what to consider if you have had a poor pregnancy history
If you have been pregnant before and had any complications it often means that you could be at risk in any further pregnancies. It is therefore very important to begin your antenatal care very early in your pregnancy or even discuss it with your GP even if you are not yet pregnant but are planning to start trying for another baby.
- premature delivery: premature labour can occur for a number of reasons, but in a lot of case your midwife or consultant can help to identify any problems early on and help minimise the risk of another premature birth
- previous low birth weight baby: if your previous baby weighed less than 4.5 pounds at birth your midwife and obstetrician will want to monitor your very closely throughout your pregnancy and will most likely send you for extra test and scans to ensure your baby is growing
- miscarriage and stillbirth: if you have unfortunately suffered more than three miscarriages or a stillbirth there is an increased risk of this occurring again; sometimes the cause of these sad events are not always known but you can be referred for tests such as genetic screening to help to see if there are any contributing factors
do i need to have a caesarean section for a 2nd child?
If you have previously had a Caesarean Section (C-Section) then it is more than likely that you may need one in your next pregnancy. Although some women can go on and deliver their baby without the need for a Caesarean, the reason for surgical intervention in your previous pregnancy would need to be considered.
Your obstetrician will advise you the safest method of delivery for you and your baby, and some of the risks they will consider are:
- if you have a low lying placenta (placenta praevia), or your baby is breech
- if during a previous caesarean a vertical cut was made in your uterus (womb) this is called a high uterine incision and is usually only done if your baby is very premature, or is lying crossways
- you've had two or more caesarean sections
- you had a uterine rupture in a previous pregnancy
how will my age affect my pregnancy?
It is becoming more common for women to choose to have a baby later in life, and there is also an increase in mums having their babies in their teenage years. Having a baby in your teens or if you're over 35 may require you to be monitored more and undergo some additional tests.
Teen mothers: If you are having a baby in your teens you could be more at risk of anaemia.
Thirty five and up: While there are many advantages to having your baby later in life, there are also additional risks that need to be considered. While most healthy women who are pregnant after 35 have a successful pregnancy, there is a small percentage who could be at risk of a genetic or chromosomal defect, and are more likely to have complications such as high blood pressure, pre-eclampsia, gestational diabetes, and placenta praevia. You will be closely monitored throughout your pregnancy and will be offered further tests. Please remember though that this is only a small percentage of women, so try not to worry and enjoy your pregnancy.
will my weight affect my pregnancy?
Being under or overweight can be an issue when you are pregnant and you should ideally try to address any weight problems before you try and conceive. If you are pregnant and your midwife or doctor decides that your weight is not within a healthy range they may refer you to a dietician for further help. You will also be closely monitored throughout your pregnancy:
Overweight: If you are overweight with a BMI of 30 and above you are more at risk of developing gestational diabetes, pre-eclampsia and are more likely to need an instrumental delivery (ventouse or forceps) or a caesarean section, so it is important that you should discuss your birth plan with your midwife. However, it is worth remembering that most woman with a BMI of 30 or more will have a healthy baby.
Underweight: If your BMI is less than 18.5 you may be advise to gain weight, although if you suffer from, or have previously suffered from an eating disorder and find this difficult explain to your midwife what feelings this causes you. They are trained to try and help you and can provide you with extra support so it is best to be honest with them so they can ensure you are properly cared for. Being underweight can carry a small risk of having a premature baby or a baby that is underweight so you will be sent for extra scans to monitor your baby’s growth.
will my height affect my pregnancy and labour?
If you are particularly petite you may have difficulties delivering your baby naturally, especially if your partner is tall or broad it could mean your baby is also bigger. If you are concerned it is definitely worth letting your midwife know so you can be monitored closely throughout your pregnancy.
will having had multiple pregnancies affect me?
If you have already had four or more children, you may be at a higher risk of certain conditions such as high blood pressure, premature delivery, excessive bleeding, retained placenta, precipitate deliveries (the baby is delivered too quickly) and, after the birth, anaemia. You will need to ensure that you eat well and get plenty of rest. Talk to your midwife about any health concerns you may have and ask her to explain which symptoms you need to be aware of to ensure you enjoy a healthy pregnancy.
what happens if baby is in an abnormal position?
Although a majority of babies will have turned into the normal head down position before 36 weeks some remain breech (with their bottom pointing down instead) and other remain lying sideways (transverse position). If your obstetrician thinks it is safe to do so they may offer to try and turn the baby into the proper position for delivery but if this is not possible you will be offered a caesarean. Make sure you ask plenty of questions and what is involved so you will feel relaxed when it’s time for your little one to be born.
mentally coping with pregnancy
It’s perfectly normal to experience a bit of anxiety when you are pregnant, worrying about the life growing inside you but if you start to experience severe anxiety, depression or panic attacks it’s time to get help from your midwife or GP. Anxiety can be triggered for a number of reasons including a fear of giving birth (tokophobia), worrying about financially supporting you baby, relationship problems and other stressful situations you may encounter. There is no reason to suffer in silence though or feel ashamed, as talking through your concerns with someone close, or your midwife or doctor may help you to understand what is causing the anxiety and help you to cope better. They may be able to teach you some simple relaxation technique or refer your for Cognitive Behavioural Therapy to help you deal better with your anxiety symptoms and enjoy your pregnancy.