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It’s complicated Prenatal Care

It’s complicated

Common pregnancy complications—and what to do about them.

In researching this article, I interviewed a number of moms who experienced complications during their pregnancies. Each had her unique perspective, but one point came up in every single discussion. Every mom I spoke to gave this advice: Ask questions! Pregnancy complications become more manageable—and less scary—when you know what to expect. Plus, you’re better able to advocate for yourself when you’re armed with knowledge.

Because knowledge is empowering, we want to share with you the basics of some of pregnancy’s most common (yet serious) complications. If you’ve been struggling throughout your pregnancy, you may even recognize symptoms in yourself before your doctor or midwife gives you the diagnosis. It never hurts to be informed, and it’s OK to ask your practitioner to run a test if you think you might have one of these conditions.

Gestational diabetes
Like other types of diabetes, gestational diabetes is marked by increased glucose levels and insufficient insulin production. Blood sugar levels become too high, putting mom and baby at risk for health problems.

Who is at risk?
Gestational diabetes is not uncommon. There are a number of risk factors that increase one’s odds, but really, any pregnant woman could be at risk for gestational diabetes. Maintaining a healthy diet and exercise regimen is the best way to lower your odds of developing this condition.

Detection
Most health care providers offer a glucose screening to expectant women near the end of their second trimester. If the glucose screening reveals that your blood sugar is too high, you could be diagnosed with gestational diabetes.

Treatment
Typically treatment includes following a balanced meal plan and exercising regularly. You will be asked to test your glucose level daily via finger pricks. You might need to give yourself insulin injections, and you could require medication to regulate your blood sugar.

Kaitlin Fincher of Vine Grove, Kentucky, kept a log of her food choices and blood sugar levels after she was diagnosed with gestational diabetes. “It made me hyperaware of the food that I was putting into my body,” recalls Fincher.“I was more active and ended up having a great recovery postpartum.”

Fincher also shares this key ingredient to her success: “Once I was diagnosed with gestational diabetes and had to go on a special diet, my husband jumped right in and embraced the diet as well.” Having a supportive partner can make such a difference!

Although diabetes treatment can be tedious, it’s nice to know that the daily rigor is well worth it. “It was hard and tiring having to always be aware of every little thing I ate,” says Fincher. “But in the end, I wouldn’t change anything because I know that I did everything I could do for my son to be born healthy.”

Preeclampsia
Affecting about 1 out of 20 pregnant women, preeclampsia is common, but it’s also serious. This condition has to do with restricted blood flow, which can put both mom and baby in danger.

Who is at risk?
Preeclampsia is more likely to affect women who have had it in the past or who have close relatives who have had it. Women who are obese, carrying multiples, suffering from other medical conditions (including hypertension), or younger than 20 or older than 40 are also at greater risk.

Detection
When your provider measures your blood pressure and takes a urine sample at each appointment, one of the things she’s checking for is preeclampsia. Elevated blood pressure and protein in the urine are two of the telltale symptoms. Other signs: headaches, changes in vision or unusual swelling (especially in the face). Report any of these to your doctor right away.

Treatment
Usually preeclampsia is resolved only with the birth of your baby. Megan Johnston of Torrance, California, describes how her preeclampsia resolved upon her daughter’s birth at 37 weeks: “My body seemed to cure itself once she came out. Headaches went away, heart rate and blood pressure came down, and I was just normal again.”

Until birth day, you will be closely monitored and perhaps put on antiseizure medication (in case you develop a full-blown case of eclampsia). You might spend some time in the hospital, and you’ll certainly be told to take it easy. Depending upon the severity of your case, you may be induced early, and you could require a C-section. Your doctor should discuss with you the progress of your condition and the risks involved for you and baby.

Premature labor
It’s normal to experience harmless Braxton Hicks contractions well before your due date. However, if you’re shy of 37 weeks and contractions are coming at regular intervals or becoming more intense and closer together, or if contractions are causing your cervix to dilate (open up) and efface (thin out), you are experiencing premature labor.

Who is at risk?
Risk factors for premature labor include previous preterm births; carrying multiples; maternal age under 17 or over 35; African American ethnicity; gaining too little weight; bleeding during pregnancy; having anemia; using cigarettes, alcohol or drugs; and poor prenatal care. You are also at an increased risk of going into premature labor if you’ve been abused or were under extreme stress during your pregnancy.

