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family planning
Family Planning After Peripartum Cardiomyopathy (PPCM) Protecting Your Heart. Planning Your Future
Peripartum Cardiomyopathy is a serious heart condition that occurs during the last month of pregnancy or within five months postpartum. For many women, the heart may heal over time—but for others, it may remain weakened. Another pregnancy could place your life at risk.
Family Planning After PPCM:
Risk of Recurrence:
Contraceptive Counseling is Critical
Contraceptive Counseling is Critical
Even if heart function improves, there's still a risk PPCM could return in a future pregnancy.
Women with lingering heart damage (reduced ejection fraction) face significant risks of heart failure or death in subsequent pregnancies.
Contraceptive Counseling is Critical
Contraceptive Counseling is Critical
Contraceptive Counseling is Critical
Birth control should be discussed early—ideally before hospital discharge or at the first postpartum follow-up. Avoid estrogen-based methods if heart function is impaired, as they can increase blood clot risk.
Safer Options May Include
Contraceptive Counseling is Critical
Safer Options May Include
- Progestin-only pills ("mini pill")
- Hormonal IUD (Mirena, Kyleena)
- Copper IUD (non-hormonal)
- Implant (Nexplanon)
- Permanent sterilization (tubal ligation or vasectomy)
Partner Involvement Helps
Future Pregnancy Discussions
Safer Options May Include
Educating partners or family members can help with shared decision-making and emotional support.
Future Pregnancy Discussions
Future Pregnancy Discussions
Future Pregnancy Discussions
If considering another pregnancy, a cardiologist and high-risk OB-GYN should evaluate your heart health.
You may need an MRI, ECHO, or BNP blood test before trying again.
Some women may be advised to avoid pregnancy completely for their safety.
What You Can Do Today?
Future Pregnancy Discussions
Future Pregnancy Discussions
Schedule a postpartum cardiology visit
- Ask your OB-GYN for contraceptive options safe for heart health
- Advocate for yourself—your life matters
- Visit LetsTalkPPCM.org for resources, survivor stories, and support-guidance
🌿Natural Ways to Prevent Pregnancy
Natural family planning (NFP), also known as fertility awareness methods, involves tracking the body’s natural fertility signals to avoid or achieve pregnancy. These methods are hormone-free and involve understanding and respecting the body's cycle.
✅ Common Natural Methods:
- Calendar (Rhythm) Method
Track menstrual cycles to predict ovulation. Avoid sex or use protection during fertile days. - Cervical Mucus Method
Monitor changes in cervical mucus. Fertile mucus is clear, stretchy (like egg whites). Avoid unprotected sex when fertile mucus is present. - Basal Body Temperature (BBT) Method
Measure your body’s temperature every morning. A slight rise may indicate ovulation has occurred. Avoid sex before and during ovulation. - Symptothermal Method
Combines tracking of multiple signs: BBT, cervical mucus, and cycle calendar for more accuracy. - Withdrawal (Pull-Out) Method
Partner withdraws before ejaculation. Less reliable, but some use it in combination with other methods.
💡 Things to Remember:
- Natural methods require commitment, tracking, and education.
- Apps and charts can help, but fertility signs vary from woman to woman.
- These methods do not protect against STIs.
- Talk to a trained family planning educator or doula for support and guidance.
🧠 Why Consider Natural Methods?
- No hormones or devices
- Low or no cost
- Encourages body awareness
- Can be empowering for couples seeking shared responsibility in family planning
Do what's best for your body.
🌿 Post PPCM Pregnancy Support
After having Peripartum Cardiomyopathy (PPCM), it carries serious health risks depending on heart function after recovery.
🔹 Risk Factors
- Persistent heart weakness (low ejection fraction, EF < 50%) → Pregnancy is very high risk and often strongly discouraged. The chance of relapse, worsening heart failure, or even maternal death is significant.
- Recovered heart function (EF > 50%) → Risks are lower but not zero. Even with a “normal” EF, some women experience a recurrence of PPCM in another pregnancy.
🔹 What Should Happen if Pregnancy Occurs
- Immediate evaluation by a cardiologist and high-risk obstetrician (MFM)
- Echocardiogram (to assess EF and overall heart function).
- BNP blood test (to check heart strain).
Care plan adjustments
- Some heart medications may need to be changed to pregnancy-safe alternatives.
- Close monitoring throughout pregnancy (frequent echocardiograms, labs, clinical check-ins).
Multidisciplinary team approach
- Maternal-fetal medicine specialist
- Cardiologist (preferably with experience in PPCM)
- Anesthesiologist (for delivery planning)
Delivery planning
- Vaginal birth may still be possible, but C-section could be recommended depending on maternal status.
- Delivery should happen in a hospital with cardiac monitoring and an ICU available.
🔹 Emotional Impact
Accidental pregnancies can be frightening for PPCM survivors, because the risks are real and the decision-making can be overwhelming.
Counseling and emotional support are just as important as medical care.
heart mom Tips
Tips for a PPCM Heart Mom
“Dealing with a serious illness can change your relationships with the people in your life,” Dr. Szabo said. “And chronic pain or illness can frustrate you, your friends and your family. How you and others respond to the stress of your condition can affect the quality of your relationships.”
Here are ways you can keep your relationship with your partner strong:
- Remember, you are still you. This illness does not define you.
- Keep communication open—be open and honest. People only understand what you are thinking or feeling if you tell them.
- Express your needs, feelings, and ideas honestly and directly, without putting down or hurting others.
- Don’t lie about your symptoms.
- Use “I” statements to describe problems. That way, your partner doesn’t feel blamed or criticized, and you keep the focus on your needs and wants.
- Avoid endless complaining, which can be draining. Instead, talk about how you can change the parts of your life that are making you unhappy.
- Adopt a positive outlook. Try to find humor in situations.
- Use honesty and transparency to foster closeness.
- Remember how you and your partner overcame difficult situations in the past and use those strategies now.
- Allow room for a “time out.” Serious illnesses can cause feelings of anger and depression. Give yourself and your partner room to feel your emotions and take a moment alone.
- Remain intimate. Intimacy does not necessarily mean sex. It means spending time together—holding hands, reading together, talking, etc.
- Find time to do the things you love.
- Let others know what to expect of you as you heal—and what not to expect.
- Let go of guilt about not doing the same things or going to the same places.
- Be gentle with yourself.
- Commit to getting and staying emotionally and spiritually strong.
Let's Talk PPCM
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