It seems nowadays that more and more pregnancies are being classified as high risk. What does that mean? A high risk pregnancy comes about due to issues (both chronic and new) that can complicate pregnancy. These situations require more care and monitoring to help ensure you and the baby remain healthy throughout the pregnancy and delivery. Typically, a high risk doctor is added to Mom's care team. This doctor has additional training and experience with the conditions that cause a pregnancy to become high risk.
Hearing your doctor use the words "high risk" may come as a shock. In most cases it is just a precaution. However, it can cause new parents a lot of stress and worry. Treatment can mean additional appointments with your high risk doctor for more in depth ultrasounds. It can mean additional testing or blood work to screen for health concerns. It can also mean stress tests, bed rest, and even scheduled cesareans to remove the baby prior to delivery.
Regardless, having a high risk pregnancy does not mean you won't have a healthy baby. It also doesn't mean you will experience risky complications. There are many factors that go into a pregnancy being deemed high risk. Based on your medical history, your doctor can help you to identify any risk factors you have. This is why prenatal care is so important! Staying ahead of potential dangers and early intervention is key to a healthy pregnancy.
Here are 12 signs your labor may become high risk.
12 High Blood Pressure
While high blood pressure is not always a danger sign, it can cause issues for both the mother and the baby. Doctors will monitor blood pressure closely at each appointment. If high blood pressure develops there is an increased chance it can develop into preeclampsia or toxemia. This condition can cause serious damage to your organs and even be severe enough to cause death. You can also develop HELLP Syndrome. It's a life threatening complication of preeclampsia that is caused from elevated liver enzymes and lowered platelet counts.
In each of these scenarios the mother is put on bed rest and is likely admitted to the hospital for observation. The pregnancy is typically induced as early as possible to protect both the baby and mother. The timing has a large impact on the baby's survival rate. They will try to keep the condition under control at a safe level as long as possible.
11 Bladder And Kidney Infections
Urinary tract infections, also known as bladder infections, are more common during pregnancy. There are so many changes happening in that area. The uterus sits directly on top of the bladder. As the uterus grows, the extra weight puts a lot of pressure on the bladder and can restrict or even block the flow of urine from the bladder causing it to back up. This causes an infection.
Bladder infections move up into the kidneys if they are not properly treated. The kidneys are working overtime during pregnancy due to the increase in blood volume, which increases urine output. If things aren't flowing as they should, it can back up and cause infection. Many times once the infection reaches the kidneys, hospitalization is involved. Kidney infections can cause low birth weight and even preterm labor. It is important to talk to your doctor if you suspect any urinary tract infections and treat them quickly.
10 A Fever of 101+
Any fever is often a symptom of an underlying condition that could potentially be harmful to your growing baby. It's important for your doctor to understand what is causing the fever so it can be properly treated. Fevers during pregnancy are not normal, so an exam with your doctor is recommended. It's always best to err on the side of caution. A baby's normal development requires a sequence of proteins be delivered to the body. This ensures the cells are growing properly. As your body temperature rises, it can impact the proteins causing a shift in the needed sequence. If it's not working properly it can lead to birth defects and even miscarriage. According to Healthline, some studies have shown that even a slight fever can disrupt a baby's fragile development so much that it can lead to things like congenital defects. Talk to your doctor about medications that are safe and recommended.
9 History Of Premature Labor
Premature labor is defined as regular contractions of the uterus resulting in changes to the cervix prior to 37 weeks. These changes cause the cervix to thin and open up in order to prepare for the birth of the baby. Premature birth occurs between weeks 20 and 37. The concern here is that the baby may not yet be developed enough (lungs, brain, digestive tract) for life outside of the womb. There is also a risk that the baby may be born with serious health problems or encounter learning disabilities throughout life. Having a history greatly increases your chances for premature labor in future births.
Typically a high risk doctor is added to your medical team to assess your needs and establish a personal treatment plan. Many times this includes bed rest, medication, and even hospitalization. Your doctor will attempt to delay delivery as long as it is healthy for both the mother and the baby.
8 Added Stress
Stress in pregnancy (and life) is normal. However, if it's constant and remains at a high level there is an impact to both the mother and the baby. Our bodies go into "fight or flight" mode when we are stressed. Cortisol is released into the blood stream, which causes our heart to pump faster. It's the same reaction that happens when we are scared or in danger. Chronic stress overall has been linked to poorer pregnancy health and development problems for the baby.
This constant stress on a pregnant mother can cause inflammation. It can lead to subtle differences in brain development contributing to behavioral issues down the road. It can cause low birth weight and increase chances for preterm labor. If you as the patient are unable to manage the stress in your life, your doctor will intervene and remove the stress by placing you on bed rest.
7 Standing Long Hours
According to a Dutch research project documented in Live Science, standing and working for long hours during pregnancy may slow the baby's fetal growth. This decrease in size was measured both in circumference of the baby's head as well as overall birth weight. This same result was found in babies where mothers worked more than 25 hours in a week. Standing for long periods of time can restrict blood flow to the baby. Sitting for too long can contribute to blood clots.