Detection
Increased vaginal discharge, spotting, pelvic pressure, or increased pain in the back or belly could mean you’re headed into labor. Let your practitioner know if you experience any of these symptoms.

Treatment
If you find yourself in premature labor, contact your OB pronto—she will likely send you straight to the hospital. If things slow down, you may be sent home and resume a normal pregnancy. If not, you and your doctor will need to determine whether it’s best to deliver right away (if it’s medically advisable) or if you and baby would benefit from extending the pregnancy.

If your labor begins before 34 weeks, your doctor will likely keep you in the hospital on bed rest and give you medication to subdue labor, so you can keep baby incubating. The longer your little one is able to stay in the womb, the better his chances are at emerging ready to breathe, feed and thrive.
Shannon Sutton of Syracuse, Utah, was expecting twins when she was diagnosed with an incompetent cervix (aka cervical insufficiency) at 20 weeks. To prevent premature delivery, she was given a cerclage (in which the cervix is tied closed) and put on long-term bed rest, first at home and then in the hospital.

“It’s easier to stay put in a bed when you don’t feel well, but when you feel good for most of the time, it is really hard to stay down,” recalls Sutton. “I just had to keep thinking about how I was keeping my babies growing and getting stronger every day they stayed in.” Because she received the medical attention her case demanded, Sutton made it to 30 weeks before delivering two healthy baby boys.

High or low amniotic fluid
Amniotic fluid is baby’s protective barrier inside the womb. It helps him to develop his lungs and digestive system, and it allows him room to move. Too little fluid (oligohydramnios) or too much fluid (polyhydramnios) can be detrimental.

Who is at risk?
Low amniotic fluid is common if you’re past your due date or if you’re carrying multiples. You’re also more likely to have low fluid if you’ve had a baby with growth restriction in the past, or if you suffer from chronic high blood pressure, preeclampsia, diabetes or lupus. High fluid is also more common among those with diabetes and mamas carrying multiples. A baby with a birth defect may come with high or low fluid as well.

Detection
If you are measuring too large or too small, or if you’ve experienced leakage, your doctor might suspect that your amniotic fluid level is off. She’ll order an ultrasound to determine how much fluid you have and go from there.

Treatment
Because both high and low fluid can cause problems with the umbilical cord, and high fluid carries the additional risk of placental abruption (when the placenta separates from the uterine wall before baby is born), your doctor will watch you closely through-out the rest of your pregnancy—think nonstress tests, extra ultrasounds and fetal kick counts. She might recommend other testing, too, and could bring you in for a C-section before your due date.

Placenta previa
The organ that provides nutrients to your growing baby through the umbilical cord is called the placenta. The placenta is normally located at the top of the uterus, but if you have placenta previa, it will be located at the bottom, fully or partially blocking the cervix (baby’s exit route from the womb).

Who is at risk?
You are more likely to have placenta previa if you’ve had it in the past, have had past C-sections, are carrying multiples, smoke or are of advanced maternal age.

Detection
Placenta previa will show up at your 20-week ultrasound. Further ultrasounds will reveal whether the placenta has moved up in the uterus as you get closer to your due date.

Treatment
Placenta previa can’t exactly be “treated,” but it can be managed. Because placenta previa can cause serious bleeding later in pregnancy, you may require complete bed rest or at least pelvic rest (no sex and no vaginal exams). You’ll also need to avoid strenuous exercise.

If the placenta hasn’t moved completely away from the cervix as you near your due date, your doctor will schedule an early C-section. If all goes well, your baby and placenta will be delivered without further complications. However, if your placenta is too firmly implanted (a condition called placenta accreta), you could experience heavy bleeding that will require blood transfusions and possibly even a hysterectomy.

Delivering your baby early means that he’s apt to experience the difficulties characteristic of premature birth. Whitney McPhee of Acworth, Georgia, delivered her daughter via C-section at 35 weeks because of the intense bleeding incurred by placenta previa. Her daughter had to spend some time in the NICU to develop her immature lungs, but today she is healthy and thriving. “At the time, my body wasn’t the safest place for her,” acknowledges McPhee. “I’m grateful the doctors were able to intervene and save her life.”

If you’ve been diagnosed with any of these conditions, don’t stop learning here! Websites such as Preeclampsia.org and Diabetes.org offer a wealth of information and advice, as well as links to local events and support groups.