The United States continues to face a maternal mortality crisis. Cardiovascular disease is a leading cause of pregnancy-related death, making the recognition and management of heart disease before, during, and after pregnancy an urgent priority.Behind every statistic is a mother, a child, a partner and a family.
At Hackensack University Medical Center (HUMC), a multidisciplinary team is working to change that narrative—one mother and one heartbeat at a time.
A Mother Who Knew Something Was Wrong
For first-time mother-to-be Ayanda Mkondwane, early signs of trouble—shortness of breath, profound fatigue, and swollen feet—were initially dismissed as normal pregnancy symptoms. As the weeks progressed, medical attention focused entirely on her unborn son’s health, leaving Ayanda feeling that her own worsening condition was being ignored.
“My body was screaming for help, but no one seemed to be listening,” she recalls.
The breaking point came when she began bleeding. Recognizing how sick she was, her husband insisted they go to HUMC. It was a decision that changed the course of her life.
Upon arrival, Ayanda was evaluated by a multidisciplinary team and quickly diagnosed with hyperthyroidism and peripartum cardiomyopathy, a potentially life-threatening form of heart failure that can develop during pregnancy. For Ayanda, the difference in care was immediate.
“The communication flowed really well,” she remembers. “Whenever I’d be in pain, I was never dismissed. It was taken seriously.”
Answering the Call for a New Kind of Care
Pregnancy places extraordinary demands on the cardiovascular system.
"We are seeing a whole new pathology of patients," Dr. Kanika Mody, Director of the Advanced Heart Failure, LVAD, and Transplant Cardiology Program explains. Women are getting pregnant later in life, more women with congenital heart diseases are surviving to childbearing age, and fertility treatments like IVF can also carry a higher cardiovascular risk.
"It's a woman's right to get pregnant," Dr. Mody states. "It's our job to take care of her."
This new, specialized cardio-obstetrics program, still in its infancy, was driven by a partnership between Jesus Alvarez Perez, M.D., of the Division of Maternal-Fetal Medicine, and Dr. Mody, “Traditional consultations aren't enough for our most vulnerable patients,” says Dr. Alvarez Perez. “They need maternal-fetal medicine and cardiology working together from day one—anticipating problems rather than simply reacting to them.”
The program brings together experts in cardiology, maternal-fetal medicine, anesthesiology, and critical care to manage high-risk pregnancies from pre-conception counseling through postpartum follow-up. The team approach is crucial because the risks are complex and multifaceted, involving the health of both mother and baby.
“Our mission in Maternal-Fetal Medicine is to make even the most high-risk pregnancy as safe as possible,” explains Abdulla Al-Khan, M.D., FACOG, FACS, Vice Chair, Department of Obstetrics & Gynecology, and Director, Maternal-Fetal Medicine & Surgery at HUMC. “This collaboration between Dr. Alvarez Perez, Dr. Mody, and our outstanding cardiology team is essential. By integrating our expertise, we are creating a unique seamless circle of care around these mothers. We are not just treating conditions; we are proactively managing risk, planning for every contingency, and ensuring that both mother and baby have the best possible chance for a healthy future."
Advanced Expertise When Every Minute Matters
For women with significant cardiovascular disease, labor and delivery can be particularly dangerous due to rapid changes in blood volume and heart rate. While cardio-obstetrics is a vital, emerging field, HUMC’s program is part of an elite tier. Most standard community hospitals simply do not have the resources to offer this level of highly specialized care.
What makes programs like Hackensack's stand out is having access to the most extreme life-saving measures under one roof. For the highest-risk mothers, advanced heart failure and transplant cardiologists are standing by directly during delivery. With immediate access to advanced technologies like ECMO (extracorporeal membrane oxygenation), the coordinated team doesn't wait for a crisis to assemble; they have already anticipated it and mapped out a plan. In maternal emergencies, that distinction saves lives.
A Mother and Son, Together
For Ayanda, the ultimate measure of success was profoundly simple: she survived, and she safely delivered a healthy baby boy. Today, she describes herself as a thriving “mamaholic” and has an urgent message for other pregnant women. “Listen to your body. Your body knows,” Ayanda insists. “If you’re not being heard, you’re not seeing the right person.”
Ayanda’s journey demonstrates what happens when a patient’s voice is heard—and met by a team capable of providing the highest level of maternal and cardiovascular care. “The rising maternal mortality rate is one of the most pressing health crises of our time,” says Lisa Tank, M.D., President and Chief Hospital Executive. “Our world-class teams are breaking down traditional silos to create this desperately needed cardio-obstetrics program.”
At Hackensack University Medical Center, it comes down to one fundamental principle: When a mother says something is wrong, we listen. And when her life is at risk, the full strength of the institution comes together around her.
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