As more children with congenital heart disease (CHD) survive to adulthood, reproductive health care in this demographic is becoming increasingly important. While all women with CHD can have an increased risk of morbidity associated with contraception and pregnancy, these risks can range from those that are medically manageable to catastrophic sequalae that can affect quality of life. Clinicians should discuss reproductive health before puberty and should counsel for pregnancy, family planning, and contraception. Comprehensive counseling during adulthood should include risks during the peripartum period, fetal risk, and long-term cardiovascular sequalae, and should be done with a cardiologist experienced in CHD.