Expert Advice

Options and Questions If You’re High Risk

Even though it can be overwhelming to hear your pregnancy is high risk, give yourself a minute to adjust. Then get busy becoming informed so you feel empowered and make good decisions. Various choices are still available to women with high-risk pregnancies. You might be surprised at the many options and questions for high-risk pregnancies!

Some are prenatal decisions and some will be included in your birth plan for labor and postpartum.

 

QUESTIONS ABOUT HIGH RISK TESTING PROCEDURES

Care providers differ on what they require of high risk women. It will be up to you to learn more about the common tests (listed below), and think about why you may or may not want to have them.

In some cases, the tests alone could add complications and risk If you and your care provider end up thinking differently about which tests are required for you, you might consider finding a new provider.

Here are some of the typical tests your care provider may require in what they determine to be a high risk pregnancy:

  1. Specialized or targeted ultrasound
  2. Invasive testing :
    1. Cordocentesis
    2. Amniocentesis
    3. Chorionic Villus Sampling (CVS)
  3. Non-Invasive Prenatal Testing NIPT
  4. Cell-free DNA
  5. Nuchal Translucency Screen
  6. Trimester Screens
  7. Cervical length measurement
  8. Prenatal lab work and tests
  9. Biophysical profile

 

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QUESTIONS TO PREPARE FOR YOUR HIGHER RISK BIRTH EXPERIENCE

As you progress in your pregnancy, you may need to update your birth plan preferences, according to how your risk factor(s) have developed or changed. Again, do your research to make sure you and your chosen care provider are on the same page. Ask lots and lots of questions, and then keep asking more questions. It is important to understand what may be going on with your body so you feel confident, prepared and safe. Answers to the key questions below could vary significantly depending on who you ask. Getting clear on these questions will help you anticipate what to expect during labor, and ultimately ensure a better birth experience when the time comes:

Given I’m high risk and assuming we don’t schedule a c-section,

  1. can I still give birth at home or in a freestanding birth center if I want to? Or, is a hospital my only option? Why or why not?
  2. if I don’t want to be induced, is that still an option? Why or why not? Could you please help me understand the reason(s) that might require me to be induced?
  3. would it be possible to have an unmedicated birth without the use of an epidural or pain relief medication if that is what I want? Why or why not?
  4. can my partner be with me in the birth room, even if we end up with a cesarean? Why or why not?
  5. will I be able to move around during labor or am I going to be stuck in bed? Why or why not?
  6. is it an option to have intermittent fetal monitoring instead of continuous? What are the advantages and disadvantages of intermittent or continuous monitoring?
  7. can I choose how many vaginal exams I receive? What happens if I want to refuse some or all of them? Why are or aren’t they necessary at all?
  8. can I eat or drink during labor? Why or why not?
  9. will it be okay to choose which position I am in during pushing? Why or why not?

 

WHAT YOU’LL DO ONCE BABY IS BORN

Immediately after the birth, what do you want to do? Once again, ask lots of questions, discuss with your care provider(s) and include your answers to these questions in your final, one-page birth plan.

  1. If I want to, can I have immediate skin-to-skin contact with my baby, even if I have a c-section?
  2. Can I breastfeed immediately if I choose to breastfeed? What are the risks and benefits of breastfeeding and formula feeding?
  3. Can I delay cord clamping? Why would I or wouldn’t I want to do that, and what exactly is cord clamping anyway?
  4. Can I delay weighing and measuring of my baby? Why would I or wouldn’t I want to delay these procedures?
  5. Can I delay bathing of my baby? Are there risks or benefits to the baby if we delay the first bath?
  6. Can I delay the vitamin K shot for my baby? Why would I or wouldn’t I do that?
  7. Can I choose to refuse the antibiotic eye ointment for my baby if I want to? What are the risks and benefits of this choice?

No matter where or how you bring your baby into this world, your birth plan can still be a guide. With it, birth attendants can help fulfill as many of your preferences as circumstances allow. One copy should be in your file, and a second one comes with you in your maternity hospital bag.

When you take responsibility for knowing your options, choose a care provider you trust, and plan ahead, you can have an empowered birth even in a high risk situation.

 

To learn more about high-risk pregnancy questions to ask, download our free Birth Plan eBook now. After three years of research, collaboration with more than 100 childbirth experts and resource centers from Healthy Child Healthy World to the American Association of Neonatal Nurses, the Best Ever Baby Birth Plan Guide is available for a free download.

This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner.  These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.

 

Published: August 19, 2015 | Reviewed by: Kim Walls, Natural Products Expert, Elizabeth Bachner, LM, CPM, L.Ac., Midwife | Last reviewed: August, 2015

Kim WallsOptions and Questions If You’re High Risk

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