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"The best surprise is no surprise."

-- Dr. Michael Katz, Chief of Perinatal Services at California Pacific Medical Center, San Francisco, CA

Just what is a high-risk pregnancy?

A pregnancy is classified as "high-risk" when the mother or baby is in danger. For the baby, this means being born prematurely and all the problems and risks that being a preemie involves. For the mother, this means serious health issues that can threaten her life, such as extremely high blood pressure, blood disorders, heart problems, or diabetes to name a few.

How do I know if my pregnancy is high-risk?

There are many medical factors that are used to determine whether a pregnancy is high risk. These include:

• Your age: if you are under 20 or over 35
• You are pregnant with more than one baby--twins, triplets, or more!
• Your mother took DES (diethylstilbestrol) when she was pregnant with you
• You have an infection, such as a urinary tract infection (UTI), bacterial vaginosis (BV), or a sexually transmitted disease (std) such as chlamydia, gonorrhea, or siphilis.
• You have a preexisting health issue such as diabetes, kidney disease, heart disease, thyroid disease, or high blood pressure
• You have an incompetent cervix, uterine abnormalities (the shape of the uterus is different), or fibroids
• Your had a cone biopsy performed on your cervix
• Your "water" broke early--known as premature rupture of the membranes (PROM)
• Your placenta is covering the cervix--this is called placenta previa
• Your placenta is separating from the uterine wall--known as placental abruption
• You have already had one preemie or you were a preemie
• You lead a high-risk lifestyle, for instance you smoke, take illegal drugs, or drink a lot of alcohol
• Your baby has severe congenital abnormalities
• There is too much fluid in the amniotic sac--this is called polyhydramnios

My pregnancy has been labeled "high-risk". What should I do now?

First, make sure that any preexisting medical conditions such as hypothyroidism or diabetes are treated and under control. Make sure that any infections are treated and resolved.

Be sure that you are comfortable with the level of care that your doctor is giving you. Be pro-active! If you think that something isn't being handled correctly, ask your doctor.

Since your pregnancy is considered high-risk, you will be seeing your health practitioner more often, every two weeks instead of every four weeks. (Near the end of the pregnancy or if some issue comes up, your doctor will want to see you more often, probably once a week.) Also, make sure you see any specialists that you need to treat a medical condition. These specialists can work closely with your health practitioner to help supervise your pregnancy.

If you are leading a high-risk lifestyle, for instance you smoke, drink alcohol or take illegal drugs, stop (at least) while you are pregnant. Your baby will suffer the consequences of the substances that you ingest. What goes in you, goes right to your baby. Remember: it's only nine months for you, but for your baby it's for life. Besides the devastating mental and physical effects alcohol and drugs can have on a baby, it's terrible to see a newborn going through addiction withdrawal.

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People and their circumstances vary, and you should always check with your medical advisor.