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How to manage a high-risk pregnancy

Karen Hawthorne is a health and lifestyle writer and producer in Toronto, Canada. Her work has appeared in print and online for publications including Glow, Homemakers, BestHealthMag.ca and the National Post.

Managing a high-risk pregnancy

The road to parenthood is tough enough. Adding the fear of a possible premature baby can make it overwhelming: bed rest, countless meds, endless tests, no sex, the list goes on.
Pregnant woman holding belly

SheKnows interviewed Kelly Whitehead, a microbiologist and mom who lost her first baby at nearly 23 weeks, then had two high-risk pregnancies -- both successful. She collaborated with Dr. Vincenzo Berghella to write High-Risk Pregnancy: Why Me? Understanding and Managing a Potential Preterm Pregnancy. Here's our Q&A.

SheKnows: After such a heartbreaking experience the first time around, what made you decide to try again?

Kelly Whitehead: It was definitely a leap of faith. I'm not going to say it was an easy decision for me and my husband to make, but inside I knew I had to try again. My husband was more reluctant to jump in again than I was. I also admit that after I found out I was pregnant again, I freaked.

High-Risk Pregnancy: Why Me? Understanding and Managing a Potential Preterm Pregnancy

I immediately regretted the decision to try again and from that day forward I was filled with fear and depression. I was still grieving my son and I felt guilty about trying to move on by having another baby. Sometimes I even questioned if losing this baby too wouldn't be easier than going through the rest of the pregnancy.

SheKnows: What did you learn about yourself in the process?

Kelly Whitehead: I learned how vulnerable I was, how it felt to feel isolated, depressed, scared and lonely. These were all very new emotions for me. I also learned about loss, as I had never experienced death in such a close manner before. On the flip side, I learned about the wonders of pregnancy, the joy of having a baby and giving birth, and the beauty of breastfeeding. I'm not saying any of these things were fun all the time. As weird as it sounds, I also came to feel that everything that happened has made me a better person, maybe even a better mom.

SheKnows: Did you have to cope with months of bed rest and sexual abstinence?

Kelly Whitehead: Bed rest was hell, plain and simple. I cried tears of self-pity on a daily basis and I worried about my baby every second of the day. Time comes to a standstill when you are on bed rest. At times it was physically and mentally painful to have to lay there and know I still had months to go.

Ah, the wonderful "pelvic rest." I'm not a sex-crazed wife (though my husband wishes), but when the option is taken away from you, it somehow messes with your head. During the pregnancy after my loss, I would have sex dreams nearly every night. I would wake up feeling so guilty afterwards. How could I be this stressed and depressed and still have these thoughts?

SheKnows: What about treatment strategies ― progesterone, steroids, contraction-stopping meds? Do you feel women should be open to trying these?

Kelly Whitehead: I have a cervix that is very weak, which leads me to dilate early. Women with this condition struggle to carry their babies to term. Sadly, many of us lose babies before this condition is discovered. I ended up having surgery, called a cerclage, placed at 21 weeks with my daughter when my cervix shrank to 1 cm, which is very short. For my third pregnancy, I had a preventative cerclage placed at 14 weeks. A transvaginal cerclage is basically a piece of "string" that is tied in and around the cervix to help hold the baby in to a healthier gestation. I've also had to get progesterone shots, fetal fibronectin testing and loads and loads of transvaginal ultrasounds.

During my research it became clear just how many unknowns and gray areas there are within the world of preterm birth. This is especially true when it comes to conflicting studies on tocolytics — contraction-stopping meds — and cerclages. One study will show a benefit, the next won't. When examining these areas specifically, you have to look at the overall picture and understand each of the issues in order to draw conclusions. Progesterone and steroids, now these are game-changers! They unquestionably have led to a reduction in early birth and to healthier babies.

More pregnancy health tips

High-risk pregnancy
Progesterone recommended in certain high risk pregnancies to help prevent preterm birth
Pre-pregnancy weight is increasing, bringing greater risk

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