Every expecting mom wishes for a joyful and uneventful pregnancy concluded by the uncomplicated delivery of a healthy baby. Sometimes, though, the journey to motherhood doesn’t go smoothly. What if, after celebrating a positive pregnancy test, you happily visit your ob-gyn, and they tell you that your pregnancy is a high-risk one?
What is a high-risk pregnancy?
Although it sounds pretty scary, just because your pregnancy is labeled as high risk doesn’t necessarily mean you can’t deliver a healthy baby. So, what does the term “high-risk pregnancy” denote?
Your pregnancy is referred to as high risk if you, your baby, or both are at relatively higher risk of experiencing potential problems or complications during pregnancy or delivery than in a typical pregnancy.
As a clinician and obstetrician, I would like to mention that no pregnancy is entirely free of risk. When you have a typical (that is, low-risk) pregnancy, you have to follow the routine prenatal check-up schedule and testing protocol.
However, suppose you are in the high-risk pregnancy category. In that case, you may be asked to make more frequent visits and undergo more testing. This way, your ob-gyn team can monitor your pregnancy more closely to reduce and manage the potential risks.
Your prenatal care team will develop an individualized plan to ensure your and your baby’s safety during pregnancy and delivery. A high-risk pregnancy doctor is referred to as a maternal-fetal medicine specialist (also known as a perinatologist).
When managed appropriately, many high-risk pregnancies have no complications at all and end in happy and healthy moms and babies.
What causes high-risk pregnancy?
The factors that make a pregnancy high-risk can be divided into two groups:
- Pre-existing risk factors
- Risk factors arising during pregnancy or delivery
Let’s discuss them.
Pre-existing risk factors
Some women enter pregnancy with prior health issues or problems that may increase the likelihood of complications and make the pregnancy high risk. These factors are:
- Age: Your pregnancy is considered high risk if you’re very young (under 17) or older than 35 (geriatric pregnancy). The risk of preterm labor and low birth weight babies is much higher among younger moms, while miscarriages, stillbirths, chromosomal anomalies in fetuses, and cesarean delivery are more likely to occur among geriatric moms.
- Weight: The weight at which you enter your pregnancy also matters. Overweight and obese women are at higher risk of preeclampsia (high blood pressure starting after week 20 of gestation), gestational diabetes, birth defects in babies, babies large for gestation age, and birth injuries. On the other hand, being underweight also predisposes both mom and baby to some problems, among them miscarriage, premature birth, gastroschisis (anterior abdominal wall defect in baby), and low birth weight. So, it’s always better to optimize your weight before conception.
- Medical conditions: Pregnancy may become more challenging if you already have an illness like diabetes, high blood pressure, heart disease, kidney disease, uncontrolled asthma, epilepsy, depression, thyroid disease, sexually transmitted diseases, or HIV.
- Substance abuse: Substance abuse of any kind is extremely harmful to the mother as well as the developing fetus. Drugs, alcohol, and tobacco directly affect the baby in the womb and may result in grave lifelong consequences. Your baby can develop serious physical or mental issues, and in some cases, the effects could be fatal.
- Significant previous history: Your pregnancy is also marked as high risk if you have a history of recurrent pregnancy loss, stillbirth, birth defects in previous kids, complicated delivery, or a family history of some genetic disease.
Risk factors arising during pregnancy or delivery
Some pregnancies become high risk as they progress because of risk factors emerging during gestation or delivery. They could be related to the mother or the developing fetus.
Maternal factors: Maternal conditions unique to pregnancy that may pose risks to both mom and baby include preeclampsia, gestational diabetes, a multiple pregnancy, placenta previa (low-lying placenta), and preterm labor. Extra medical care and surveillance are mandatory if any such condition arises.
Risk factors associated with the fetus: A pregnancy will be labeled as high risk if, during prenatal testing, the fetus is found to have some structural defect (such as neural tube defects, gastroschisis, kidney defects, heart defects, or limb defects) or chromosomal anomalies (such as Down syndrome, trisomy 13, or Turner syndrome).
How can you reduce complications during pregnancy?
In many cases, the factors that make your pregnancy high risk are unavoidable. Still, you can reduce the potential risk by taking specific steps, such as:
- Book an appointment with an ob-gyn before conception to make sure you’re healthy and fit to have a baby.
- Try your best to be in the healthy weight category before your pregnancy starts.
- Don’t forget to optimize your health beforehand if you have any pre-existing illnesses.
- Get the recommended immunization before conceiving.
- Stop all substance abuse. Don’t use any drugs except for medications approved by your doctor.
- Start taking folic acid (400 micrograms) prior to pregnancy as it decreases the chances of neural tube defects in babies.
- Eat healthy and exercise (unless advised otherwise by your doctor).
- Follow the advice of your health care provider and see them regularly. Don’t skip prenatal visits.
- Stay calm and hope for the best.
Psychological implications of high-risk pregnancy
A high-risk pregnancy can be very stressful for both the mom and her family.
A woman may experience various emotional issues, including sadness, anger, frustration, fear, guilt, disbelief, shock, and anxiety. Her emotional response may also be affected by the lifestyle restrictions imposed by her high-risk condition, including changes in her eating and sleeping habits and disruption in her social, recreational, and work-related activities. Her family life may also get disturbed because of prolonged hospitalization, bed rest, or frequent testing.
Here are some easy and practical tips to help you minimize the psychological impact of a high-risk pregnancy.
- Make self-care a priority. Spare time for activities that make you feel better and relaxed, like meditation, listening to music, yoga, or painting. Listen to your body. Rest.
- Educate yourself about your condition and the associated risks but get information only from reliable and authentic sources. In this way, you can take better care of yourself.
- Don’t consider yourself alone; join a local high-risk pregnancy support group. This will provide you with a platform to share your feeling and also learn about what other women in the same situation are going through.
- Ask for help if you are feeling overburdened and struggle to manage your daily tasks because of your health.Talk to your family and friends about it.
- If you are dealing with emotional issues, express your feelings and don’t hesitate to consult a mental health physician if required.
A high-risk pregnancy could be extremely challenging, and you may experience many highs and lows during this period. However, by staying optimistic and working closely with your healthcare team, you can achieve the best possible outcome.