Many expecting mothers do whatever they can to make sure that nothing negatively affects their baby’s development. Whether they’re reading pregnancy books or getting advice from their family, friends, some of the neighbors even, moms plan out everything. However, no matter how much planning they do, sometimes unforeseen circumstances arise that worries moms for themselves and their child. When pregnancies are labeled “high-risk,” moms may think it means there is a danger to themselves and/or their baby, that they will have no control and will have unfortunate results. What expecting moms need to know is there is more to high-risk pregnancies than their name implies; they just need to be more cautious. 

What Do You Mean “High-Risk”?

When moms hear “high-risk pregnancy”, they may feel confusion and negative emotions. Haley Nameth is a mother to one daughter and had such thoughts after being labeled high-risk due to in vitro fertilization (IVF). “Initially, I was sad, but later angry that my body failed me and I couldn’t give my husband a child,” says Nameth. Her reaction is one that many women can relate to once they are told such news. Similarly, Donna Anzalone is a mother of two and was anxious about her high-risk pregnancy. “When I was first told,” says Anzalone, “I was nervous because I suffered a miscarriage before and was afraid it would happen again.” 

However, before expecting moms begin worrying, they need to realize that there are many reasons why pregnancies can be deemed high risk, some just need a more careful approach. In her two years with Woman’s Hospital, Dr. Pamela Simmons has had many women come to the Woman’s Maternal-Fetal Medicine Clinic who are nervous when their pregnancy is labeled high-risk, but she lets them know this: “There are three categories that high-risk pregnancies can fall under: something with mom, with the baby, or with the placenta,” says Dr. Simmons. In each of these three categories, even though high-risk, it does not always mean there is a high chance something is dangerous. 

“If it’s high-risk because of mom, there are extreme cases where she may have cancer or an auto-immune disorder,” says Dr. Simmons. “However, more common types of high-risk pregnancies are because of high blood pressure, diabetes, older than 35, or just having multiple children.” If it is from the baby, it may be simply precautionary. “If the high risk is because of the baby, it is normally because of something caught on ultrasound or genetic testing,” says Dr. Simmons. While high-risk labels are mostly associated with mom or the baby, many are unaware of a third reason for high-risk pregnancies: the placenta. “The placenta is the interface between both, and problems happen depending on where and how it’s located isn’t right,” says Dr. Simmons. Seeing what all causes high-risk pregnancies, expecting moms may have no idea what to do. Fortunately, there are ways that can help mom feel safe and secure throughout the pregnancy.

Plan Accordingly and Possibly Change Course

Moms need to remember not all pregnancies are the same. Each woman is different and reacts differently to different methods and treatments. For some women, this would only be additional doctor visits and ultrasounds. “If mom’s OB/GYN notices something on the ultrasound or [through] genetic testing, they refer moms to a specialized womens doctor to discuss what to expect during their pregnancy and help refer and meet with the appropriate specialists to help them,” says Dr. Simmons. If this is the case, normally it is only an additional doctor’s visit to help explain what mom can expect during the pregnancy and plan ahead. 

If extra visits are needed, they would monitor the progress of the baby’s development. This is what happened with Anzalone. “After talking with doctors, I felt more comfortable because I was under constant observation and care with more check ups and ultrasounds,” she explains. However, if a high-risk pregnancy is more extreme, then moms may need to think about changes to their routines. For Nameth, it was a tedious process at the beginning, but as the pregnancy went along, things became easier. “Along with my infertility, I have Polycystic Ovary Syndrome (PCOS), so I had to change my diet to support a pre-diabetic diagnosis, so I could be healthy and ready when I began IVF,” says Nameth. During pregnancy, the only change she needed to include was a close monitoring of injections. “My lifestyle didn’t change much, but I did have a tight injection timeline. Plans had to be made around when I would need to do my shot and because I did IVF, they had to be injected on an exact schedule before and during my first trimester, but once I got into my second trimester, I didn’t have to do them anymore and it was much better,” she explains. 

Along with doctor’s visits and other medical procedures, there may be other treatments for high-risk pregnancies. “If it’s the placenta, women may need more bedrest and limited exercise, along with other activities,” says Dr. Simmons. “If mom is sick, has an illness, or she is in a more rural area, we may suggest that she move closer to a specialty hospital.” 

At the End of the Day…

It’s important to know that both mom and baby are safe and healthy throughout the pregnancy. “Ultimately, the goal is a healthy mom, healthy baby,” says Dr. Simmons. “The best thing for [a mom with a] high-risk [pregnancy] is to sit down and ask questions with their OB/GYN, and if needed, talk about what to expect with specialists.” 

This article was originally published in Spring 2024.