If you have been told by your OBGYN that you are a high-risk pregnancy it’s natural to have questions. You may want to know if there are any lifestyle changes you’ll need to make or how often you’ll need to visit your obstetrician for routine checkups throughout your pregnancy. The goal of your OBGYN is to provide the care you and your baby need for a healthy pregnancy and delivery, so don’t be afraid to ask any and all questions that you may have.

What makes a pregnancy high risk?

A high-risk pregnancy may be the result of certain factors that already existed before your pregnancy or the result of a medical condition that occurs during the course of your pregnancy. Here are some factors that can cause a high-risk pregnancy:

Advanced maternal age: pregnancy complications are higher for women who are over 35 years old, as well as women under 17 years old

Lifestyle factors: smoking, alcohol, and using drugs can also affect pregnancy

Medical history: women who have chronic conditions such as diabetes, high blood pressure or heart disease are also more likely to experience other health problems during the pregnancy (talk with your OBGYN about any pre-existing health problems you have)

Multiple births: there is a higher chance for pregnancy risks when a woman is carrying two or more babies at a time

If I have a high-risk pregnancy what can I do?

The most important thing you can do to ensure a healthy, risk-free pregnancy is to make sure that you have an obstetrician that you trust. It’s very important that you keep up with routine checkups and exams. Women who have high-risk pregnancies may need to visit their OBGYN more regularly. In some instances, you may be referred to a maternal-fetal medicine specialist or other physicians.

Along with your routine checkups your OBGYN may also recommend various screening tests along with the standard prenatal screening tests. Some of these tests include specialized ultrasounds, amniocentesis, chorionic villus sampling (CVS), cordocentesis, and lab testing.

Eating a healthy diet, getting regular exercise and following the necessary steps to protect against infections can also go a long way to maintaining a healthy, risk-free pregnancy. If you find yourself dealing with high levels of stress this is something to discuss with your doctor to find the most effective strategies for reducing stress.

Whether you just found out you are pregnant or you are looking for an OBGYN to provide you with preconception counseling before getting pregnant, you want a doctor who puts your needs first. While a high-risk pregnancy can feel overwhelming at first your obstetrician will help guide you throughout the course of your pregnancy to make sure you get the care you deserve.

Congratulations! You just found out you are going to have a baby. Now what? First and foremost, it is important that you and your unborn child get the proper care you both need over the next 9 months.

Your OBGYN will be an invaluable part of your medical team, as they will be able to not only provide you with a host of good advice for a healthy pregnancy, but also they can check for health issues in both you and your unborn child that could potentially cause further and more serious complications. Turning to an OBGYN regularly is vitally important for a healthy, complication-free pregnancy.

Of course, there are also some wonderful milestones to enjoy throughout the course of your pregnancy. Here are some things to look forward to before getting to meet the new addition to your family,

Baby’s First Ultrasound

Once you find out you’re pregnant, it’s important that you visit your OBGYN to confirm the pregnancy, determine your due date and to schedule your very first ultrasound. This first ultrasound can occur as early as between 6 weeks and 9 weeks and it allows your obstetrician to check your baby’s size and heart rate, while also checking the health of the placenta and umbilical cord. This is an exciting moment for parents, as they often get to hear their baby’s heartbeat for the first time.

The End of the First Trimester

We know that saying goodbye to the first trimester is high on most pregnant women’s lists. This is because most miscarriages occur during the first trimester. This is usually around the time that expectant mothers want to announce their pregnancy to family members and friends. Plus, if you were fighting terrible morning sickness during your first trimester you may be relieved to hear that a lot of these symptoms may lessen or go away completely once you reach the second trimester.

Feeling Your Baby Kick

Most expectant mothers can’t even describe how incredible it is to experience their baby kicking for the first time. Your baby’s kick may feel more like a flutter or tickle while other women may feel a nudging sensation. At some point, you may even see an indent of an arm or leg as your stomach expands and the baby grows.

Your Child’s Gender Reveal

While some parents don’t want to know whether they are having a boy or girl until that moment in the delivery room, some couples can’t wait to find out and share the news. In fact, gender reveal parties have become a popular trend today and once you find out whether you are having a little boy or girl you may just feel that exciting urge to start decorating the baby room.

Your Due Date

This is the moment you’ve been waiting for: your baby’s expected birth date. While most babies won’t show up right on schedule, you may be experiencing some warning signs that labor is soon on the way and you’ll soon get to welcome your baby into the world.

Finding out that you’re pregnant can be exciting news; however, if you’ve also been diagnosed with HIV then you may be feeling more concerned about what this means for your pregnancy, the health of your child and your health. Of course, it will provide some relief to know that HIV-positive women can give birth to an HIV-negative baby. The most important thing you can do for you and your child is to visit your OBGYN right away for care as well as turn to other doctors who are providing you with your HIV treatments.

In most cases, the medications used to treat your HIV should be safe to use throughout the course of your pregnancy. Of course, there are some instances in which women may need to change the antiretroviral medications they take. This is why it’s important to talk to your medical team as soon as possible after finding out you are pregnant.

