by Corey Whelan
As infertility technologies improve, so do success rates. Statistically, increases in pregnancy and live birth rates have been seen for women across all age ranges over the past decade. These success stories include pregnancies resulting from donor egg IVF cycles in older women. More women who have undergone infertility treatment hear the magical words “You’re pregnant” than ever before, and find themselves being discharged from their infertility specialist’s office into the care of an obstetric/gynecologist.
This happiest of all days can be colored by the knowledge that pregnancies resulting from assisted reproductive technology are often classified as high-risk. While these technologies do not inherently produce weak or unstable pregnancies, there are a variety of reasons for this, including the high rate of multiple gestations (twins or greater) associated with infertility treatment, as well as the advanced age of many patients.
Factors that might contribute to high-risk pregnancies include:
- Advanced maternal age – a classification pertaining to women 35 years of age and older
- Multiple gestations (twins or greater)
- Obesity, or higher than normal BMI (body mass index)
- High blood pressure
- Concerns about the fetus
- Lifestyle choices, such as heavy drinking, smoking and recreational drug use
- History of pregnancy related issues, such as multiple miscarriages, prior C-section, having a low birth weight or premature baby
Sometimes, complications can arise during the pregnancy itself that will create the need for more monitoring and greater precautions, such as placenta previa and other medical conditions relating to either mom or baby.
The term high-risk sounds scary, but essentially serves to simply mark the pregnancy as needing extra monitoring. If you find yourself in this situation, your physician will schedule frequent pre-natal visits, and possibly more sonograms than is typical. As with any pregnancy, you will be instructed to take a daily pre-natal vitamin, and watch your weight gain. Of course, eating a wide range of healthy foods, reducing stress, and avoiding toxins such as tobacco, phtalates and BPA make sense during any pregnancy. Sometimes, bed rest will be recommended.
Your physician will also want to discuss delivery options with you. These include:
- Vaginal birth is the preferred method for healthy women who do not anticipate complications upon delivery. Many high-risk pregnancies fall into this category, even if the mother is carrying multiples or of advanced maternal age.
- Caesarean section (C-section) is a surgical operation which requires local anesthesia.
- VBAC delivery refers to vaginal birth delivery after a C- section has already taken place in a prior pregnancy.
The increased rate of C-section births have become a concern in this country. Currently, C-section deliveries account for more surgical procedures than any other type of surgery in American hospitals and are not without risk; complications to both mom and baby often result. According to perinatal support specialist and doula, Cyndi Gross, “It is important that women know the pros and cons of all the options available. This means an expansion upon the concept of informed consent. Patients should request full communication with their providers and complete informed consent, which encourages those providers to present women with unbiased information on the risks and benefits of each suggestion. In the case of c-section, both potential reasons for the surgery and also the risks of the surgery as they pertain to both mother and baby or babies should be discussed. Only then can the patient decide if the risks outweigh the benefits or vice versa.”
Nothing is ever sure in life, and this includes pregnancy, delivery, and the entire experience of parenting. If your pregnancy has been classified as high-risk, it is important to remember the vast majority of these types of pregnancies result in positive birthing experiences and beautiful babies born. Take care of yourself, follow your doctor’s suggestions and watch your stress. There is no reason to assume your pregnancy, delivery, and baby will be anything less than perfect.