While having a baby can be daunting for some women, it is a dream come true for women who want to become a mother and give proper care to their child. It’s a natural process – a woman goes into labor and gives birth to a healthy baby. However, this isn’t the case with every woman. There are times when it can become a matter of life and death and specialized care needs to be given. A high-risk pregnancy can threaten the life of a mother or her child before, during, or after delivery.
Some even require a visit to urgent care or the emergency room.
There can be numerous reasons for a high-risk pregnancy. While some women are at an increased risk for complications even before they get pregnant, others can get a high-risk pregnancy as they progress. A specialist can help manage these kinds of pregnancies and make sure that special prenatal care is provided.
Let’s take a look at the maternal mortality rates and their causes.
What is a High-risk Pregnancy & What to Expect?
Maternal Mortality Ratio: What do the Studies Suggest?
Maternal mortality ratio is defined as the number of women who die during pregnancy or within 42 days of the end of the pregnancy (per 100,000 live births).
According to the World Health Organization (WHO), the overall maternal mortality rate was 19 per 100,000 deliveries in the year 2017. The prevalence increases in non-white women and is 3 to 4 times higher than that of white women. As compared to other Western countries, the maternal mortality rate is significantly higher in the US and 50% of these deaths occur in non-Hispanic black women.
These statistics include both direct obstetric and indirect causes and women from different races and ethnicities. Talking about the US, the maternal mortality rate is 3.3 times higher in black women and 2.5 times higher in American Indian and Alaska Native women than in white women. On the other hand, in Brazil, this ratio is about 5 times higher in women of African descent than in white women.
The causes of maternal deaths worldwide along with their incidence are as follows:
- Hemorrhage – 27%
- Hypertensive disorders – 14.1%
- Sepsis – 10.7%
- Abortion (induced/miscarriage/ectopic pregnancy) – ~8%
- Pulmonary embolism
- Certain other preexisting disorders such as obesity and infectious diseases can also lead to maternal deaths.
As per the Morbidity and Mortality Weekly Report (MMWR) published in the Centers for Disease Control and Prevention (CDC), about 3 of 5 maternal deaths are preventable. And they often occur due to delay in providing medical assistance, delay in seeking assistance (by the patient and their family), and lack of transportation.
Risk-factors for High-risk Pregnancies
Certain risk factors are present before women become pregnant. Some other problems that can increase risk and further complications can develop during pregnancy or during labor.
- Age – One of the most common risk factors for a high-risk pregnancy is maternal age. About 13% of all pregnancies occur in adolescents. And women who are under 17 or over the age of 35 are at a higher risk of complications than women in their late teens or early 30s. Furthermore, adolescent girls being naive are less likely to get medical care and may not understand what all activities and behaviors can put their pregnancy at risk. Adolescent girls can have babies who are underweight.
On the other hand, women over the age of 35 can have pre-existing disorders such as hypertension or diabetes that increase the risk during pregnancy. Certain other problems such as chromosomal abnormalities, gestational diabetes, and placental abruption can cause complications.
- Abortion – A study published in the National Library of Medicine suggests that women whose first pregnancy is terminated by induced abortion are at a higher risk of delivering a premature or low birthweight baby than. Thus, an induced abortion does not protect a woman against the risk of delivering a low birthweight baby. While abortion procedures are often thought to be safe and convenient, they can cause complications in some cases. Whether a woman chooses to go for medical abortion (that involves the use of MTP Kit) or a surgical abortion (makes use of surgery), she should discuss her options and potential risks with her healthcare provider. However, if the need of abortion is considered early in pregnancy due to medical reasons, the pills can work well enough. One should also consider the treatment and cost of abortion pills before making any decision.
- Medical conditions – Medical issues that can occur during pregnancy or exist before pregnancy can increase the chances of a high-risk pregnancy. Problems such as diabetes, high blood pressure, kidney problems, and sexually transmitted diseases can be detrimental for both mother and the baby’s health.
Furthermore, a woman may fall prey to certain health concerns during pregnancy. Medical issues such as preeclampsia that include high blood pressure, urinary protein, and swelling can be fatal for both mother and her baby if not treated properly.
- Weight – Weight also plays an important role in determining the health of a baby. Women who weigh less than 100 pounds or have a body mass index of less than 19.8 are likely to give birth to underweight babies. On the other hand, obese and overweight women are likely to deliver very large babies, babies with birth defects, stillborn babies, and these women can often suffer from problems such as gestational hypertension, gestational diabetes, and have a miscarriage.
- Pregnancy-related concerns – Certain issues that arise during pregnancy can pose problems for both mother and her baby. Premature labor that begins before 37 weeks of pregnancy is one of the common issues. The risk of complications increases significantly in women carrying more than one fetus, and it further increases the risk of premature labor and gestational diabetes.
In some cases, the placenta can cover the cervix which can cause bleeding. The doctor may perform a C-section to reduce the risk of bleeding to the mother and baby.
Prevention and Treatment of Pregnancy Complications
“It doesn’t matter whether you have an existing health problem or not. If you’re thinking about becoming pregnant, you should schedule a preconception treatment with your doctor to ensure you’re healthy before you become pregnant”, says Dr. William Henderson, a physician and health consultant at Hisblue. “Your doctor may advise you to take a prenatal vitamin with folic acid daily and suggest you reach a healthy weight before you become pregnant”, she adds on.
To reduce the risk of certain problems, you should seek regular prenatal care and avoid consuming risky substances such as drugs, cigarettes, and alcohol. Depending upon your situation, your doctor might recommend certain tests to ensure that there aren’t complications involved. If your pregnancy is a high-risk one, you may be referred to a perinatologist. To ensure the best outcome for you and your baby, your doctor will work with their team to provide special care and help you manage the problems.
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