High Risk Pregnancy
A high-risk pregnancy might pose challenges before, during or after delivery. If you have a high-risk pregnancy, you and your baby might need special monitoring or care throughout your pregnancy. Understand what causes a high-risk pregnancy, and what you can do to take care of yourself and your baby.
Many factors can make a pregnancy high-risk. You may be considered high risk if you had problems in a previous pregnancy – if you delivered a baby early, for example. This doesn’t mean you’ll definitely experience the same problems again, but your provider will want to keep a closer eye on you as your pregnancy progresses.
Some health conditions can make your pregnancy high-risk too. See a doctor before you start trying to get pregnant if you have a chronic condition, so you can be as healthy as possible before you conceive. There are many health conditions that affect pregnancy including:
If you have a high-risk pregnancy, you might consider various tests or procedures in addition to routine prenatal screening tests. Depending on the circumstances, your health care provider might recommend:
Some prenatal diagnostic tests — such as amniocentesis and chorionic villus sampling — carry a small risk of pregnancy loss. Ultimately, the decision to pursue prenatal testing is up to you and your partner. Discuss the risks and benefits with your health care provider.
If you have a high-risk pregnancy, you may need more frequent prenatal appointments and will be monitored closely by your providers. You may also be referred to a maternal-fetal medicine (MFM) doctor. This is a physician who is specially trained to care for women who have a high-risk pregnancy.
The exact care you and your baby need depends on your particular circumstances and on the reasons your pregnancy is high-risk. You might see your MFM doctor just once or regularly throughout your pregnancy. Your MFM doctor will work with your ob-gyn and other providers to keep you and your baby healthy as your pregnancy progresses.
It’s worth preparing yourself for the idea that the birth you have may not be the birth you’d choose. If your pregnancy is high-risk, you won’t have the option of a home birth or attending a birth center. You’ll need to give birth in a hospital where you and your baby can be monitored closely and specialist care is available during the birth and afterward.
If you’re having multiples, you’re more likely to go into labor early. Preterm labor is also more likely if you have a high-risk pregnancy for other reasons, such as having too much amniotic fluid around the baby or having certain medical conditions.
You may also need to have your labor induced to prevent or reduce health problems for you and your baby. Or there may be reasons why a vaginal birth isn’t possible and you need to have a c-section. Talk to your provider about what you can expect during labor, so you can prepare yourself in the best way possible.
If you have a high-risk pregnancy, one of your biggest worries will probably be whether any harm will come to your baby. It’s natural to be concerned.
However, with good prenatal care it’s possible to have a healthy baby. Healthy moms grow healthy babies: That’s why it’s so important to talk to your provider to find out how best to keep you and your baby safe. Some conditions, as well as the drugs that are usually prescribed to manage them, pose a risk to your baby’s health. But stopping medications that you take for a condition can also be very dangerous.
You may be asked to change the drugs you take for a health condition, such as high blood pressure, to another medication that’s safer during pregnancy. This can help to reduce the risk of problems that the side effects of your medication might cause for your baby while he’s developing in the uterus. Note: Don’t stop taking any medication without consulting your provider first.
If your baby is born early, he could have difficulty breathing or feeding, or develop infections or other complications. If this happens, he needs extra care and support, which means staying in the hospital for several weeks, probably in a neonatal intensive care unit (NICU).
There are a few things you can do to reduce the risk of pregnancy complications when you’re high risk:
- If you’re not yet pregnant, schedule a preconception visit with your healthcare provider. Aim to do this at least a few months (or more, depending on your condition) before you start trying to conceive. This gives you time to make any changes your provider recommends before you become pregnant.
- Find out all you can about your condition and what you can do to stay healthy. Ask your provider for information.
- At your first prenatal visit, tell your provider about any current health problems you have, any medication you’re taking, and any difficulties you had in previous pregnancies.
- Go to all your prenatal appointments and follow your healthcare provider’s advice.
- Have a healthy lifestyle: Follow your provider’s nutritional guidance, gain the right amount of weight, and stay active if you’re able. Don’t smoke or drink alcohol.
- Ask your partner, family, and friends for support – this is likely to be a stressful time.
- Look after your emotional well-being. Take time out for yourself and reduce your stress levels where you can.
If you have a high-risk pregnancy, you might feel scared or anxious about your pregnancy. You might be reluctant to think about the future and nervous about prenatal visits — for fear that you’ll hear bad news.
Unfortunately, anxiety can affect your health and your baby’s health. Consult your health care provider about healthy ways to relax and stay calm. Some studies suggest that certain techniques — such as imagining pleasant objects or experiences or listening to music — can reduce anxiety during pregnancy.
Consult your health care provider about how to manage any medical conditions you might have during your pregnancy and how your health might affect labor and delivery. Ask your health care provider to discuss specific signs or symptoms to look out for, such as:
- Vaginal bleeding
- Persistent headaches
- Pain or cramping in the lower abdomen
- Watery vaginal discharge — in a gush or a trickle
- Regular or frequent contractions — a tightening sensation in the abdomen
- Decreased fetal activity
- Pain or burning with urination
- Changes in vision, including blurred vision
Also, find out which signs or symptoms should prompt you to contact your health care provider and when to seek emergency care. A high-risk pregnancy might have ups and downs. Do your best to stay positive as you take steps to promote a healthy pregnancy.