It’s imperative that you continue taking your HIV medication throughout the course of your pregnancy just as you had been prior to your pregnancy. Taking your medication at the same time everyday is also important to your health and the health of your child to make sure that they do not contract the virus.

If you haven’t already started taking HIV medication it’s necessary to get on a medication schedule right away. Women with HIV who start taking their antiretroviral drugs right away during their pregnancy will have a lesser amount of the virus in their blood when it comes time for their delivery.

You will want to work with your HIV doctor and your obstetrician to discuss the best ways to manage your HIV while pregnant to reduce the likelihood of passing HIV onto your child. This first consultation should be scheduled right away. From there, your obstetrician will decide how often you should come in for routine monitoring and care. During these routine visits, an ultrasound will often be used to see how the fetus is developing.

When it comes to your birth plan, this is something you should discuss as soon as possible with your OBGYN. It is possible for women with HIV to deliver their baby vaginally, but the safest and best method for delivery will depend on how low or high the viral count is at time of delivery. Based on the viral load at around 34 to 36 weeks, your OBGYN will be able to determine if a vaginal delivery is possible or whether you will need to undergo a cesarean section prior to going into labor.

Along the way, you may have questions or concerns about your pregnancy and managing your HIV. When you do, make sure that you have an OBGYN that you trust to provide you with the caring and compassionate care that you need to have a smooth and stress-free pregnancy.

Giving birth is one of the most exciting, beautiful, and difficult things many women will ever do. Taking care of yourself afterward may seem trivial in comparison with the demands of your new baby. However, postpartum care is a crucial part of recovering properly and getting yourself back into top physical health to provide the care your newborn requires.

What to Expect

• Vaginal Birth: You will experience soreness in your vaginal area, especially if you had a tear or episiotomy during the birth. You may feel afterpains, or mild contractions after giving birth. These will accompany several weeks of vaginal discharge called lochia, which presents itself as bright red and flows heavily during the first days after delivery, tapering off over the next few weeks. Bowel movements may be difficult and cause hemorrhoids.
• Caesarean Section: Caesarean sections require a longer hospital stay than a vaginal birth, usually around three to four days. After receiving pain medication, your doctors and nurses will encourage walking short distances to help with the buildup of gas within the abdomen. Many women find walking to be very difficult at first, but gets easier with time. You will also experience some vaginal bleeding in the days or weeks after delivery.

Postpartum Care 
Postpartum care after a vaginal birth is different than caesarean section aftercare. After a vaginal delivery, sitting on a pillow or donut may help avoid pain from a tear or episiotomy. Drinking plenty of water and eating foods that are high in fiber can help keep stools soft if you have problems passing bowel movements. Your doctor can also prescribe stool softeners if necessary. Using an icepack or a frozen sanitary pad coated with witch hazel can help relieve discomfort and pain along with over-the-counter pain relievers.

Aftercare for a caesarean section begins during your hospital stay. Your doctor may administer narcotics like morphine to help with pain relief for the first day or two. After leaving the hospital, you will require as much help as possible. You may receive a prescription for pain relievers. Your incision will remain tender and sore for several weeks after delivery though it will heal gradually and feel better every day. Be sure to get plenty of rest and avoid lifting heavy items for at least eight weeks. Your scar will start out very obvious but shrink as you heal.

It can be a difficult topic to address but one that remains on some women’s minds.

There are so many emotions that a woman experiences after going through a miscarriage, and it can be even more challenging if you’ve had to deal with multiple miscarriages. Of course, your OBGYN is always here to provide you with the care and support you need through this difficult time. Find out more about the causes behind multiple miscarriages and the treatment options available to you.

A recurrent miscarriage means having three or more miscarriages in a row. Common risk factors for recurrent miscarriages include:

• Being older when trying to conceive (For women this is over the age of 35 while it’s over the age of 40 for men)
• Being overweight or obese

Also, one of the most common but treatable causes of recurrent miscarriage is a blood clotting disorder known as antiphospholipid syndrome (APS), where your immune system attacks the fats, or phospholipids, in your blood.

Other causes of recurrent miscarriages include:

• Other blood clotting disorders
• Incompetent cervix (or cervical weakness)
• Abnormal chromosomes
• Uterus abnormalities
• Polycystic ovary syndrome (PCOS)
• Serious infections such as toxoplasmosis or listeria
• Diabetes
• Thyroid disorders

To put your mind at ease there are tests that your gynecologist may recommend to determine whether any of the causes listed above could be responsible for your miscarriages. Common tests include:

• Antiphospholipid Syndrome (APS) testing
• Blood clotting testing
• Genetic testing
• Ultrasound or laparoscopy (to check the shape and health of the uterus)

Sometimes your obstetrician can pinpoint the exact cause and sometimes it’s not detectable through diagnostic tests. Not being able to pinpoint the root cause can be very distressing. After all, if nothing is wrong why does this keep happening? It’s a frustrating question that can leave some couple feeling disheartened. But it’s important to know that even though many couples go through recurrent miscarriages, many of them go on to have a healthy baby the next time.

Don’t go through this process alone. Speak to your obstetrician and gynecologist who can shed some light on what’s going on so that you can finally have the piece of mind you deserve.