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What it means to have a high-risk pregnancy
You’ll need some extra care during all three trimesters — but you can still have a healthy pregnancy. Here’s what doctors want you to know.
The words “high risk” can be concerning to hear when you’re pregnant. But there are many things that can put you in that category. Some of them have to do with a health issue you already have, such as diabetes. Others are related to your age or if you are carrying twins.
These factors have one thing in common though. You, or your baby, have a higher-than-normal chance of complications during pregnancy and delivery. But just because a pregnancy is considered high risk, it does not mean you’ll have problems, according to the Cleveland Clinic. So, take a deep breath. You may need some extra care during your pregnancy — and your doctor has a plan.
Your provider will keep a close eye on you to help avoid pregnancy complications, says Marc R. Parrish, D.O. He’s an ob-gyn and maternal and fetal medicine specialist at the University of Kansas Health System.
Dr. Parrish says that he focuses on reassuring his patients. “I tell my patients ‘With very close monitoring we’re going to have a good outcome no matter what the preexisting issue is,’” he says. “I try to take that label away of being ‘high risk’ and just try to address specifically what’s happening with that patient.”
Here’s what you need to know about high-risk pregnancies, and how to remain calm and healthy.
Medical factors that can make a pregnancy high-risk
There are many medical conditions that might cause your doctor to keep a closer watch during your pregnancy, and every pregnancy is different. Here are some of the more common “high-risk” factors:
You have a preexisting health condition
This refers to a health condition you already had before you got pregnant. Common problems that can increase pregnancy risks include:
- Diabetes (type 1 or type 2)
- High blood pressure
- Obesity
- Autoimmune disorders (such as lupus, rheumatoid arthritis, inflammatory bowel disorders, multiple sclerosis)
Other issues such as thyroid disease, poorly controlled asthma, epilepsy, and heart or blood disorders can also increase the risk of complications, says the Mayo Clinic.
Why it can lead to potential problems: Preexisting high blood pressure and diabetes can affect the blood vessels in the placenta, says Dr. Parrish. The placenta supplies your growing baby with oxygen and nutrients. In the case of high blood pressure, your baby may not get enough oxygen and nutrients to grow well. And with diabetes, your baby may grow bigger, making labor more difficult, he says.
Other conditions can cause different issues during pregnancy. For example, women with obesity are more likely to develop gestational diabetes and preeclampsia, according to the American College of Obstetricians and Gynecologists (ACOG). And women with an autoimmune disorder may be more prone to flare-ups.
You’re 35 or older
In this case, your provider will also want to see you more often. Research shows that older women are more likely to have pregnancy complications than younger ones, says the Cleveland Clinic.
Why it can lead to potential problems: “As women get older, there’s more risk of things that come about just with normal aging,” says Dr. Parrish. That includes conditions such as high blood pressure and insulin resistance, meaning your blood sugar levels are higher, he adds.
Those in turn increase your odds of developing pregnancy-related conditions such as preeclampsia and gestational diabetes.
You’re carrying multiples
Finding out you’re pregnant with twins or triplets can be a thrill. But carrying more than one fetus can also mean challenges, starting in the first trimester.
Why it can lead to potential problems: Women carrying two or more babies tend to have more severe morning sickness. They may also have more breast tenderness. Another challenge is early labor. Half of all moms with twins deliver before 37 weeks, according to ACOG. And almost all triplets are born early. Your chances of gestational diabetes and preeclampsia are also higher.
You had a previous preterm baby
If your first baby was born before 37 weeks, you have a higher risk of delivering early again this time around. That’s especially true if you became pregnant before your first baby turned 18 months old, according to the March of Dimes.
Why it can lead to potential problems: Premature babies can have many health challenges, both at birth and as they get older. They often also need to stay in the hospital longer after birth than full-term babies do.
What to expect from your provider if your pregnancy is high-risk
Get ready for your doctor to be highly involved in your pregnancy. “We’re going to be watching you and your baby like a hawk,” says Dr. Parrish. “So, if anything is starting to change in a negative manner, we’ll be able to address it early.” What that means for you:
More visits. For the first 20 weeks, you’ll go about once a month, same as other pregnant women. But after week 20, expect two visits per month, so that doctors can keep an eye on your baby’s growth, says Dr. Parrish. During the third trimester (around week 27), you’ll probably go once a week, he adds.
More tests and ultrasounds. One way your doctor will check on your baby’s growth is to perform more ultrasounds. You’ll probably have an ultrasound every four weeks in the second and third trimester, especially with multiples, says ACOG. You’ll also have more non-stress tests. That’s when the doctor straps a monitor around your belly to measure your baby’s heart rate. It will tell your provider how well the baby is doing.
More attention to what you eat. Your doctor will especially want to monitor your diet if you have preexisting diabetes. Then you might have to work with a nutritionist to discuss how to watch your carb intake, says Dr. Parrish. Otherwise, your provider will urge you to stick with a well-balanced diet as much as possible. That will help you avoid gestational diabetes and other pregnancy complications.
More focus on exercise. Your provider will want you to do some physical activity every day, such as a 30-minute walk. This is important even if you haven’t been that active before, says Dr. Parrish. Even if you’re carrying multiples, you can do low impact workouts such as swimming, prenatal yoga, or walking. Talk to your doctor about what’s right for you.
Lots of support and updates. Your doctor knows that a high-risk pregnancy can feel stressful. They’ll keep you up to date on your health, even if nothing’s changed, says Dr. Parrish. In that case, he tells his patients that things look great. “The best way that I’ve discovered to relieve anxiety is just to pump [my patients] full of information,” he adds.
So, don’t be afraid to ask your provider to keep you in the loop. That way, you can stay informed and reassured.
Additional sources:
High-risk pregnancy background: Cleveland Clinic
Obesity and pregnancy: American College of Obstetricians and Gynecologists
Preexisting conditions: Mayo Clinic
Preterm labor: March of Dimes
Multiples: American College of Obstetricians and Gynecologists
Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association.
