Stressful life events and perceived stress are associated with cardiovascular issues in women over the course of their lives. Pregnancy is associated with an increase in psychosocial stress, which can lead to higher cardiovascular risks and increase the risk of adverse pregnancy outcomes, or complications during pregnancy and/or delivery.

Pregnancy acts as a stress test for the heart and can uncover, or even worsen, problems like high blood pressure and diabetes. During pregnancy, the heart must work harder to support a growing fetus, and cardiac stress often continues after delivery.

665 pregnancy-related deaths occurred in the United States in 2024

Cardiovascular disease is the leading cause of pregnancy-related death in the U.S., yet most of these deaths are preventable. The National Academies of Sciences, Engineering, and Medicine report on maternal health highlights that although 57% of cardiovascular-related deaths occur between seven days and one year postpartum, preventive care is often focused on the prenatal and immediate postpartum period.

What can be done to manage stress

Clinicians must treat pregnant women with chronic hypertension so that their blood pressure is reduced to less than 140/90 millimeters of mercury.  This is because consistently elevated blood pressure during pregnancy can cause pregnancy complications and increase a woman’s risk for developing cardiovascular disease.

The new guidelines also recommended that clinicians caring for patients with postpartum hypertension or other hypertensive disorders give their patients home blood pressure monitors and use a program that allows the patients to report their readings. This way, clinicians can adjust treatment and set clear thresholds for action.

How often should women visit a doctor in the year after giving birth?

How frequently a woman should see her doctor during the postpartum period depends on her cardiovascular risk.  Not every woman can easily see a doctor or health specialist—especially in rural areas or when cost is a concern. Using telehealth, rural health and maternal health programs can reduce geographic, financial and system barriers to preventive cardiovascular services.

Prevention and Care Before, During, and After Pregnancy

What can pregnant women do to protect heart health? Following are a few tips to help you manage your cardiovascular health:

• Share your history. Tell your healthcare team your family history of heart disease, especially early heart attacks or strokes, and your pregnancy history, including any past complications. Tell your clinician if you have ever had any of the following, even if it was years ago:
  • High blood pressure problems in pregnancy (e.g., gestational hypertension, preeclampsia/eclampsia, HELLP)
  • Gestational diabetes
  • Preterm birth
  • Baby smaller than expected (growth restriction)
  • Placental abruption
  • Pregnancy loss (miscarriage, stillbirth, or recurrent loss)
• Keep postpartum follow-up appointments on your calendar. It’s important not to miss these appointments because risk for complications continues through the first year after delivery.
• Take warning signs seriously—trust your instincts. If something feels wrong during pregnancy or after birth, seek care right away and tell providers that you’re pregnant or that you gave birth recently.

As you can see stress during pregnancy increases the risk of several complications, including preterm birth, low birth weight, and preeclampsia. Some level of worry is normal, but when stress becomes chronic or severe, it triggers hormonal changes that can affect both your health and your baby’s development. The good news is that your body has a built-in protective barrier for your baby, and stress reduction techniques have been shown to measurably improve outcomes. And with proper care stress can be managed.

References:

CDC. 2025. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees. https://www.cdc.gov/maternal-mortality/php/data-research/mmrc/index.html

CDC. 2025. Data from the Pregnancy Mortality Surveillance System. https://www.cdc.gov/maternal-mortality/php/pregnancymortality-surveillance-data/index.html