High-risk pregnancy? 5 questions to ask your OB-GYN


by April Bleich, MD

Mar 3, 2022

There are lots of reasons that any given pregnancy may be considered “high risk.” It might be a medical condition affecting the mom or a fetus with a heart defect or other structural problem. Or maybe you’re having twins or triplets (the more the merrier!). But don’t let the term “high-risk” scare you. 

While we can’t fix all medical problems, our job as OB-GYNs is to make sure we keep you and your baby safe. We will do everything in our power to make your pregnancy as “normal” and enjoyable as possible.

If you are concerned you may have a high-risk pregnancy, the best thing to do is to meet with your OB-GYN to discuss your pregnancy plans before you attempt to conceive. There are often things we can do ahead of time to make your pregnancy safer for you and your baby.

If you’re already pregnant, don’t stress—it’s not too late. Your OB-GYN can help guide you safely through every stage of your pregnancy and answer all your questions along the way. Here are just a few questions to ask your OB-GYN to help prepare for the exciting road ahead!

1. Will my prenatal and pregnancy care look different?

Depending on your health conditions and history, your physician may refer you to a maternal fetal medicine specialist or have you meet with a genetic counselor. They may also offer you further testing to determine your risks. In general, a high-risk pregnancy will involve more monitoring and more frequent appointments so any potential issues can be spotted right away. This should give you some peace of mind rather than cause you stress.

While it is important to know about your additional risks, it is also important to know that most women have uncomplicated pregnancies and that your physician will help guide you safely through your pregnancy the entire way!

2. Am I “too old” to have a baby?

If you’re 35 or older at the time of your due date, you are considered “advanced maternal age” or what some people call a “geriatric pregnancy.” These terms sound scary, but the majority of these women have completely normal pregnancies.

Your OB-GYN will be able to walk you through the potential risks that you and your baby may face. One of these increased risks is having a fetus with certain genetic conditions involving an extra set of chromosomes. Think of chromosomes like book chapters that store genetic information. Down syndrome is an example. 

3. I have a health condition. Is it safe for me to get pregnant? 

It depends. This is where close coordination and transparency with your OB-GYN becomes extremely important. If you have a condition like high blood pressure that is well controlled and you are otherwise healthy, it is safe to get pregnant. If your blood pressure is uncontrolled or you have other medical conditions such as heart or kidney disease, it may not be safe. Every pregnancy is different, just like every woman is different. 

The safest way to prepare is to make an appointment with your OB-GYN to discuss pregnancy planning before you get pregnant. That way we can make sure you are healthy enough to tolerate pregnancy, ensure your medications are safe for pregnancy, and have you fully prepared to begin the adventures of pregnancy.

Related: Your guide to high-risk pregnancy

4. Do full-term babies ever need to go to the NICU?

Delivery, just like parenthood, is a little unpredictable. Some babies have a harder time adjusting to life outside their mother’s body. When babies are in their mother’s womb, their lungs are filled with fluid and they get their oxygen from the umbilical cord. When a baby is born, the baby’s lungs must adjust to breathing in air instead of fluid. For some babies, this transition takes a little longer and may require an admission to the neonatal intensive care unit (NICU).

Another common reason for NICU admission is low blood sugar. Fortunately, the NICU stay for most full-term babies is typically very brief. NICU staff is specially trained in how to care for both pre-term and full-term babies, so if your baby does end up spending time in the NICU, rest easy. They’re in very capable and caring hands.

5. Should I be scared about my baby needing to spend time in the NICU?

I had a NICU baby my first pregnancy. Being discharged from the hospital while my baby girl was still admitted was emotionally very difficult. But, even then, I knew the doctors and nurses in the NICU would take wonderful care of her and get her home to me as soon as possible. I am forever grateful for the care they gave my daughter and the care they give my patients every day.

If there is a high chance your baby will require a NICU stay, talk to your OB-GYN about your fears and worries. Your care team will make sure you have all your questions answered so you are as prepared as possible.

Questions about pregnancy? Find an OB-GYN near you.

About the Author

April Bleich, MD, is an OB-GYN on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth. Dr. Bleich specializes in maternal-fetal medicine. Connect with Dr. Bleich today.

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