TRIGGER WARNING: This article discusses sensitive topics including the realities of high-risk pregnancy and fetal death.
Most women do not begin a pregnancy expecting anything to go wrong, but the reality is that high-risk pregnancies happen. Only 6-8% of U.S. pregnancies are considered high-risk but that means about 200,000 women are affected each year. These pregnancies not only require extra medical appointments and testing, but they also add so much extra stress to the expectant mother and her loved ones.
Some pregnancies are high-risk from the beginning due to a pre-existing medical condition such as high blood pressure, obesity, or diabetes. An advanced maternal age, problems in a previous pregnancy, or multiple births are also considered high-risk. Some pregnancies become high-risk as they progress when gestational diabetes or pre-eclampsia develops, and others are high-risk due to a discovered prenatal diagnosis affecting the baby, mother, or both.
A prenatal diagnosis could include chromosomal abnormalities and conditions such as Spina Bifida, cerebral palsy, Down syndrome, and a whole host of other genetic conditions that many have never heard of until it happens to them.
A high-risk pregnancy is defined as one that threatens the health, or life, of the mother or her baby. In these cases, the mother often needs to see a specialist trained in the specific condition affecting her and go to many more doctor appointments than normal. She'll also receive more ultrasounds and additional monitoring like a non-stress test to track the pregnancy, and the baby's development closely as it progresses.
A diagnosis is often unexpected and can seem to throw your whole world upside down. This is a normal reaction and everyone reacts differently. There will be many "Why me?" moments and tears. These pregnancies are more likely to result in a low birth weight, premature births, and in the worst and most tragic scenarios, death.
As a mother of two with two high-risk pregnancies, I know the soul-crushing feeling of knowing that everything happening inside of you is not normal. I know what is like to be questioned if you want to continue your pregnancies and I know the worry, sadness, and guilt that comes with this news and the decisions that need to be made.
My situation includes two separate prenatal diagnoses found during routine testing for two different pregnancies. The shock of having another genetic condition found during my second pregnancy after a stressful and worrisome first made it all the more terrible. Based on my experiences, here is some advice for moms going through quite possibly the hardest and most overwhelming time in their lives, and how to get through it all. You are not alone.
Try Not To Worry Until There Is Something to Worry About
This was some advice I received from my perinatologist which was impossible for me to understand at the time. Certain prenatal tests, like the quad screen, is an indicative test of a problem, but they are not diagnostic. If your quad screen indicates a higher probability of an issue, that does not officially mean that there is something wrong with your baby and frankly, all the odds are in your favor.
Further testing, like a more invasive blood test or an amniocentesis, may be needed and will give you a diagnosis if there is one. These results can take several weeks to receive. Don't drive yourself crazy with worry until you know what is going on. It may be nothing more but watching your diet and taking a new medication. Carry on the best you can until you know exactly what is happening.
Know Your Diagnosis
Once you receive your diagnosis, research all you can. Become informed and educated so you can better advocate for yourself and your baby. Don't depend on Google or Mommy blogs for this advice. Those are usually filled with worst-case scenarios and internet doctors who really don't know what they're talking about. This will most likely lead to panic.
Look at the true statistics and find the stories of hope. Seek out local resources as well. There are many Facebook groups around for parents of children with genetic abnormalities or for women who are experiencing the same thing. These women can have fountains of advice and knowledge for you based on what they went through. Most groups are extremely supportive and focus on giving education and support to new families joining a club that no one expects or wants to be in.
Take All The Appointments
Or better yet demand them. You will most likely be offered multiple appointments with multiple specialists. Take them all. Things may change for you as your pregnancy progresses especially if the issue is with your baby's heart or another organ. It's better to be safe than sorry, and with multiple doctor's visits with trained specialists who have seen it all, you'll feel better constantly knowing your progress and being monitored. Plus you'll become even more educated and prepared and know the steps that you'll need to take after birth.
Forget Your Dream Birth
High-risk pregnancies are not treated like typical pregnancies and will most likely involve an induction for the delivery. You will not be having an at-home water birth so get that out of your head now. You'll be giving birth in a hospital with a team of doctors. This is all in the best interest of you and the baby. In the end, it will never matter how you give birth, it just matters that you and your baby have a healthy positive outcome. I gave birth to my second at a children's hospital an hour away that only allows births on a needed medical basis in a room full of 20 strangers who were on hand "just in case". Was it ideal? No. But it was what we needed.
Take Time For Yourself
Without a doubt, a high-risk pregnancy takes the biggest emotional, mental, and physical toll on the mother. During your pregnancy, take things a bit slower. Pamper yourself, let chores go, and rest. Prenatal yoga can calm your body and soul. Let go of any guilt. Nothing you did caused this. If fetal death is a real possibility for you, prepare as best you can. Seek faith if that is for you, and reach out to friends and family. Consider all of your options and do what is best for you, your baby, and your partner (if you have one). Keeping yourself as stress-free as possible is one of the best things you can do for yourself and your baby.