This is why it's extremely important to mix it up. Move around as much as possible, but also make sure you get plenty of time for rest. Being on your feet too much can cause an increase in swelling into your legs and feet. All of this can quickly contribute to problems in pregnancy. The main course of treatment is often bed rest allowing time for the body to heal and rest.
6 35+ Years Old
In the eyes of obstetrics, expectant mothers 35 years of age or older are considered "elderly" or "women of advanced maternal age." Why is this? Many times there are undiagnosed conditions like high blood pressure or diabetes that can impact your pregnancy. It's also known that your chances of having a baby with a chromosomal abnormality increases each year with age. Because of this, women of "advanced maternal age" are offered genetic counseling or additional testing related to DNA and chromosome screening.
The main condition you will hear doctors talk about is Down Syndrome. The possibility also increases for a variety of other conditions such as preterm labor, low birth weight, placenta previa or preeclampsia. There is a higher risk for miscarriage. Plus, a higher percentage in this group require a cesarean for delivery. So for whatever reason, 35 is the magic number to assign you in the "potential high risk" category.
5 Lack Of Prenatal Care
Prenatal care is recognized as the first line of defense to ensure a healthy pregnancy. It's recommended that you have your first appointment around the 8-week mark. From there you will see your doctor regularly, increasing in frequency as your due date approaches. During these appointments various blood and urine tests will be completed to ensure there are no heath concerns with the mother that could impact the baby. In addition, having an ultrasound helps to ensure the baby is developing correctly.
If issues are identified, additional doctors may be included to assist with your care. There will also be a proactive plan to deal with any issues at the time the baby is born. This helps to increase the likelihood that the baby will receive the best care to provide the best chances of survival. The lack of prenatal screening and counseling are shown to cause an increase in low birth weight, preterm birth, obstetric complications, even death.
4 Congenital Uterine Abnormalities
There are certain conditions and abnormalities of the uterus that can cause a pregnancy to become high risk. These are things like a having what's called a separate uterus (muscle or tissue divides the uterus in two), fibroids, or uterine scars. Congenital means it's something you are born with so often times a woman isn't even aware she has them. They can cause infertility issues. For those that do get pregnant, they can increase your chances for miscarriage or preterm birth. Some conditions restrict or limit the baby's growth. Others can cause heavy bleeding following birth.
Many times these conditions don't have symptoms and so they go undiagnosed until a woman becomes pregnant for the first time. It's important for your doctor to be aware of these conditions to monitor you properly and have a plan in place for safe delivery and proper care as your due date approaches.
3 Pregnant With Multiples
Double the babies means double (or triple) the opportunity for things to go wrong. Doctors watch closely to stay ahead of any risks. According to the American Pregnancy Association, placental abruption is three times more likely to occur with multiple babies. This means the placenta pulls away from the uterus and interferes with the baby's supply of oxygen and nutrients. It typically happens during the third trimester, but the risk jumps significantly after the first baby is delivered.
The doctor must also watch for intrauterine growth restriction. It's known that multiples tend to be much smaller at birth versus single babies. This happens because as the babies start to grow they begin to compete for nutrients. The placenta is only able to support so much continued growth. Therefore, the babies must be monitored to ensure they are growing properly as the end of the pregnancy nears to ensure they will be ready for birth.
2 Gestational Diabetes
Every pregnant mother is tested for gestational diabetes. This is a temporary form of diabetes during pregnancy where the body doesn't produce enough insulin to regulate sugar. What happens is the placenta produces hormones that can cause insulin resistance. The frequency of these tests depends on your medical and family history of diabetes. It's important for your doctor to know whether or not you have it because it greatly impacts the baby. It increases the risk for large birth weight and premature delivery.
If your test comes back positive, your doctor may increase the frequency of your visits and work with you to closely monitor your blood sugar levels through diet, exercise, and insulin therapy. If you have had gestational diabetes during past pregnancies, this will increase the likelihood you will develop it again in the future. It also increases your chances for developing type II diabetes later in life.
1 Previous Miscarriage And Stillbirth
Miscarriage is the spontaneous loss of a pregnancy before 20-weeks. The reasons for miscarriages vary greatly. The most common is due to a chromosomal abnormality (or something not being right in the baby's DNA as it divides and multiplies). Other causes include hormone changes, poor lifestyle choices, the improper implantation of the egg, advanced maternal age, and maternal trauma. In most healthy women, the risk of miscarriage is anywhere between 10% and 25%. Stillbirth happens when the baby dies inside the womb after the 20-week mark.
If you have a history of miscarriage or stillbirth, it's important to talk with your doctor so they are prepared. Depending on your medical history, your pregnancy may become high risk. There may also be additional tests or monitoring that will be recommended to ensure the baby is developing properly. Your doctor will also want to make sure you are properly supported emotionally.