What is a high-risk pregnancy?

From the moment you find out you are pregnant, you want the best for your baby. So, understandably, learning that your pregnancy is ‘high risk’ can be a cause of stress or anxiety.

Before I delve into what makes a pregnancy high risk, I want to make it clear that having a high-risk pregnancy does not mean that you won’t have a healthy baby. What it means is that there is an above average chance of you or your baby having complications during pregnancy, birth or after delivery.

Because of that increased risk, your doctor will monitor you more closely during pregnancy. This will involve more frequent antenatal visits and tests throughout your pregnancy. Having additional antenatal visits means that your doctor will pick up any issues without delay, allowing prompt intervention to improve outcomes for both you and bub.

It’s quite common for obstetricians to increase the frequency of antenatal visits to be extra cautious. In fact, between 10 and 15% of all pregnancies are considered high risk. Rather than pregnancies being ‘normal’ or ‘high’ risk, it’s better to think of risk as a scale from low to high. There’s a point where we decide the risk of complications is high enough to warrant closer monitoring, and this is likely to be different for each unique pregnancy situation. We are simply taking measures to reduce the chance of any problems for you and your baby.

While it might seem daunting that there’s an increased chance of complications during your pregnancy or delivery, knowing this means that your doctor can work with you to decrease the risk or manage any problems that do arise early.

What makes a pregnancy high risk?

Your pregnancy may be considered high risk for a range of different reasons – sometimes it’s for multiple reasons. I generally keep a closer eye on my patient’s pregnancy if:

• You have a pre-existing health condition: Chronic conditions such as diabetes and other autoimmune diseases, kidney disease and high blood pressure may lead to pregnancy complications. In some cases, we may need to change how your condition is managed, including the medications you take, while you are pregnant.
• You’re are an older mum-to-be: The increased risk of complications from around age 35 means that monitoring these pregnancies more closely is necessary.
• You’ve developed a health problem during pregnancy: Conditions such as gestational diabetes and pre-eclampsia increase your risk of complications. As well as monitoring you closely, I’ll prescribe medications and recommend some lifestyle changes to further reduce your risks.
• You are overweight or underweight: There’s an increased risk of complications if your weight falls outside the healthy range when you enter pregnancy or if don’t have healthy weight gain during pregnancy. These include developing gestational diabetes and pre-eclampsia, as mentioned above.
• You had problems during a past pregnancy: Mums who have previously had a caesarean, premature birth or a baby with low birthweight will be monitored closely to try and prevent this issue from presenting again.
• You have had multiple previous miscarriages: Because the chance of having another miscarriage is higher if you are suffering from recurrent miscarriage, I’ll monitor your pregnancy very closely.
• We have detected a problem with your baby: If a health problem such as a birth defect or growth issue is suspected or detected in your baby, I will monitor your pregnancy more closely to minimise the harm to your child.
• You are pregnant with twins or triplets: Carrying more than one baby puts extra strain on your body and increases the risk of premature birth, so you’ll be monitored more frequently.
• Your pregnancy was conceived through IVF, particularly if using donor eggs or sperm: Because there is a higher risk of complications such as pre-eclampsia and growth restriction in these situations, I monitor the pregnancy very closely.

What can go wrong with my pregnancy?

The main complications that we are worried about for a high-risk pregnancy are:

• Miscarriage
• Birth or developmental defects
• Premature birth
• Low birthweight.

Rest assured that when a high-risk pregnancy is managed well, the likelihood of these complications occurring is greatly reduced.

How will my pregnancy and delivery be different?

The way your pregnancy and delivery are managed will depend on your specific situation. In addition to having more frequent checkups and testing, together with attentive assessment of your baby through regular ultrasounds, you may be prescribed medications or recommended to rest or change certain lifestyle habits. In some situations, you may not be able to fly or you may be told to stay close to your hospital. You’ll also need to give birth in a hospital in case of an emergency situation. Women who have a high-risk pregnancy are more likely to go into labour early, and sometimes we induce labour if that is going to benefit you and your baby. In many situations, a caesarean delivery may be recommended.

How can I reduce my chances of having a high-risk pregnancy?

If you are planning a pregnancy, make sure you are healthy and that your body is ready for pregnancy by following these preconception tips. It’s also a good idea to consult your GP or an obstetrician if you are planning a pregnancy, to make sure you reduce the risk of potential complications before becoming pregnant. This is particularly important if you have a pre-existing medical condition that may need to be managed differently while you are pregnant.

Choose an obstetrician who is thoroughly experienced in high-risk pregnancy

High-risk pregnancies require a special level of attention and expertise to ensure that you and your baby are kept safe and healthy. Many obstetricians claim to specialise in high-risk pregnancy, but few look after these pregnancies on a regular basis, and they may not be equipped to provide the expertise required for optimal care. If you’re looking for an obstetrician who specialises in high-risk pregnancy, please call my rooms on (03) 9418 8299 or book online to make an appointment.