What is Considered a Higher Risk Pregnancy?
If you have been told that your pregnancy may need closer monitoring, it is understandable to have questions. A pregnancy being considered higher risk does not necessarily mean that something will go wrong. It usually means there is something in your health, pregnancy or medical history that may mean you and your baby benefit from additional assessment, monitoring or specialist care.
Individualised obstetric care
Dr Karen Paice is a Melbourne obstetrician with over 15 years’ experience caring for women with both uncomplicated and higher risk pregnancies. Her approach is to explain what is happening clearly, discuss what it means for you and your baby, and make decisions with you as your pregnancy progresses.
Karen consults at 145 Victoria Parade, Fitzroy and delivers babies at St Vincent’s Private Hospital Fitzroy and Epworth Freemasons Maternity Unit, East Melbourne.
What is considered a high risk pregnancy?
A pregnancy may be considered higher risk for many different reasons. Sometimes a health condition is already known before pregnancy. In other cases, something develops during pregnancy or is identified through routine screening.
A higher risk pregnancy simply means there is a reason to consider closer assessment, monitoring or planning. This may relate to your health, a previous pregnancy, something identified in your current pregnancy or another individual factor.
It does not mean that something will go wrong. The purpose of identifying risk is to tailor care for you and your baby.
Your care plan
How is higher risk pregnancy care different?
For many women, pregnancy care will still feel very similar to routine antenatal care. The difference is that appointments, tests or monitoring can be adjusted according to what is happening in your pregnancy.
Karen will explain why additional monitoring is being recommended and what the results mean, so you can remain informed and involved in decisions about your care.
Depending on your circumstances, you may need:
- More frequent obstetric appointments
- Additional blood tests or investigations
- Extra ultrasound scans
- Closer monitoring of blood pressure, blood glucose or other health conditions
- Monitoring of your baby’s growth and wellbeing
- Input from other specialists where appropriate
- Additional discussion about the timing or safest way to give birth
Reasons you may need closer pregnancy monitoring
Pregnancy at 38 or over
Many women have healthy pregnancies in their late 30s and 40s. Age is one of a number of factors considered when planning pregnancy care because some pregnancy complications become more common as maternal age increases.
Rather than treating age alone as a problem, Karen considers it alongside your overall health, pregnancy history and the way your current pregnancy is progressing. If additional screening or monitoring is recommended, she will explain the reasons and talk through the options with you.
High blood pressure and pre-eclampsia
Blood pressure is monitored throughout pregnancy because some women develop high blood pressure for the first time while pregnant. Pre-eclampsia is a pregnancy complication involving high blood pressure and, in some cases, effects on other organs.
Your individual risk, symptoms, blood pressure and test results help determine whether additional assessment or monitoring is required. If there are concerns, Karen will talk you through what has been found, what needs to be watched and how this may influence the rest of your pregnancy.
Gestational diabetes
Gestational diabetes occurs when blood glucose levels become higher than recommended during pregnancy. For many women it can be managed with changes to diet and physical activity, while some women require medication or insulin.
Pregnancy care may also include additional monitoring of your baby’s growth and discussions about birth planning. Your care will be based on your individual blood glucose levels, health and your baby’s progress.
Twin pregnancy
A pregnancy with twins generally requires closer monitoring than a singleton pregnancy. The type of twins you are carrying, their growth, your own health and how the pregnancy progresses will all influence your care.
Karen will discuss the recommended monitoring with you throughout pregnancy and, as you get closer to birth, the options for timing and mode of delivery.
Pregnancy with an existing medical condition
Some medical conditions require additional planning or monitoring during pregnancy. These may include conditions affecting blood pressure, thyroid function, diabetes or other aspects of your health.
Your obstetric care can be coordinated with your GP, physician or other specialists where needed so that decisions take both your health and your pregnancy into account.
Previous pregnancy complications or traumatic birth
A previous complicated pregnancy or traumatic birth does not mean the same thing will happen again. It does, however, provide useful information when planning your next pregnancy.
Karen will review your previous pregnancy and birth history, including any previous complications or traumatic birth, discuss any relevant investigations or records, and consider whether additional screening or monitoring may be helpful this time. If your preference is to give birth by caesarean, this will be supported. If you are planning another pregnancy following a previous complication, pre-pregnancy counselling may also be useful.
Karen’s approach
Clear information throughout your pregnancy
Karen’s approach is to work with you throughout your pregnancy, making sure you understand what is happening, why additional monitoring may be recommended and what the results mean for your care.
There is time to ask questions, talk through your options and make decisions together, with your care plan reviewed if your circumstances change during pregnancy.
When should I see an obstetrician about a higher risk pregnancy?
If closer monitoring may be helpful, an obstetric appointment can be arranged from around 6-7 weeks of pregnancy. This may be relevant if you have a medical or pregnancy history that may affect your care, are carrying twins, or have questions about how your health may affect pregnancy.
Pre-pregnancy counselling may also be useful if you already know that your medical or pregnancy history may require additional planning.
Where Karen provides pregnancy care
Karen consults at 145 Victoria Parade, Fitzroy VIC 3065.
She provides private obstetric care and delivers at St Vincent’s Private, Fitzroy and Epworth Freemasons Maternity Unit, East Melbourne.
Discuss your pregnancy with Karen
If you are pregnant and would like to discuss whether Karen’s care is appropriate for your circumstances, please contact the rooms.
