Pregnancy can be termed high risk for many reasons. These reasons include:
- Having a pre-existing medical condition such as diabetes, epilepsy, cancer, or heart disease.
- Currently pregnant with more than one baby (multiple pregnancies).
- A fetus has a congenital abnormality (present at birth) or another genetic condition.
- Women who have had three or more miscarriages in the past.
- Women with an active infection, such as HIV or hepatitis C.
- A severe problem in a prior pregnancy, such as pre-term labor or pre-eclampsia.
- IVF pregnancies (higher rates of stillbirth, fetal anomalies, fetal cardiac defects)
- Obesity (people with a BMI of greater than 30 have a two-fold increase in fetal anomalies detected by ultrasound)
- Advanced Maternal Age: Women who are 35 years or older.
Whatever the reason, having a high-risk pregnancy means you will get some extra care and support throughout your pregnancy. The extra attention is to help ensure everything goes as smoothly as possible. What this means in reality is that you’ll be attending a few more check-ups, possibly undergoing more scans, and speaking to your healthcare team more often.
What happens next in a high-risk pregnancy?
Maternal-Fetal-Medicine specialists
The first step is to make an appointment to see a Maternal-fetal medicine specialist if your doctor hasn’t referred you already. Maternal-fetal medicine doctors specialize in dealing with at-risk pregnancies to help prevent high-risk scenarios—they optimize outcomes. They are a great source of advice when dealing with pregnancies that require a greater degree of specialization. Your Maternal-fetal medicine doctor can discuss the following with you:
- Details about your condition. This may be your medical condition or that of the baby.
- Information on the results of any past or current testing or scans. This also includes the need for future scans and when they should be carried out.
- Any changes or adjustments to your current medications.
- Your general birthing plan and how best to proceed with the labor and delivery.
Make an appointment to see a high-risk pregnancy specialist – if needed.
Suppose the cause of your high-risk pregnancy is the presence of a pre-existing condition such as heart disease, diabetes, or epilepsy. In that case, your doctor may also recommend making another appointment with the appropriate specialist, such as a:
- Cardiologist
- Neurologist
- Nephrologist (kidney specialist)
- Neonatologist
Not all high-risk pregnancies will require consultation with a further doctor. Your own doctor or OBGYN will recommend any additional specialists if needed.
In the event that additional specialist help is required, these doctors will also play a role in guiding you through the pregnancy process. Whether it’s a change to your medications or advice on ways to help stabilize your medical condition before childbirth, specialists can be another great avenue of information.
Keep all of your prenatal appointments.
It goes without saying that you should attend all of your prenatal appointments. This will ensure that you take tests that help to monitor how you and the baby are doing. Your doctor can also speak to you about any new issues you may have noticed. Testing at these appointments can include
- Urine testing
- Blood pressure testing
- Blood tests
- Doppler ultrasound (to listen to the baby’s heartbeat)
- Any possible pre-arranged neonatal scans or tests
Be aware of signs and symptoms to look out for
Throughout your pregnancy, pay close attention to how you’re feeling and if the development of any symptoms suddenly occurs. For yourself, look out for the following:
- Excess nausea and vomiting
- New onset headache
- Vaginal bleeding or cramping
For the baby, look out for the following:
- Decreased fetal movements
- Sudden abdominal pain
If you notice any of these symptoms, you should immediately speak to your doctor or midwife. In the case of high-risk pregnancies, your level of doubt to seek help should be lower, so do not hesitate to reach out for help sooner rather than later.
Other tips to keep in mind
- Don’t be afraid to ask questions -No matter how minor you think it is, do not hesitate to reach out to your provider to ask questions about anything you are unsure of. They’re here to help you. We have a patient portal to improve communication.
- Keep a low threshold for getting help. If you think something is wrong, follow your instinct and get help or speak to your midwife or OBGYN.
- Take care of yourself. That includes looking after your diet, exercising, and monitoring stress levels.
Feeling a bit anxious about your health and your baby’s is expected. But remember that you are not alone. Be sure to reach out to your medical team and support network if you encounter any issues you are unsure of or need extra advice.
