Congenital Heart Disease and Pregnancy Priorities

omen rarely make decisions about nancy based on its physical and physiologic consequences alone.These opinions evolve over a woman's lifetime and are influenced by society, her peers and partners, and stories she hears from other women and, in this era, from social media.Women with congenital heart disease (CHD) are no different in this regard.As medical and surgical advances have improved outcomes in our CHD patients, many perceive pregnancy as just another normal milestone that they can accomplish.Historically, pregnancy counselling for adult CHD (ACHD) women has not been consistent.As ACHD physicians, we have anecdotes of women who have undergone reproductive sterilization for simple cardiac defects.Many ACHD women have stories of successfully carrying multiple pregnancies after defying their physicians' recommendations.These experiences have caused a mistrust in the "expertise" that our medical opinions offer.Over the years, systematic studies have been adapted into risk scores 1-3 and guidelines 4 to help physicians and their ACHD patients make decisions about pregnancy.