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 very minor problems, but in some cases, a high-risk condition can be life threatening for a woman or her baby.
That’s why a high-risk pregnancy requires extra monitoring. 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.
Impact of health
Some health conditions can make your pregnancy high-risk too. There are a few things you can do to reduce the risk of pregnancy complications when you’re high-risk. If you’re not yet pregnant and if you have a chronic condition, schedule a preconception visit with your health care provider so you can be as healthy as possible before you conceive. Aim to do this at least a few months (or more, depending on your condition) before you start trying to conceive.
This gives you time to make any changes your provider recommends before you become pregnant. 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 a problem is found
About 3 in 100 babies born will have a birth defect. Some birth defects can be detected by ultrasound or by genetic testing before birth. If a birth defect is suspected or diagnosed, you and your baby will be followed more closely during pregnancy. Depending on the defect, you may also need to give birth at a hospital with pediatric specialists available to care for your baby immediately. With good prenatal care it’s possible to have a healthy baby.
For most parents, the news that an abnormality has been identified in their baby is completely unexpected. A problem or abnormality identified in the developing baby generally comes as a shock. This can be a time of mixed feelings such as devastation, sadness and uncertainty. It can also be a time to prepare for the future.
Some couples who considered CVS or amniocentesis, have had prenatal diagnosis counseling. During this process, they may have had the opportunity to discuss their concerns about the possibility of a test result revealing a problem in the developing baby. Other couples have thought of this possibility because they have a family history or a previous child with a particular condition for which the current pregnancy is at risk. You may have a condition yourself which has now been detected in your baby.
Emotional impact
Perhaps the abnormality was identified as a result of a genetic screening test on maternal blood such as a first trimester screen, quad screen or non-invasive prenatal screening with fetal DNA. The diagnosis may have been made by prenatal diagnostic procedures such as CVS (chorionic villus sampling) in the first trimester of pregnancy or by amniocentesis in the second trimester. The baby’s problems may have been seen through an ultrasound examination offered as a routine screening test.
More and more abnormalities are also being identified through “routine” examinations such as ultrasound due to improvement in technologies available. Often the parents of babies identified in this way have never given consideration to the possibility that such a routine test would find something wrong with their baby. Whichever way the diagnosis is made, most people are quite unprepared for the reality.
You may have received the news by telephone, or in person from your doctor, a genetic counselor, obstetrician or maternal-fetal medicine provider. Like many others, you may be feeling numb, confused or alone. Often parents cannot believe what they have heard and will want frequent reassurance that the diagnosis is correct. It is perfectly acceptable for you to question the accuracy of the information and even to seek a second opinion about the diagnosis from another medical expert.
It is not unusual to have feelings of guilt. Regardless of the cause of the baby’s problems, it is common to wonder if you could have possibly contributed to the abnormality or if anything could have been done to prevent it from happening. Whatever the cause of your baby’s problem, it is unlikely that there was anything that you or your partner did or did not do that made it happen. Many of the problems found in a developing baby are “chance” events. Even if the problem is hereditary, no one can control which genes a baby inherits from its parents. It may be helpful to remind yourself that neither you, nor your partner is to blame for your baby’s problem.
At the time you receive the diagnosis, you may be up to halfway through your pregnancy. The 20 weeks or so that remain can be some of the most difficult weeks of your life. Some parents want to start planning and organizing straight away. Others may feel they don’t want to be flooded with information and worst-case scenarios, but do want to plan for the birth and have contact with the staff who will be caring for them and their baby in hospital.
Response tips
It is important to allow yourself time to experience and accept your emotions both now and in the days, weeks and months ahead. It is important to share your thoughts and feelings with your family and friends. You will find that you have to make your way through a complex medical system. You will have a lot of questions and you do have a right to have those questions answered. Your obstetrician may not have all the information you need, and you can ask to be referred to a specialist pediatrician or other source of information.
You can ask your doctor for written material or appropriate site on the internet that will help you gain a picture of what the disability actually means. It may also be helpful to ask to be put in touch with a parent support group if there is an appropriate one for your child’s problem. If there is no support group, you could ask to be put in touch with someone else whose child has the same diagnosis. This may help reduce your anxiety about the future and enable you to start to prepare for your baby’s arrival in a positive way.
Sometimes it is not easy to know how to explain your baby’s problem to others, when you barely understand it yourself. The needs and feelings of your other children can also be hard to deal with. However, it certainly helps if people around you know your baby has a problem, and that he may need transfer to pediatric specialist care, or surgery, after birth. Often you are preparing for a very uncertain future. Your medical team may not be able to provide you with specific and detailed information about your baby’s condition until after birth.
Birthing high-risk babies
The birth itself may not be as easy or straightforward as you would have wished. You might need to deliver at a specialized center. You might need to relocate while you are pregnant, far from home and your familiar supports. You may have a planned induction or cesarean delivery, so that the pediatric team can be available and standing by to offer care for your baby if it is needed. It is also helpful to find out what facilities they have for parents to live in locally.
You might need to be admitted to the hospital for a prolonged period of time before delivery. It is perfectly normal to feel exhausted during a long hospitalization; many hospitals run parent groups or other activities which can be very sustaining and help lessen your sense of isolation. They may also offer massage or relaxation programs.
You may be facing a long period of hospitalization for your baby. It is important to try to keep a balance and look after yourself. It’s likely that your will encounter a multitude of feelings. You may experience anger and disappointment that you could not have the kind of birth you wished, exhaustion after the months of preparation and resentment of other women in the hospital whose concerns seem very minor by comparison with yours. Most maternity and pediatric units have a social worker whose role it is to help you voice your feelings in a safe environment and ease your contact with the medical team. Most hospitals also have chaplains available, and a chapel or quiet room where you can sit in privacy.
Resources available
In conclusion, if your baby is diagnosed with an abnormality prior to birth, there are resources available to you to help you through the antepartum period, labor and delivery and the postnatal period for your baby. Make sure to attend all of your doctor appointments and ask questions. Do your best to keep strong emotionally and know that support is there for you if needed. As health care providers, our goal is to provide you with the best possible experience even in the event of complications.
Learn more
- Understanding high-risk pregnancies
- Helpful information on pregnancy after age 35
- What to know about an ectopic (tubal) pregnancy
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Posted In Pregnancy, Specialty Care, Women's
