You just found out you're pregnant and you immediately went to Google. What to expect when you're expecting. You find out all the symptoms you might experience. What you can no longer eat. What warning signs to look for if something's wrong. What side you can't sleep on anymore. Kick counts. Our minds automatically go to the negative, that's human nature.
There is no such thing as no risk when it comes to pregnancy. You are either categorized as a low risk or high risk mama. But did you know that only 15% of pregnancies are actually high risk? Your chance of being someone with higher risk than normal is only 1.5 out of 10 women. When you look at it like that, does that help ease your mind?
Another thing to note is that you could be considered a high risk pregnancy, but not high risk labor. They are separate concepts. You could have pregnancy risk factors such as obesity or hypertension, but still have an uncomplicated labor and birth. Also, you could be over the age of 35, but not have other more significant risk factors such as preeclampsia. Both label your pregnancy as high risk, but they are not equally significant.
What are some reasons I could be high risk?
-Gestational Diabetes
-Preeclampsia
-Pregnant With Multiples
-Obesity
-Hypertension
-Lifestyle choices
-Advanced maternal age (over 35)
-Pregnancy history
-Maternal health problems
How to promote a healthy pregnancy:
-Nutrition! We are what we eat! Even before becoming pregnant, your nutrition can help you to become pregnant. During doula training, I heard "pregnancy is a sign of health." If you are pregnant, there is some correlation to being healthy enough to conceive. If you are not consuming key nutrients, not only can you develop life threatening conditions, but your baby could have low birthweight, developmental delays, and other life threatening conditions. Growing another human takes a lot out of the pregnant person's body. Make sure you are fueling yourself and your growing baby with a balanced diet. While pregnant, I had the lowest levels of vitamin d that I've ever had, even though I take a supplement every day! Iron, folate, calcium, vitamin d, choline and protein are essential for baby's development.
-Regular prenatal care! Prenatal visits can monitor your health and your baby's health, as soon as you find out you're pregnant. The US has the highest maternal mortality rate of any nation studied. Women in the US face the highest rates of preventable and maternal mortality when compared with women in 10 other wealthy nations. In 2020, the maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 live births, 2.9 times the rate for non-Hispanic White women. In comparison, Norway did not have any maternal deaths in 2019. The risk of death by race/ethnicity may be due to several factors including access to care, quality of care, prevalence of chronic diseases, structural racism, and implicit biases. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care. Access to prenatal care in the US also needs to be better.
-Avoid any substance that could increase risk! Smoking, drinking, and drugs can affect your baby. The placenta transfers anything you consume to the baby. I had to stop taking my migraine prescription when I became pregnant, as Tylenol is the only pain medication looked at as "safe" to treat occasional headaches. Your provider can also point you in the right direction with other recommendations. When I had a sinus infection, their only recommendations were a hot shower, a Neti Pot, cough drops and rest, because if you can limit what you take while pregnant, that is the healthiest option.
-Stay active! If you were training to run a marathon, would you just show up and expect to finish the race? Have you done squats for hours before? Do you work your glutes and quads regularly? You are more than likely going to be laboring in positions that you aren't typically in for extended periods of time. The main reason birthing people get an epidural is because they're so stinking tired! Do 3 sets of 10 squats every day, walk a couple miles, do some lunges to stretch and work those powerful legs you have. I can't guarantee that this will help you too, but I think my "can't sit still" lifestyle attributed to my baby being head down in the right position at 30 weeks and an easy labor and birth. Think about gravity... it works! The head is the heaviest part of the baby's body so it wants to be down. You can promote a healthy pregnancy AND labor by staying active.
Even after all of this prep, some complications still arise. 3-4% of full term babies will still be breech. I'm not sure we will ever 100% know why some babies don't flip. In Buffalo, there are only 6 doctors that will deliver a breech baby vaginally, and it cannot be your first birth. Your "muscle memory" from a first birth significantly helps in subsequent births. Whether you birth your baby vaginally, or through a cesarean section, you are still a bada** mama, and cesareans are there for situations such as these.
The World Health Organization recommends that cesarean rates should not exceed 10 to 15% of births for optimal maternal and neonatal outcomes. When the rate goes above 10%, there is no evidence that mortality rates of mom or baby improve. In the United States in 2021, 32.1% of live births were cesarean deliveries, and New York State has the 12th highest rate with 34%.
There is risk in anything. Just driving down the road has risks. I urge you to see the positive sides of pregnancy and to not give in to the easy temptations to worry. A lot of tests during pregnancy are not 100% conclusive, and I know dozens of women who can tell stories of a diagnosis that were not correct once the baby was born. Science and advanced medicine is great, but nothing is 100%. Trust your gut and intuition. Get a second opinion. Heck, get a third opinion if you want. Then make a decision. No one other than YOU should be making a decision about your care. If you are labeled as "high risk" because of any of the above reasons, there are so many things you can still do to have your birth preferences honored. Hospital choice may be among the biggest independent risk factors for undergoing major surgery, so make sure you choose a provider you feel will support you in your birth.
As always, I strive to provide you with evidence based resources:
*I am not a medical professional. Please refer to your doctor for medical advise.*