A Complete Guide To High Risk Pregnancy

High Risk Pregnancy – Reasons and Ways to Cope With It

In a high-risk pregnancy, extra care needs to be taken to have a healthy pregnancy. A bad health condition is one of the main reasons behind high-risk pregnancy. Other factors include advanced maternal age, bad lifestyle choices or being pregnant with multiple babies. If you have been told that you have a high-risk pregnancy, pay attention to what your doctor says and take the medicines as prescribed. Lastly, the most important part is to “stay happy and positive”.

What Is a High-risk Pregnancy?

In a high-risk pregnancy, the health or the life of the mother or the foetus is threatened, and hence, a pregnant woman should take extra care to have a healthy pregnancy. If you have a high-risk pregnancy, you will need specialised care from specially trained providers. Some pregnancies become high risk as they progress, and in some cases, a woman may face complications even before she conceives.

Causes of High-risk Pregnancy

Several factors cause high-risk pregnancies if they are present before conception. These include:

  • Maternal age over 35
  • Being overweight or underweight
  • Problems in previous pregnancies
  • Pre-existing health conditions, like high blood pressure, diabetes or HIV.

Certain health problems can crop up during pregnancy and put you in a high-risk pregnancy category. Such cases include:

  • Pre-eclampsia
  • Gestational diabetes
  • Depression, anxiety and insomnia

How to Reduce Stress?

Being stress-free is the key to a healthy pregnancy. Here is how you can try to relax.

  • Getting good prenatal care can help reassure you.
  • Reduce your workload if you are in a high-stress job.
  • Ask your husband or family members to help you with the household chores.
  • Take ample rest and frequent power naps.
  • Pre-natal yoga classes could relax you. They teach you to stretch and help improve your balance and breathing while acting as a support group.
  • Going for light walks. Exercising produces Endorphins which are brain chemicals known as neuro-transmitters that fight stress naturally.

How to Reduce Stress?

What Are the Possible Risk Factors for High-Risk Pregnancy?

Factors that place pregnancy at high risk can be divided into four categories :

1. Existing Health Conditions

    • High Blood Pressure
    • Polycystic Ovary Syndrome (PCOS)
    • Diabetes
    • Kidney disease
    • Auto-immune diseases like Lupus and Multiple Sclerosis
    • Thyroid disease
    • Infertility
    • Obesity
    • HIV/AIDS

2. Age of the Mother

    • Teen Pregnancy
    • First-time pregnancy after 35 years of age

3. Lifestyle Factor

    • Alcohol use by the mother
    • Cigarette smoking

4. Conditions of Pregnancy

    • Multiple gestations
    • Gestational diabetes
    • Pre-eclampsia and eclampsia

Can Your Baby Get Affected While You Are Having a High-Risk Pregnancy?

In a high-risk pregnancy, along with the mother, the baby may also have to face several challenges even before he is born. In some cases, like pre-eclampsia, the baby may be born pre-matured, which could be life-threatening. For conditions where the mother is suffering from some Auto-immune disease or Cancer, the medication to treat the mother could have side effects on the child. Diseases like HIV are automatically transferred from the mother to the child, which in the long run, is life-threatening for the baby.

Lifestyle factors such as smoking, drinking or using drugs before and during pregnancy could be harmful to the baby. As such, the baby could be born with different types of disabilities, like physical or intellectual disability. Such a child may also have vision or hearing problems.

Medical Conditions That Can Develop During High-Risk Pregnancy

Anything can happen during pregnancy. Even the healthiest of person can develop a medical condition during this period, which could make the pregnancy a risky one for the mother and the baby. The most common medical conditions of these are:

  1. Gestational Diabetes: A type of Diabetes that develops during pregnancy. Usually, the disease resolves after delivery. Women with this type of Diabetes are at increased risk of developing type 2 diabetes. However, if they follow the treatment plan properly, women with Gestational Diabetes can have a healthy pregnancy and a normal delivery.
  2. Preeclampsia: It is a condition which includes high blood pressure, protein in the urine and swelling which occurs after the 20th week of pregnancy. With proper management, however, most women who develop it have healthy babies.
  3. Depression: It can happen at any time in your life, but women are more at risk during pregnancy and the year after their delivery. Depression and Anxiety are the most common types of mental illness that women suffer from in the Perinatal period. These two illnesses further give rise to Insomnia (sleep disorder). The important thing is to know how to recognize the signs and seek medical help immediately.

