A: Not necessarily. “There is a misperception with the general public and with many physicians that a C-section is not only necessary, it’s beneficial in patients with heart disease,” says Stephanie Martin, D.O., medical director for labor and delivery and the obstetric intensive care unit at the Texas Children’s Pavilion for Women in Houston. “In fact, that is rarely the case. The majority of these patients can safely have a vaginal birth, and it is safer than a C-section for most of them. If a heart can tolerate the stress of pregnancy, it should tolerate delivery just fine.” If a woman isn’t able to push during labor, physicians can help the baby out with forceps or vacuum. Most women with heart disease can receive epidurals during childbirth, if they wish.