Post-partum cardiac care aims to improve women's health for the long term

When a woman in her 50s arrived at Campbell River Hospital in 2022 with an acute cardiac event, her doctors were bemused. She didn’t fit the typical profile—no high blood pressure, no diabetes, no obvious red flags. Yet, she was part of a troubling pattern.  

Family physician Dr Jennifer Kask and internal medicine specialist Dr Valentyna Koval had started noticing an increase in female patients in their 40s and 50s presenting with these same concerns.  

“We kept coming back to these cardiac events and asking, ‘Why? What are we missing here to prevent it from happening again?’” recalls Dr Koval.  

 “How does someone who is relatively young and seems to be doing all the right things, present with an acute cardiac event? How can we address female-specific reproductive cardiovascular risk factors?” 

Local audits show nearly 30 percent of pregnancies every year are affected by one or more pregnancy complications. Pregnancy itself is sometimes described as a “stress test” for the heart because of the metabolic demands that growing a fetus has on the vascular system. Yet many health care providers aren’t trained to recognize how those complications can affect cardiovascular health later in life. 

“Even I am guilty of this,” says Dr Koval.  “My template as a specialist did not have that obstetrical lens on women’s cardiovascular events in the past.”  

With funding support from Facility Engagement, part of the Specialist Services Committee, Drs Kask and Koval worked with colleagues and community partners to share ideas and develop a solution which eventually resulted in the  BiRCH Clinic—short for birth-related cardiovascular health. 

Operating out of the Campbell River Hospital Wellness Centre, BiRCH has quickly made its mark. In just three years, it has expanded access to specialized care, reaching even remote communities through virtual visits. It’s also educating future physicians and equipping health care providers with practical tools—like “aide-memoire” cards that summarize key information on postpartum cardiovascular risk and risk reduction in future pregnancies. 

Their passion is palpable, and Drs Kask and Koval encourage other physicians to recognize the link between pregnancy history and long-term heart health and seek support in implementing these processes in their own communities. 

“All you need is to fill that knowledge gap—educate the health care providers and educate your patients. You don’t need to prescribe anything; you don’t even need to order a lot of tests—just talk. Educate.” says Dr Koval. “With the right knowledge, anyone can do that. It is absolutely possible.”   

The BiRCH clinic was funded by the Specialist Services Committee and the Vancouver Island Health Authority, through the Facility Engagement Initiative. To learn more about the clinic and its resources, visit the BiRCH website. Aide memoire cards can be requested online.