How to Reduce Complications?

Here is how you can reduce complications in a high-risk pregnancy

  1. Understand the medical condition we are suffering from
  2. Address it with the help of a Gynaecologist/Obstetrician and specialized doctors
  3. Go for regular checkups and tests
  4. Stay fit not just physically but mentally too
  5. Take bed rest if you must
  6. Go for strolls, do pregnancy asanas and, if possible, practice a bit of meditation every day
  7. Avoid stress

Avoid smoking during preganancy

How Can Pregnant Mother Keep Energy Up?

Most expectant mothers experience fatigue during pregnancy, especially in the first and third trimesters. Here are some ways to manage energy levels

  • Exercising from the fifth month onwards and with the doctor’s permission. Pre-natal yoga, kegel exercises, walking, swimming and some stretching are especially helpful.
  • Ensuring proper nutrition and getting enough fluids
  • Sleeping well. Power naps during the day help too

High-risk Pregnancy Care

In a High-Risk pregnancy, there are three crucial factors that are to be looked into :

1. Logistical Care

The expectant mother often requires hospitalisation. The mother may have to leave her other child/children with family or hired help. This may add to expenses. The need to stop working or hospital bills may cause a financial burden too.

2. Health Care

A mother may be responsible for home monitoring of her condition. That might mean monitoring Uterine contractions, maintaining a diet or blood sampling several times a day. Prioritising self-care should be given importance, even if it means having to get extra help.

3. Emotional Care

Anxiety and depression are common in high-risk pregnancies. There is always a fear of losing the baby or even losing one’s life in such a pregnancy. Moreover, being in the hospital for most of the time and away from the comforts of one’s home, family, and friends makes the expectant mother feel isolated, lonely and emotionally drained.

How Can You Make Others Understand What You Are Going Through?

One should get support from family, friends, counsellors, or other women who have gone through the experience. This will help ease stress and enable others to empathise and offer support.

Here is how you can go about it:

  1. Be willing to talk about your fears and experiences.
  2. Share articles, books or other information relating to your condition so that others understand your situation.
  3. Bring a partner or a friend along for the appointments with your doctor; it could also help them understand your problem

How to Build a Support Network?

Doing everyday household chores could also look like a herculean task when an expectant mother is experiencing a high-risk pregnancy. Reach out to your friends and family for help without any guilt.

Talking to people who have been in similar situations through online communities and pregnancy support groups helps, too.

Taking the help of a Therapist can also help you to manage prenatal issues.

Husband helping wife to wear shoes

Asking Your Partner for Help

A supportive husband can relieve a lot of stress. Therefore your partner can help whenever required. Your husband can:

  • Accompany you to doctor visits;
  • Help out with household chores or babysitting.

How to Deal With Extra Medication, Appointments and Tests?

In a high-risk pregnancy, you will need extra appointments with the doctor and, in turn, more logistic hurdles. Here are some ways to ease the load:

  • Do some research or speak to your HR at work to learn your rights before you ask for leave.
  • Ask a friend or someone in the family to babysit when you visit the doctor.

These measures will help curb expenses and reduce financial stress.

How to Deal With Not Having Your Dream Birth?

Accepting the situation with support is the first step towards completing this difficult journey. In addition, you can help yourself come to terms with not having your dream birth by chronicling your experience. Focus on your future with your baby rather than the way you give birth, and start feeling like a survivor who made it through a difficult phase.

If you are still disheartened, it is a good idea to seek professional help.

Best Way to Talk to Health Care Expert

Your doctor should be your “best friend” till the time of your delivery. Nothing should be kept hidden from the doctor so that in case of an emergency, she can act quickly.

