A pregnancy is considered high-risk when there are potential complications that could affect the mother, the baby, or both. High-risk pregnancies require management by a specialist to help ensure the best outcome for the mother and baby.
If you’re being treated for a lifelong (chronic) condition, you may have known for a long time that becoming pregnant carries additional risks. Or you may find out you have a high-risk pregnancy because of a problem that develops for the first time during pregnancy. having a high-risk pregnancy means it’s more likely that you or your baby will have health problems during pregnancy, birth, or after delivery. These could be minor problems, but in some cases, a high-risk condition can be life-threatening for a woman or her baby.
Risk Factors for High-Risk Pregnancy
Reasons that a pregnancy may be considered high risk include:
- Blood disorders. If you have a blood disorder, such as sickle cell disease or thalassemia, the additional strain pregnancy puts on your body can make your condition worse. There are also potential risks to your baby (both during pregnancy and after delivery) if she inherits your condition.
- Chronic kidney disease. This condition increases your risk of miscarriage, developing high blood pressure and preeclampsia, and having your baby early. Pregnancy can also put an extra strain on your kidneys.
- HIV or AIDS. If you have HIV or AIDS, your baby can become infected before birth, during delivery, or when you breastfeed. Fortunately, medication can dramatically reduce this risk.
- Lupus. Lupus and other autoimmune diseases can increase your risk of preterm delivery, preeclampsia, and have a small baby. Being pregnant may also increase the likelihood of your disease flaring up or getting worse.
- Maternal age. Your age can affect how likely you are to have a high-risk pregnancy. Being an older mom (age 35 or older in your first pregnancy) or a younger one (in your teens) puts you at greater risk of some complications and health problems.
- Obesity. Having a body mass index (BMI) of 30 or higher before pregnancy puts you at greater risk of gestational diabetes, type 2 diabetes, and high blood pressure during your pregnancy. When it comes to giving birth, you’re more likely to need your labor induced or a cesarean delivery.
- Thyroid disease. Both an underactive thyroid (hypothyroidism) and an overactive thyroid (hyperthyroidism) during pregnancy can cause problems for you and your baby if the condition isn’t controlled. These problems can include miscarriage, preeclampsia, low birth weight, and having your baby early.
- Type 1 or type 2 diabetes. If your diabetes isn’t managed well, you could be at risk of complications including birth defects, high blood pressure, having your baby early, and having a very big baby. Your baby may have problems with breathing, low glucose levels, and jaundice.
Often a pregnancy is classified as high risk because of issues that arise from the pregnancy itself and that have little to do with the mother’s health. These include:
- Premature Labor is also called preterm labor. It’s when your body starts getting ready for birth too early in your pregnancy. Labor is premature if it starts more than three weeks before your due date. Many factors have been associated with an increased risk of preterm labor, however, including Previous preterm labor or premature birth, particularly in the most recent pregnancy or in more than one previous pregnancy. Pregnancy with twins, triplets or other multiples. Problems with the uterus, cervix or placenta
- Multiple births mean you are carrying more than one baby (twins, triplets, quadruplets, etc.). Multiple pregnancies, which are more common as women are using more infertility treatments, increase the risk of premature labor, gestational diabetes, and pregnancy-induced high blood pressure.
- Placenta Previa is a problem of pregnancy in which the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix. The placenta grows during pregnancy and feeds the developing baby. If the placenta still covers the cervix close to delivery, the doctor may schedule a cesarean section to reduce bleeding risks to the mother and baby.
- Fetal problems, which can sometimes be seen on ultrasound. Approximately 2% to 3% of all babies have a minor or major structural problem in development. Sometimes there may be a family history of fetal problems, but other times these problems are completely unexpected.
How does being high-risk affect my labor?
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 cesarean section.
Talk to your provider about what you can expect during labor, so you can prepare yourself in the best way possible.
Will my baby be okay if I’m high-risk?
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: 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.
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).
How can I reduce the risk of pregnancy complications?
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. 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 your pregnancy is considered high risk, your doctor may refer you to a perinatologist. Also called a maternal-fetal medicine specialist, a perinatologist is an Obstetrician with special training in high-risk pregnancy care. This specialist will work with your other doctors, nurses, and other health-care professionals to ensure the best possible outcome for both you and your baby.
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