There are few experiences in life as powerful as the experience of pregnancy. The journey of pregnancy is like life itself and sometimes runs into troubles and complications. With the goal of achieving a healthy mother and baby, some pregnancies are categorized as ‘high risk pregnancy’ and need special care.
What constitutes a high-risk pregnancy?
The presence of certain risk factors during pregnancy makes it a high risk one, such as-
Maternal age: Pregnancy in women older than 35years increases the chances of medical disorders like high blood pressure, pregnancy induced diabetes etc
Preexisting Disorders: Women who have medical disorders like diabetes, high blood pressure, epilepsy, rheumatoid arthritis etc need special care in pregnancy. The effect of pregnancy on the disease and that of the disease on the pregnancy is best managed by a multidisciplinary team of doctors.
Previous surgeries on uterus like fibroid removal, previous caesarean deliveries
Multiple pregnancies like twins, triplets.
Previous miscarriages or complicated births like preterm deliveries, previous babies requiring NICU stay
Sometimes you begin with a low-risk pregnancy but due to the development of some complications, the risk may rise in pregnancy and move to a high risk category.
Myths associated with High Risk Pregnancy?
High-risk does not definitively mean that something will go wrong. You will be closely monitored while you are pregnant and may have special tests to check the health of the mother-to-be and the baby. The healthier you are and the better you take care of yourself, the more likely you are to have a smooth, successful delivery
High-risk pregnancy does not mean all my future pregnancies will also be high-risk : Certain health conditions may change over time and will no longer be a risk in future pregnancies
Having a high-risk pregnancy does not mean that pregnancy will be more difficult: While high-risk pregnancy may require additional appointments and fetal monitoring, it doesn’t always mean your pregnancy will be more difficult.
High-risk does not mean something is wrong with your baby: High-risk doesn’t mean complications are guaranteed. Many women deemed “high-risk” go on to have problem-free pregnancies and happy, healthy babies.
If you’re over 35 then your pregnancy will be high-risk: If you’re 35 and healthy, then your pregnancy has a good chance of also being healthy. Age alone isn’t the only driver of high-risk pregnancy. Typically, high-risk pregnancies are a combination of age and other medical factors.
Any major change in your lifestyle is hazardous with a high-risk pregnancy: Under the advice of your doctor, lifestyle changes can actually help you and baby. Changing your diet to include more nutritious foods and adding in moderate activity and exercise will help you feel great and kick-start healthy habits for baby, too.
Some Tips to Prevent & manage a High Risk Pregnancy
We all want a smooth pregnancy and a happy delivery. Here are some ways to minimize risk and ensure that yours is an uncomplicated pregnancy
· Plan Early – Don’t wait for the biological clock to start ticking. The older you get, the chances of certain issues like subfertility (difficulty conceiving), miscarriage, incidence of medical disorders like hypertension, diabetes increase.
· Start with healthy BMI- Your weight plays an important role in determining you risk of pregnancy. The more overweight you are, riskier it is both for you and your baby. Exercise regularly and keep your weight under control before pregnancy and during pregnancy.
· Do your medical checkup regularly – Your sugar and TSH ( thyroid stimulating Hormone) should be measured regularly. Even before conceiving, these and other blood tests are important to ensure a healthy start.
· Do a pre pregnancy counselling with your gynecologist – A preconception visit with a gynaecologist is vital in improving your chances of a smooth pregnancy. You will be advised a folic acid supplementation, some tests and lifestyle measures to improve your health. A healthy couple makes a healthy pregnancy which makes a healthy family.
· Visit doctor regularly - During pregnancy, visit your gynecologist regularly. Timely checkups, blood tests and ultrasounds help to pick up any trouble early and prevent adverse outcomes. Communicate openly with your doctor about any concerns you may have about nutrition, your baby’s growth, safety and purpose of tests advised, warning signs and special care needed for you. Tele-medicine is a boon in the times of this pandemic. Some visits can be replaced by an online video consultation with your doctor to ensure continuity of care while restricting hospital visits.
· Vaccination: Taking the recommended vaccinations during pregnancy, such as the flu shot (in flu season), tetanus toxoid, Tdap (tetanus, diphtheria, acellular pertussis) are important. Discuss with your doctor any concerns you may have regarding these and other special vaccines recommended for you.
· Eat Healthy – Eating a nutritious diet in pregnancy is of utmost importance. Fresh, homecooked, seasonal and local foods eaten as small frequent meals are the best. A balanced diet with right mix of proteins, carbohydrates, fats and vitamins will prevent common deficiencies in you and the baby. Inclusion of fibre in diet will keep common problem of constipation away. Make sure all dairy products are pasteurized and all meat/eggs are fully cooked which will bring down the risk of infections. Avoid consuming junk food, excessively oily or spicy or stale food. Certainly, avoid smoking, alcohol and any recreational drug use in pregnancy.
· Pet care – If you have pets, discuss with your doctor the special precautions to be taken to protect your pregnancy. Avoid handling the waste directly. If you must, use gloves and sanitise your hands thoroughly after.
It is very important to stay informed and have a support system with family and friends during this time and communicate your needs. They say it takes a village to raise a child. The time to build or strengthen your ‘village’ is during your pregnancy! By making self-care a priority, you will ensure a better outcome for yourself and your baby. This means eating a healthy diet, reducing exposure to toxins and harmful environmental factors, exercise, getting enough sleep and minimising stress. Research shows a correlation between high stress and disease. It’s important to address difficult feelings that may arise and to know its normal to experience a wide range of emotions. Despite how difficult things may feel, be sure to take time to engage in activities you enjoy. This could be going for a walk, meditating, connecting with friends or taking a yoga class. Residing in the Here and Now is a powerful practice to reduce stress which invariably arises from dwelling in the past or worrying about the future.
Pregnancy is a wonderful opportunity to realise our oneness with nature. Surrendering to the intelligence that enables and guides this process along with astute professional care and support brings about the best outcomes.
Wishing you a joyful pregnancy!
Obstetrician, Gynecologist & Laparoscopic surgeon
Senior consultant
Cloudnine hospital, sector 14, Gurugram