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Today, we’re delving into a topic that takes up a lot of space with worry for expecting parents: high-risk pregnancies. If you or a loved one are navigating a high-risk pregnancy, I’m sure you are feeling lots of uncertainty about your journey and are possibly grieving the pregnancy you’d hoped for. 

The presence of a doula can provide invaluable support, guidance, and reassurance throughout your pregnancy, birth, and postpartum. In this post, we’ll explore what a high-risk pregnancy is, share six examples of high-risk situations, delve into the ways doulas can make a positive difference, and shed light on the medical aspect of handling emergencies.

What is a High Risk Pregnancy?

Before we dive into the role of doulas, let’s understand what high-risk pregnancies are. A high-risk pregnancy refers to a situation where the health of the birthing parent or the baby is at a heightened level of concern. These concerns can stem from various factors, such as pre-existing medical conditions, age, or complications that arise during pregnancy.

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High Risk Pregnancy Examples:

1.  Gestational Diabetes: involves having elevated levels of glucose in the blood during pregnancy and usually resolves after birth. This is different from having established diabetes prior to pregnancy.

Having GD during pregnancy can include risks of preterm birth, breathing difficulties for baby, and low blood sugar post birth for baby.

2.  Gestational Hypertension (Pre-Eclampsia): High blood pressure that happens after 20 weeks (and you had normal blood pressure before being pregnant) High blood pressure can lead to pre-eclampsia, a serious condition characterized by high blood pressure and organ damage. If you have high blood pressure prior to pregnancy, this will be monitored as well.

3.  Placenta Previa: occurs when the placenta covers part or all of the opening of the uterus (cervix). This condition can lead to bleeding during pregnancy or during/after delivery and potential other complications during labor. 

4.  Multiple Gestation (Twins, Triplets): Expecting multiples can increase the risk of preterm birth and other complications. 

5.  Advanced Maternal Age: As individuals choose to have children later in life, they may face increased risks due to the possibility of a decrease in egg quality. “Older” eggs are more likely to cause chromosomal anomalies. 

6.  High BMI**: classified as 30 or higher, can increase the risk of gestational diabetes, sleep apnea, larger fetal birth weight, etc.

Is BMI a legitimate reason to categorize someone as high-risk?

** We believe that a high BMI is not a legitimate reason to categorize someone as high-risk. The evidence and research is still very inconsistent about whether it is the actual extra adipose tissue that increases these risks or other factors that are not looked at in combination with BMI.

Additionally, we do not believe BMI is an accurate representation of health and therefore a flawed marker to center studies around. Subscribe to our monthly newsletter and you’ll receive a 6 page informational guide about the top myths during pregnancy, we show the statistics around this.

We also want to make a quick note that being classified as high-risk does not mean that complications or interventions will absolutely occur, many folks classified as high-risk have uncomplicated and “normal” pregnancies and labors. Additionally, what providers may consider high-risk does not always jive with current research or lived experience. Being fat and pregnant is a perfect example!

The Power of Doulas: Support, Advocacy, and Compassion

Doulas are like steadfast companions on this remarkable journey. They provide continuous emotional and physical support, tailored information, and unwavering advocacy. Here’s how doulas can make a substantial impact in the face of high-risk pregnancies:

    • Emotional Well-being: High-risk pregnancies often come with heightened emotions and fears. Doulas offer space for the birthing parent to express their concerns, ensuring that they feel heard, validated, and supported.

    • Information and Education: Doulas provide evidence-based information about medical procedures, interventions, and options available. This empowers the birther to make informed decisions aligned with their preferences.

    • Getting Clear on Preferences: High-risk pregnancies may require extra decisions. Doulas work collaboratively with the birthing parent and support person(s) to create a comprehensive list of birth preferences that honor the individual’s wishes while considering possible safety issues.

    • Comfort Measures: Doulas are well-versed in comfort techniques such as breathing exercises, massage, and positioning adjustments that can alleviate discomfort and reduce stress during labor and birth. Many are also comfortable accompanying you into the operating room should you need a c-section.

    • Communication Bridge: Doulas can act as a bridge between the birthing parent, support person(s)  and medical staff, facilitating clear communication and ensuring that the individual’s voice is heard during medical discussions and decision-making processes.

Medical Professionals and Emergency Situations in a High Risk Pregnancy Matter

In high-risk pregnancies, medical professionals can play a crucial role in monitoring the health of both the birthing parent and the baby. They are trained to identify potential complications and take appropriate actions.

In emergency situations, such as placental abruption (the separation of the placenta from the uterus) or fetal distress, care providers may opt for interventions such as cesarean sections to ensure the well-being of both individuals. 

Most midwives do not take on high risk pregnancies or if a pregnancy becomes high risk during their care, they may request that you transfer your care to a local OB to assist with the remainder of your delivery. 

Common Tests and Care Options

To manage high-risk pregnancies, care providers may recommend various tests and interventions. These can include:

  • Regular Monitoring: Regular check-ups, ultrasounds, and blood tests to monitor the birthing parent and the baby.

  • Non-Stress Tests: These tests measure the baby’s heart rate in response to their movements, helping to assess the baby’s well-being.

  • Biophysical Profile: This test combines ultrasound and fetal heart rate monitoring to evaluate the baby’s health and well-being.

  • Amniocentesis: In cases where genetic conditions are a concern, amniocentesis can provide valuable information about the baby’s health.

  • Bed Rest: Care providers might recommend bed rest to manage certain complications and reduce stress on the body.

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Your Pregnancy Journey, Your Pregnancy Choices

In the realm of high-risk pregnancies, it’s essential to remember that you are not alone. Doulas offer unwavering support and guidance, and many care providers are equipped to handle medically complicated pregnancies. Your journey is unique, and your choices matter. By embracing the support available to you and making informed decisions, you can navigate potential challenges of a high-risk pregnancy with confidence and resilience.

Remember, a high-risk pregnancy doesn’t define your experience—it’s a chapter in your remarkable journey toward parenthood.

*Disclaimer: The information provided in this blog post is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider for personalized guidance and recommendations.*

GD Info: https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339

HBP: https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy#:~:text=If%20blood%20pressure%20goes%20up,placental%20abruption%2C%20and%20cesarean%20birth.

Previa info: https://www.mayoclinic.org/diseases-conditions/placenta-previa/symptoms-causes/syc-20352768

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