[Never give negative pregnancy advice]

Many doctors still tell some patients that a (subsequent) pregnancy is contraindicated. Aside from the fact that the desire to have a (or another) child is often extremely strong, which often results in ignoring the message, this type of advice may have serious negative consequences. Women at high risk of cardiovascular complications may decide to delay in making their first appointment to avoid an angry doctor who might push them towards an abortion. Women may postpone a subsequent pregnancy out of fear of preeclampsia, while this in fact increases the recurrence risk. Doctors often scare patients with stories about drugs causing fetal anomalies, while only a small minority of drugs, and then only during a limited time in pregnancy, are truly teratogenic. Prepregnancy counselling should involve a well-informed, balanced discussion on risks, while acknowledging a woman's desire for childbearing and ensuring that she will receive all possible support when she does become pregnant.