What to do if your doctor says your pregnancy is high risk

If your obstetrician has told you that your pregnancy is high risk, you probably have a lot of concerns and questions. Your first step should be to put together a list of questions and make an appointment with your doctor to discuss your concerns. Questions you may want to ask include:

• What factors make my pregnancy high risk? There are many different factors that can put a pregnancy into the high-risk category. These include being younger than 17 or 35 or older; having a chronic health condition such as diabetes, high blood pressure, epilepsy, kidney disease, or autoimmune disease such as lupus; being pregnant with more than one baby; problems with a previous pregnancy or having three or more miscarriages; carrying a baby with a genetic condition such as Down syndrome; certain infections; and taking certain medications.
• Will I need the care of any specialists? Depending on what factors make your pregnancy high risk, your doctor may recommend that you see a perinatologist or maternal-fetal medicine specialist. These obstetricians specialize in caring for mothers and fetuses that are at high risk and undergo three additional years of training on treating the complications of pregnancy. Studies have shown that when women with pregnancy complications are cared for by these specialists, the outcomes are better for both the baby and mother. You may also be referred to a geneticist.
• Are there steps I can take to lower the risks associated with my pregnancy? Your doctor may recommend lifestyle changes including changes to your diet and/or activity and steps to manage any chronic conditions.
• Are there tests I will need to undergo in addition to routine prenatal screenings? Depending on what factors make your pregnancy high risk, your doctor may recommend additional lab, imaging, and genetic tests to monitor your health and the health of your baby. You will also see your doctor for prenatal checkups more frequently than you would during a routine pregnancy.
• What symptoms or signs could indicate a problem with my pregnancy and which ones mean I should seek emergency care? Talk to your doctor about what signs to watch for, when to call your doctor, and when to go to the emergency room.
• How can I manage my stress and anxiety? While being told your pregnancy is high risk is bound to make you feel anxious, take whatever steps you can to lower your stress. Find a support network. Your doctor may be able to recommend a support group for high risk pregnancy or connect you with a mental health specialist. Consider practicing anxiety management techniques like meditation and breathing exercises.

A health advisor can be a valuable resource of information and support during a high-risk pregnancy. Your advisor can connect you with experienced perinatologists, geneticists, and other specialists, and provide information about which medical centers have the experience and expertise to handle your baby’s birth and your post-partum care.