By: Dr. Sarah Berg, Founder of Selfority

I grew up with the smell of hospital hallways in my hair. The Warnings We Don’t Talk About
My father is a cardiologist, so my childhood weekends were spent sitting in waiting rooms outside the cath lab, swinging my feet off vinyl chairs while he rounded on patients.

I ate popsicles in doctors’ lounges and played with the anatomical heart models other kids only saw in textbooks — the ones where you could lift the chambers like tiny doors and see the intricate machinery inside.

I knew early on that the heart is never silent.
It whispers, signals, compensates. It tells stories long before it fails.

And yet, even with that upbringing, I didn’t know pregnancy could foreshadow heart disease.
Not until it became my story.

The Warning Signs Hidden in Pregnancy

When people think about heart disease, they think about the familiar villains:
smoking, obesity, diabetes, high cholesterol, high blood pressure, physical inactivity.
Those were the ones plastered on the clinic walls I walked through as a kid.

But the ones that disproportionately affect women — the nontraditional ASCVD risk factors — are the ones we barely talk about:

• Hypertensive disorders of pregnancy (like preeclampsia or gestational hypertension)

• Preterm delivery

• Gestational diabetes

• Autoimmune disease

• Breast cancer treatment

• Depression

These aren’t rare complications.
They’re common.
And they increase a woman’s lifetime risk of cardiovascular disease in ways most women never hear about.

Which is frightening, considering:

Cardiovascular disease kills more women than ALL cancers, tuberculosis, HIV/AIDS, and malaria combined.

(WHO, World Health Statistics 2017)

And pregnancy is often the first window into future risk.

My First Window

I didn’t need a medical degree to know something was wrong when my twins were born at 22 weeks.

I developed preeclampsia — the kind of diagnosis that feels like it strikes from nowhere, even though it doesn’t.
My blood pressure climbed as my world collapsed.

A week or two after their birth and death, I tried to go see American Hustle.
Normalcy felt like something I should attempt.

But halfway through, heat rushed up my face.
My chest felt tight.
I could feel my blood pressure rising — not metaphorically, but literally.

I slipped out of the theater.
When I got home, the cuff confirmed what my body already knew:
mildly elevated, but deeply wrong.

It was grief, yes — but it was also physiology.
A signpost I didn’t yet know how to read.

Pregnancy as a Cardiovascular Stress Test

None of my pregnancies were simple:

• 22 weeks.

• 36 weeks.

• 35 weeks.

Each one marked by hypertensive disorders of pregnancy or preterm birth — some of the strongest early predictors of future cardiovascular disease.

But at the time, I believed what most women believe:
“Once pregnancy is over, it’s over.”

Except bodies keep score.

By my pregnancy with my son, I was checking my blood pressure twice a day in the office — before patients, between patients — practicing breathing exercises in exam room doorways just to keep going.

I thought I was trying to stay calm.
I was actually trying to outrun a risk no one ever explained to me.

Now That I’m Perimenopausal, I See the Pattern

Perimenopause is when all the threads come together — hormonal shifts, vascular changes, the unspoken history of your pregnancies, and the risks they signaled early on.

Now I can look back and see it clearly:

• Preeclampsia was a cardiovascular cue.

• My preterm deliveries were cardiovascular cues.

• Gestational hypertension was a cardiovascular cue.

But no one connected those dots for me until I connected them myself.

And if this can happen to someone who grew up dissecting heart models on the kitchen counter, it can happen to anyone.

Why This Matters for Every Woman

Because women deserve to know that pregnancy complications are not isolated events.
They are predictors.

Because depression doesn’t just affect the mind — it’s a cardiovascular risk.
Because autoimmune disease isn’t just rheumatologic — it’s cardiometabolic.
Because breast cancer treatment doesn’t only affect survival — it affects the heart.
Because preterm birth and pregnancy loss aren’t just reproductive events — they are cardiovascular ones.

Because we should all be thinking about our hearts — not only at 70, but at 35, 40, 45, the invisible crossroads where risk becomes reality.

What I Want Every Woman to Know

If you’ve had:

• a preterm delivery

• preeclampsia or gestational hypertension

• gestational diabetes

• depression

• autoimmune disease

• breast cancer treatment

your heart deserves proactive care, not reactive cleanup.

Tell your clinician.
Bring it up even if they don’t ask.
Bring it up even if it was years ago.
Bring it up even if you’re healthy now.

Your pregnancy story is also your cardiovascular story.

And the earlier we acknowledge it, the longer and healthier the story becomes.