Pregnancy is usually an exciting and happy time in a woman’s life.
Yet for some women who are classified as ‘high risk’ it can be stressful and challenging.
It can be overwhelming to hear you have a high risk pregnancy.
But it’s important to remember even high risk women can have reasonably easy and problem free pregnancies.
Take some time to adjust, and then gather as much information as possible, so you feel in control, and can make the best decisions about your care.
There are still plenty of choices available to you, and you can be just as empowered about your pregnancy and birth as you had hoped.
What Does A High Risk Pregnancy Mean?
The term ‘high risk pregnancy’ means a woman has a pre-existing health condition, or develops a condition during pregnancy, which has the potential to cause complications for her, or for her baby.
Being high risk during pregnancy usually means you will need extra care and monitoring, to ensure the condition doesn’t cause problems for you or your baby. You might need treatment, to make sure your health stays stable, and will often be under the care of an obstetrician who is a specialist in high risk pregnancies.
Being high risk during pregnancy doesn’t automatically mean you will have complications during pregnancy or birth. It depends on your individual situation, taking into account your past and current health.
Most women who are classed as high risk will have problem-free pregnancies and their babies will be born healthy.
What Are Existing Risk Factors?
In general, a pregnancy might be considered high risk by a doctor if the pregnant woman:
- Is under 18 or over 35 years of age
- Was underweight or overweight before becoming pregnant
- Has any sexually transmitted diseases
- Previously had a baby with a birth defect (particularly a heart or genetic disorder)
- Has previously gone into premature labour, or had a premature baby
- Has experienced fertility issues
- Has a long term health condition, such as: heart disease; high blood pressure; diabetes; autoimmune disease, such as lupus; cancer; seizure disorders, such as epilepsy; or some blood disorders.
- Previously had a c-section
Due to the impact pregnancy can have on your body, your existing health condition might be affected.
Some of these risk factors might simply require extra monitoring, to make sure your baby is growing well, and your body is coping with the extra work it has to do.
Alternatively, changes to medication or treatment might be needed, to help you manage your condition, and ensure you and your baby are healthy.
What Risk Factors Can Develop?
There are several conditions that can only develop during pregnancy, and might increase your risk of having a more complicated pregnancy and birth.
A woman is considered high risk if the following conditions develop during pregnancy:
- A pregnancy with more than one baby (multiples)
- Gestational diabetes
- Premature labour (labour begins before 37 weeks)
- Placenta problems, such as placenta previa
- HELLP syndrome
What Will Happen If I Am High Risk?
There are different approaches to maternity care, depending on where you live and how your maternity system works. Some developing and preexisting conditions – having had a previous c-section, for example – can be managed very well and will have little impact on your health.
You might find your care provider has different views about how best to manage your pregnancy care. You have the right to ask questions, and to have a second (or third) opinion from other specialists. It’s important you feel the treatment being recommended is best for you.
In most cases, a pregnant woman characterised as high risk will be transferred to the care of an obstetrician. This is not always the case; it depends on where you live.
You will need to understand why you have been classed as high risk. Ask your care provider to explain the reasons in non-medical terms. Being told you are high risk during pregnancy can be stressful, so make sure you have all the information you need to help you better understand what is happening.
Find out whether the condition you have requires that you see a specialist – a cardiologist for heart conditions, or a neurologist for epilepsy, for example. Most conditions just need extra monitoring by your pregnancy care provider, but in some cases a specialist might have to be consulted, to determine what treatment you need, and what medication you can safely take, if necessary.
What Monitoring And Tests Will I Have?
Depending on the reason why you have been classed as high risk during pregnancy, there are tests or procedures you will be offered, in addition to the routine pregnancy screening tests.
These extra tests include:
- Growth scans: Ultrasounds which look at your baby carefully, to ensure she is growing on schedule
- Cervical checks: Measuring the length of your cervix by ultrasound, to see whether there are any premature changes
- Pathology tests: You might have blood tests or vaginal swabs taken for a number of tests
- Anomaly scans: Ultrasounds that looks for any abnormal development in your baby
- Amniocentesis: Taking a sample of fluid from the amniotic sac, to test for genetic conditions
- Chorionic villus sampling (CVS): Taking placenta cells, to test for genetic conditions
- Biophysical profile: Checking on your baby’s wellbeing, by looking at her heart rate (nonstress test), and by ultrasound.
- Medications: Sometimes drug treatment is necessary to ensure the wellbeing of you and your baby.
Some tests and procedures come with risks. It is important you are aware of them before deciding whether to continue. Discuss the risks and benefits carefully with your care provider, so you can make an informed decision about your care.
You might want to read more about procedures during pregnancy you may want to reject.
What Can I Do To Reduce My Risk Level?
If you have a preexisting health condition, the best way to lower your risk factors is to plan ahead, before you become pregnant.
In countries like Australia and the US, however, around 50% of pregnancies are unplanned, so it can be difficult to prepare first.
Whether you know ahead of time that you’ll have a high-risk pregnancy, or you simply want to do whatever you can to prevent a high-risk pregnancy, here are some things you should think about:
- Preconception health: Having a healthy lifestyle benefits every woman at every stage of life. Eat a balanced and nutritious diet, get some daily exercise, and maintain a healthy weight for your height and age.
- Preconception appointment: If you are thinking of becoming pregnant, talk your care provider about anything you need to do beforehand, whether it is changing your medication, or finding out about potential risks, such as having a baby with a genetic condition.
- Pregnancy diet: You will need plenty of folate, calcium, iron, and other essential vitamins and minerals during pregnancy. If your diet isn’t adequate to meet these needs, you might find your health condition worsens. Talk to your care provider about any special nutritional needs you might have. Avoid sugar (in food and drinks) and processed grains (bread, pasta, cereals etc) which spike blood sugar levels.
- Pregnancy weight: Gaining weight during pregnancy can be linked to your existing health, and what you are eating. If you’re given the ok to exercise, this can be a great way to keep your body healthy, and avoid becoming unhealthily overweight during pregnancy.
- Lifestyle choices: Smoking, drinking alcohol, and using recreational drugs during pregnancy automatically increase any risk factors you have. Your care provider can talk to you about how to quit safely during pregnancy.
- Stress Reduction: Stress has a huge impact on fertility and pregnancy. Learn techniques such as yoga or meditation, to reduce stress, and levels of stress hormone in your body.
- Regular check ups: Good prenatal care makes sure you and your baby are looked after, helps to prevent or minimise any problems, and reduces the risk of complications during later pregnancy and birth.
Check out BellyBelly’s preconception checklist and how to prepare for pregnancy.
Pregnancy is a time when things can be normal one minute, and change the next. Thanks to good pregnancy care, and efficiency in diagnosing problems quickly, women who are classed as high risk during pregnancy are likely to stay healthy and avoid major complications.
Doing all you can before becoming pregnant will increase your chances of having a problem free pregnancy and birth. You might also need the care of a specialist in high risk pregnancy, who will work with you on the best way to manage your treatment and care.