During any pregnancy there is an increase in blood volume of 30% – 50% resulting in increased pressure on the heart and heart valves and the work of the heart is increased by up to 50%.

Pregnancy can lead to the appearance or worsening of symptoms including shortness of breath with simple activity and waking at night out of breath. For women with more severe RHD, it could lead to the development of more serious complications. RHD in pregnancy poses a direct risk to the well-being of the woman and her fetus or newborns.

Women living with RHD need to be monitored carefully and during pregnancy by a team which may include obstetric and cardiology specialists. However, many women with RHD can have healthy pregnancies and healthy babies with the right medical care.

Some women with specific types of severe RHD may need to avoid pregnancy. Access to family planning is important to allow women and their families to make safe choices about having children.

It is important that all young women who have had ARF and RHD consider :

• preconception counselling – as it provides an opportunity for young women and their families to talk with midwives, nurses and their doctors about risks involved during pregnancy. This helps young women address:

• ways to minimise complications,
•  have contraception options, and
• the ability to make informed choices for birthing options.