Other Ways to Manage High-risk Pregnancy

Symptoms of high-risk pregnancy that an expectant mother should be aware of are:

  • Loss of consciousness
  • Vaginal bleeding
  • Extreme pain in the pelvis or belly
  • Heavy fluid discharge from the vagina
  • Persistent pelvic pressure or back pain
  • Reduction of cessation of foetal movement
  • Signs of pre-eclampsia such as swelling in the face, hands or feet, vision problems such as dimness or blurring and severe headache.

Unfortunately, if you have any of these symptoms during your pregnancy, consult your doctor immediately and get all the high-risk pregnancy tests done like:

  • Ultrasound on a routine basis to evaluate specific high-risk issues like pre-eclampsia, intrauterine growth restriction, placenta previa etc.
  • Apart from this, there are other tests that are done specifically for some particular health condition that the mother may be suffering from, like heart disease, renal disease, thyroid dysfunction, diabetes, neurological problems, blood pressure, auto-immune diseases, cervical/uterine anomalies, cancers and miscarriages.

Depending on the risk factors that you are diagnosed with, high-risk pregnancy treatment will be prescribed like :

1. Gestational Diabetes

  • Keeping track of blood sugar levels by testing multiple times a day.
  • Eating smaller and frequent meals throughout the day that are low in carbohydrates and sugar and high in fibre.
  • Keeping track of weight gain.

2. High Blood Pressure

  • Some changes to blood pressure medicine can be recommended.
  • Lifestyle changes such as low salt intake and regular exercise can be prescribed along with light walks.

3. Preeclampsia

  • If it’s mild, then the doctor may advise just bed rest.
  • In severe cases, you will be asked to take Vitamin C and Vitamin E.

4. Placenta Previa

  • In case of low bleeding, the doctor will just monitor carefully.
  • In rare cases where the placenta blocks the cervix completely, the expectant mother may be asked to take complete bed rest.
  • Recurring bouts of bleeding would require hospitalization.

5. Pre-Term Labour

  • Treatment varies from case to case. However, treatment measures like bed rest and lots of fluid intake are recommended.

Even though high-risk pregnancy sounds “ominous”, there is no reason to panic. It does not mean that you will have problems because of it. More often than not, a majority of women who have high-risk pregnancies go on to have problem-free ones and give birth to healthy babies. All that is required is care, patience and positivity by the expectant mother and the people around her.

References/Resources:

1. High-risk pregnancy: What you need to know; NIH MedlinePlus Magazine; https://magazine.medlineplus.gov/article/high-risk-pregnancy-what-you-need-to-know

2. High-risk pregnancy: Know what to expect; Mayo Clinic; https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/high-risk-pregnancy/art-20047012.

3. High-Risk Pregnancy; Cleveland Clinic; https://my.clevelandclinic.org/health/diseases/22190-high-risk-pregnancy

4. What is a high-risk pregnancy?; NIH; https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/high-risk

5. What’s a “High-Risk” Pregnancy?; Nemours KidsHealth; https://kidshealth.org/en/parents/high-risk.html

6. High-Risk Pregnancy: What You Need to Know; Johns Hopkins Medicine; https://www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-during-pregnancy/high-risk-pregnancy-what-you-need-to-know

7. High-Risk Pregnancy; Yale Medicine; https://www.yalemedicine.org/conditions/high-risk-pregnancy

8. High-Risk Pregnancy Care; NewYork-Presbyterian; https://www.nyp.org/womens/pregnancy-and-birth/high-risk-pregnancy-maternal-fetal-medicine/symptoms

9. What is a High-Risk Pregnancy?; American Pregnancy Association; https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/what-is-a-high-risk-pregnancy/

10. High-Risk-Conditions-in-preg-modified-Final.pdf; MoHFW; https://pmsma.mohfw.gov.in/wp-content/uploads/2016/10/High-Risk-Conditions-in-preg-modified-Final.pdf

11. High-risk pregnancy; UCSF; https://www.ucsfhealth.org/conditions/high-risk-pregnancy

12. High Risk Pregnancy; Complementary Therapies in Medicine, 2022; ScienceDirect; https://www.sciencedirect.com/topics/medicine-and-dentistry/high-risk-pregnancy

Also Read:

Abdominal Pregnancy
Heterotopic Pregnancy
Types of Twin Pregnancy
Different Types of Pregnancy

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