In general, pregnancy can be fraught with worry and anxiety — from labor and delivery concerns to ensuring that you have everything prepared and in its place before baby comes. But add the term “high-risk pregnancy” into the mix, and it can become downright scary. But it doesn’t have to be — especially if you’re armed with the right information and the right care.
Why a pregnancy could be considered ‘high risk’
There are a variety of factors that can determine whether or not a pregnancy is considered “high risk.” According to Dr. Kathryn Villano, Chief of Perinatal Services at Baptist Health and Wolfson Children’s Hospital and a maternal-fetal medicine specialist with Regional Obstetric Consultants, the most common reason for a high-risk pregnancy has to do with to maternal factors such as high blood pressure, gestational diabetes, or a history of complex pregnancies — all of which can increase the risk of complications during pregnancy. Another reason might have to do with the baby, like prenatal development and growth in the womb, certain birth defects, a genetic condition, or if it’s a twin or triplet pregnancy.
“As maternal-fetal medicine physicians, or ‘high-risk OBs’ as we are sometimes called, we really have two patients. We’re taking care of the mom, and we’re also taking care of her baby before he or she is born,” notes Dr. Villano. “In some cases, we are focused on Mom’s medical problems and ensuring she stays healthy with all the changes that happen to our bodies during pregnancy. In some cases, we are focused on the baby’s condition and making sure we have the healthiest newborn possible. And frequently, Mom’s and baby’s conditions are connected, and we are taking care of both of them.”
The ‘advanced maternal age’ factor
Expectant mothers over the age of 35 are sometimes considered “high risk,” and these moms might find themselves faced with a few not-so-flattering terms such as “geriatric pregnancy” or the more commonly used “advanced maternal age” — though Dr. Villano jokingly prefers to call it “The Well-Prepared Mom’s Club.”
“Most of my mamas over 35 are having a planned and much-desired pregnancy — often after finishing their education, achieving personal goals, establishing a career, and then deciding to grow their family,” she says. “These are awesome moms-to-be!”
She adds that the reason behind this age factor is twofold: For starters, women over the age of 35 are at a higher risk to pass on certain genetic conditions. Over time and as we age, there is a higher chance of conceiving a pregnancy affected by an abnormal or extra chromosome. This can increase the risk of certain birth defects and medical conditions.
“We have great options to screen and diagnose these genetic conditions early in pregnancy,” says Dr. Villano. “If we diagnose a genetic condition, we help our parents learn what this may mean for their child and coordinate any special care or preparations their baby may need.”
The other reason a pregnancy may be considered high-risk is due to problems surrounding placenta function. Essentially, our placenta organ is put in place to allow our uterine blood vessels to grow and meet baby’s blood vessels, allowing crucial oxygen and nutrition to pass through. As we age, our blood vessels may not grow and change as readily, possibly causing babies to be smaller at birth or trigger high blood pressure issues in expectant moms such as pre-eclampsia, a potentially serious condition that not only results in high blood pressure, but can contribute to swelling, headaches, protein in the urine, and blurred vision.
Dr. Villano adds, “We routinely monitor our moms over age 40 for these complications and help them prevent them in the first place.”
Specialized care is not ‘one size fits all’
A maternal-fetal medicine physician such as Dr. Villano works hand-in-hand with your OB/GYN throughout your pregnancy. This extra support can be critical to ensuring the best possible outcome for you and your baby.
“Every high-risk mom has different needs, so there is no one-size-fits-all formula,” Dr. Villano shares. “Sometimes, you may only pay one or two visits to our office for counseling, screening tests, or a specialized ultrasound. Some pregnancies will need to be monitored more carefully.”
This more thorough monitoring could include follow-up visits for ultrasounds to check on your placenta function or baby’s growth, ultrasound exams to help screen for risk of preterm delivery or birth defects, or specialized management of certain health conditions.
You can still be ‘high risk’ and have a healthy pregnancy
Above all, if your OB/GYN recommends you see a high-risk specialist, don’t panic. Dr. Villano assures that the referral definitely doesn’t mean you won’t have a healthy pregnancy.
“Yes, we take care of all kinds of pregnancy complications and complex conditions. We are the doctors who specialize in evaluating babies in the womb,” she notes. “But we provide lots of reassurance, too! More often than not, we are giving families good news.”
Dr. Villano also recommends asking a lot of questions when they arise — and cautions against consulting Dr. Google (a.k.a. researching too much on the internet).
“Ask your provider for handouts or good resources for information to read at home,” she says. “Sometimes resources on the internet are great, but sometimes they are not accurate or don’t give you the best information about your baby’s specific condition. Medical terminology can be confusing, and it’s easy to get bad info online.”
When you’re expecting, it’s important to find the right provider for your needs, especially if you are experiencing a high-risk pregnancy, as well as your baby’s. Seeking expert care throughout your pregnancy? Call 904.202.4HER (4437) to find an OB/GYN who delivers at a Baptist Health facility. To learn more about Baptist Health’s labor and delivery, high-risk obstetrics, newborn and neonatal intensive care services, visit baptistjax.com/baby.