness. See a doctor the same day, or go to hospital straight away if you are very breathless or have chest pain.

Who is at higher risk of heart problems in pregnancy?

Risk is higher if you are over 35, have diabetes, obesity, high blood pressure or preeclampsia, an autoimmune condition, a family history of heart disease, smoke, or are carrying twins. A check-up before pregnancy and regular blood pressure checks help catch problems early.