For many women, finding out that they are pregnant is a moment of joy and anticipation. That joy can be replaced by worry and worry when one learns that her pregnancy is at high risk. But what does that really mean?
According to the National Institutes of Health, a high-risk pregnancy is one in which a mother, her baby, or both are at greater risk of problems during pregnancy or childbirth than a typical pregnancy. Some pregnancies become more risky as they progressed, while other women have an increased risk even before pregnancy.
Some risk factors can put women and their babies at greater risk of problems. These include, but are not limited to:
“We are seeing metabolic syndrome, diabetes and high blood pressure more often as the general population becomes more obese and less healthy lifestyles,” said Dr. Emily Riggs, Gynecologist at Lawrence OB-GYN Specialists. “All of these can increase a woman’s potential for a high-risk pregnancy.”
Lauren, Carson, and Josh Woodward
Lauren Woodward had no previous illnesses prior to pregnancy. She was surprised when she was diagnosed with gestational diabetes during her third trimester last year.
“I didn’t have any real symptoms before I was diagnosed,” she said. “I had a fasting glucose test and failed, so I had to do a three hour draw and thought everything was fine. I didn’t pass that either. “
Woodward said she did a lot of research to learn more about her condition. She discovered that she had done nothing to help develop gestational diabetes. It was just a side effect of the placenta changing the way her body processed glucose, so she set out to figure out what steps to take to protect both herself and her son Carson.
“You get this diagnosis and you think, ‘Okay, now what?’ I met with LMH Health’s diabetes advisors and they explained everything to me – what I can do, what I can eat to treat gestational diabetes, and how to use the blood glucose meter. After that appointment, I felt much better. Having a plan was a real relief, ”she said.
Care of risk patients
Dr. Emily Riggs
There is no one-size-fits-all approach to caring for women with high-risk pregnancies. Dr. Riggs said standard of care was to screen all women with risk factors. For example, women of advanced maternal age are examined for thyroid diseases, among other things.
She also shared that just because pregnancy is high risk doesn’t necessarily mean you need to have a midwife throughout your trip.
“We spent time reviewing certain criteria and evidence-based literature to determine who would risk midwifery care. Our midwives still see patients with risk factors such as those with a BMI up to 40 or patients with diet-controlled gestational diabetes. If they develop a need for medication, they would switch to medical treatment for closer monitoring, ”she said.
Recognize the role of mental health
Mental health is also a major condition that affects pregnancy – one that Dr. Riggs said it could be overlooked.
“People don’t think about mental health and it overlooks that it’s a real illness,” she said. “There is a lot of stigma around and women fear that it will make them look like they aren’t ‘fit’ parents. The reality is that we need to help women realize that mental health is something to focus on and improve, like exercise and better nutrition. “
Melissa Hoffmann
This is where Melissa Hoffman comes in. Hoffman is a registered psychiatric nurse who cares for patients with Lawrence OB-GYN Specialists. She said that taking medication is not a contradiction in terms of mental health and a healthy pregnancy. You can balance your mental health needs with a successful, healthy pregnancy.
“For someone contemplating pregnancy, it is ideal to consult with a mental health provider prior to conception. Many psychiatric drugs are compatible with pregnancy and breastfeeding, ”said Hoffman. “If an adjustment of the medication is recommended, this should ideally be done before the pregnancy if possible.”
What if you are already pregnant or need help during pregnancy? It is important to consider the risks and benefits of taking medication, as well as the risks of untreated mental illness.
“A risk-benefit analysis is a conversation a woman should have with her provider. There are many ways to manage mental health issues during pregnancy, including psychotherapy, peer support, and medication, ”she said.
Misconceptions about high-risk pregnancies
Dr. Riggs said there was a misconception that the clinic only cares for low-risk patients.
“Lawrence OB-GYN Specialists’ providers see and care for the majority of our high risk patients. We all do caesarean sections and give birth to twins, ”she said.
