High-Risk Pregnancy: 9 Things Doctors Want You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Nancy LeBrun on December 15, 2020
  • Pregnant woman smiling with female doctor touching stomach
    Specialists Can Address Complications of High-Risk Pregnancy
    You may be taken aback to learn you have a high-risk pregnancy, but highly trained doctors, including maternal-fetal medicine specialists (MFMs), can guide you through a time that may seem overwhelming. Find out what practicing specialists have to say about common risk factors, new treatments, and how you can work together toward the goal of a having a healthy baby.
  • Young African American pregnant woman getting blood pressure checked by African American female doctor
    1. “MFMs are experts in dealing with high-risk pregnancies.”
    “Maternal fetal medicine, or MFM, is a specialty of Ob/Gyn. It involves, in addition to a four-year residency, two or three years of additional training,” says Eva Pressman, MD, an Ob/Gyn and MFM at the University of Rochester Medical Center in Rochester, N.Y. “That gives us exposure to the high-risk conditions of the mothers and fetuses. It allows us to better understand, diagnose and treat chronic health problems in the mother as well as problems that develop with the pregnancy or fetus.”
  • Pregnant Caucasian woman at home sitting on chair looking at laptop
    2. “You can help us make your high-risk pregnancy as safe as possible.”
    “I always tell my patients a healthy mom is so beneficial for the baby,” says Shannon Clark, MD, Ob/Gyn MFM at the University of Texas Medical Branch in Galveston, Texas. “If you came into the pregnancy with poorly controlled diabetes, it’s going to be a complicated pregnancy. If you come into it with well-controlled diabetes and you maintain that, the chances are your pregnancy is going to be just fine,” she says. “All patients should be in optimal health before they get pregnant and that’s particularly true for women with underlying medical problems,” adds Dr. Pressman.
  • Older Caucasian pregnant woman in nursery
    3. “Age is one common high-risk factor we can’t control.”
    “Anybody over 35 has a high-risk pregnancy. Especially if you are over 40, there’s a higher chance of having miscarriages or trisomy–three instead of two of certain chromosomes–which results in Down syndrome,” says Jan Rydfors, MD, an Ob/Gyn at the Freyja Clinic in Redwood City, Calif., with extensive experience in high-risk obstetrics. “Age increases your risk of having gestational diabetes and preeclampsia, and there’s an increased risk of stillbirth as you get close to the due date,” he says. Still, many older women have perfectly healthy babies, especially if they are healthy themselves.
  • Close-up of doctor showing pregnant woman ultrasound of fetus on digital tablet
    4. “We have made major advances in maternal-fetal medicine for both mother and baby.”
    “We have the ability to do treatments inside the uterus, both medical and surgical, that weren’t available 20 years ago. We’re able to diagnose problems with pregnancy earlier and that gives us the opportunity to intervene sooner and improve outcomes. We also have a real initiative to make pregnancy safer for mothers, which is getting a lot of attention,” says Dr. Pressman. “I think it’s important for everyone to know that though all sorts of things can go wrong in pregnancy, most mothers do really well,” she adds.
  • Close-up of premature baby's foot inside NICU incubator
    5. “Preterm labor is one of our biggest concerns.”
    “Preterm labor hits one in 10 [high-risk] pregnancies. Compare that to gestational diabetes and preeclampsia, which is maybe one in 20, but even in those cases you can often have a pretty healthy pregnancy,” says Dr. Rydfors. Treatment with the hormone progesterone can help prevent preterm birth for some women, but sometimes it’s unavoidable, so take steps to prepare ahead of time. “If something requires that the baby be delivered preterm, go see the NICU, go see the pediatrician that’s going to be taking care of your baby, go tour the labor and delivery unit,” says Dr. Clark.
  • African American woman with headache sitting on couch
    6. “We understand that a woman’s going to have anxiety about a high-risk pregnancy.”
    “It’s hard. I went through it myself, and I’m a physician,” says Dr. Clark. She points to the importance of a support system, ideally family or close friends. “When a woman’s pregnant, it’s going to be very difficult for her not to think about what’s going on with her pregnancy, but if it’s getting to the point where it’s interfering with her daily life or quality of life, she needs to let her physician know. She may need counseling or therapy, either with an antidepressant or anti-anxiety medication,” says Dr. Clark.
  • Young pregnant woman getting blood pressure checked by nurse
    7. “The degree of risk varies from woman to woman, and so can our approach.”
    “There’s a close correlation between obesity and preeclampsia, and an even closer correlation between obesity and gestational diabetes,” says Dr. Rydfors. “We can do very personalized nutritional consultations, watch your weight, and do early testing so that you pick up a problem early and try to carefully keep the sugars at a good level. Most people with gestational diabetes end up having a normal pregnancy, albeit it’s often a bigger baby.”
  • Asian American mother holding her newborn infant in hospital room
    8. “Your risk factors can affect how you will deliver your baby.”
    “Certain high-risk conditions may mean that you require a special kind of delivery. Some high-risk conditions mean you’re not going to go to term,” says Dr. Clark. It’s not always known from day one that you’re going to be delivered at 37 weeks and you’re going to have a C-section, but keep having that dialogue with your physician so you can prepare.”
  • African American pregnant woman getting stomach examined by Caucasian female doctor
    9. “Don’t be afraid to ask your doctor questions about your high-risk pregnancy.”
    While friends and family may offer well-meaning perspectives, “You can’t rely on people who are not trained medical professionals to get advice on your high-risk pregnancy,” says Dr. Clark. She also encourages women not to feel rushed during appointments. “If a physician is in it for the right reasons, they’re going to take the time you need. If you find a doctor that cannot make time for you, then maybe you should find another doctor,” she says. “I signed up to take care of pregnant women. We took an oath and we agreed to take time with our patients, so ask those questions,” she adds.
High-Risk Pregnancy: 9 Things Doctors Want You to Know
Contributors
  • Shannon Clark, MD
    Ob/Gyn, MFM at the University of Texas Medical Branch in Galveston, Texas
  • Eva Pressman, MD

    Ob/Gyn, MFM specialist at the University of Rochester Medical Center in Rochester, N.Y.

  • Jan Rydfors, MD
    Ob/Gyn, High-Risk Obstetrics at the Freyja Clinic in Redwood City, Calif.

About The Author

Nancy LeBrun is an Emmy- and Peabody award-winning writer and producer who has been writing about health and wellness for more than five years. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors.
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  2. What is prenatal or low-dose aspirin?  Preeclampsia Foundation. https://www.preeclampsia.org/aspirin
  3. Understanding a High Risk Pregnancy. American Pregnancy Association. http://americanpregnancy.org/pregnancy-complications/high-risk-pregnancy/
  4. High-risk pregnancy: Know what to expect. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/high-risk-pregnancy/art-20047012
  5. High-Risk Pregnancy: What You Need to Know. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/healthy-woman/sexual-reproductive/high-risk-pregnancy-what-you-need-to-know
  6. What are some common complications of pregnancy? NIH National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/complications
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Last Review Date: 2020 Dec 15
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