Coronary heart disease is the biggest killer in the UK, causing more than a quarter of deaths in 2018 (British Heart Foundation, 2018). Congenital defects are the most common cause of heart disease in pregnancy (Wylie and Bryce, 2016). This article will discuss Marfan syndrome and the impact this has on pregnancy and childbirth. Current literature and research will be appraised and discussed to explore mode of delivery during the second stage of labour and calculate the most appropriate method of delivery. Additionally, this article will address how the midwife can support women with Marfan syndrome during the pregnancy booking, antenatal period and intrapartum period without labelling them, and discuss how this may be achieved in relation to the uncertainty reduction communication theory.