Lori Tillema, director of the Maternal Child Service, said LMH Health for mothers and newborns staff have extensive experience caring for mothers whose pregnancies are at higher risk of complications. This starts with the inpatient maternity navigator that works with the clinics and each patient to ensure that the patient’s needs are taken into account.
“The navigator tells our team about the patient’s needs in preparation for the upcoming delivery. It prepares mothers with higher risk diseases by determining what to expect in the hospital and answering any questions the patient might have, ”she said.
Sometimes a high-risk condition does not arise until a mother is already in the hospital and in labor. That was the case when Caitlin Laird was in labor with her son two years ago.
“I have never had blood pressure problems in my entire life. Maybe 4 to 6 hours before he was born, mine shot through the roof. I had magnesium sulfate – which they called The Mag – and had my pressure checked every half hour, ”she said. “Things went downhill after Grant was born.”
The level 2 crèche offers care for small children
Caitlin Laird, Grant and Grace
When Laird didn’t have many blood pressure issues during her second pregnancy, she didn’t think much of it when she went to see Dr. Riggs went to do her 38 week check up.
“When (Nurse) Carrie came in and took my blood pressure, everything changed. It was really high and Dr. Riggs wanted me to be admitted that day, ”Laird said. “Carrie drove me straight from the office to the lab and delivery. I had to be instructed because my pressure was so high. “
Laird said she was in labor for over 20 hours after being introduced – twice as long as when her son was born. When Grace was finally born, she was not breathing properly and had to be intubated. She was later taken to Overland Park on a rescue flight for extra care when the team discovered that Grace had either meconium or a piece of placenta in her lungs.
LMH Health’s Level 2 Special Care Nursery at the Cindy Murray Family Birth Center cares for babies as young as 34 weeks of age, including babies with breathing problems, nutritional problems, or those in need of antibiotic and IV therapy.
“When babies need special care, our pediatric nurses are available 24/7 to work with caregivers and other hospital staff to provide appropriate treatment and stabilization,” said Tillema. “We are also fortunate to have instant access to newborn counseling services through Sunflower Neonatology. They are available at the push of a button and offer expert guidance and support in the treatment of numerous diseases. “
Laird said that while she feared for her daughter, she knew Grace was in good hands with the LMH team.
“I can’t say enough about Dr. Riggs and the staff, the nurses and the doctors in the lab and delivery say. Everyone was so nice and made it a more convenient process, ”she said.
While the team cares for most high-risk patients, there are some situations when it is safer for the mother and baby to be cared for elsewhere.
“If we think you are likely to need more care, we can refer you to another provider. We want you and your baby to look after yourself and your baby as well as possible, ”said Dr. Rigs.
What can I do to reduce my risk?
Dr. Riggs said that focusing on optimizing your pre-pregnancy health to reduce your risk factors can go a long way in reducing your chances of having a high-risk pregnancy.
“If you have a history of having a high-risk pregnancy or a complicated birth, talk to your doctor before you become pregnant. We know that substances like alcohol and drugs can cause problems during pregnancy, and when it comes to marijuana we see increasing amounts of new evidence linking its use to an increased risk of learning and attention problems in children. If you have substance abuse, stop using it before you become pregnant and ask for help when you need it, ”she said.
Hoffman said that when it comes to substance abuse, it is important to speak to your doctor in order to find the most appropriate treatment options.
“Unfortunately there is fear and stigma surrounding substance abuse and pregnancy. Both therapeutic and drug treatments are available for pregnant women. We are fortunate to have First Step in Douglas County, a program that provides inpatient and outpatient services to pregnant and parenting women, ”she said. “There are resources for a woman to get help anytime during her pregnancy.”
Dr. Riggs stresses that you should speak to your doctor about any concerns you have. They want you to have a safe and successful pregnancy.
“We’re here to help you prepare for this journey and get yourself to a good place before you add the added stress and responsibilities of pregnancy,” she said. “At LMH Health, our focus is on healthy families. Our most important goal is to guarantee you and your baby the best possible care. “
