Being told that your pregnancy is considered “high risk” can be one of the most stressful moments in a woman’s life. Almost immediately, images of every worst-case outcome come to mind, and a sense of dread can descend like a dark cloud.
Getting through a pregnancy with any degree of complication requires that you quell such images as best you can and surround yourself with a steadfast support system. Arming yourself with knowledge about your pregnancy—a valuable tool, both practically and emotionally—is possible only by forging a relationship with a skilled and compassionate medical team.
Maternal-fetal medicine specialists are at the forefront of innovation in high-risk pregnancy care. These specialists have completed advanced training on the treatment of high-risk pregnancies—those in which the mother has a chronic health condition, there is an abnormality of the fetus, or unexpected complications arise during pregnancy or childbirth. The specialists work in tandem with your delivering OBGYN to ensure he or she has all the important information they need for you to have a smooth pregnancy.
One such physician is Nathan Fox, MD, at Englewood Health. “Pregnancies can be classified as high risk for any number of reasons,” says Dr. Fox “You may be expecting twins, you may be of advanced maternal age, you may have pregestational diabetes, or you may have developed preeclampsia during pregnancy.”
Regardless of your particular situation, you can find solace in knowing that there are specialists right here in your own backyard who can work with your care team to help achieve the best possible outcome for your pregnancy.
“High-risk pregnancies can be stressful and scary for both mothers and families,” says Dr. Fox. “My main focus is reassuring everyone and providing care that results in positive outcomes.”
According to Dr. Fox, the field of pregnancy care has exploded in the best possible way—beginning with physicians’ increased ability to detect fetal issues through imaging and blood testing.
“If an issue with the fetus is detected, we are able to monitor the fetus before birth, perform certain procedures if necessary, and craft the best possible birth plan for that individual pregnancy,” Dr. Fox says.
Andrei Rebarber, MD, a colleague of Dr. Fox at Englewood Health, recalls that when he was in medical school back in 1989, the field of maternal-fetal medicine was still new, having earned its subspecialty certification in 1977—a time when only about 10 physicians in America were practicing it.
“I was lucky to be able to do a rotation in maternal-fetal medicine at that time, and I saw some amazing cases. One, in particular, stuck with me: a fetal blood transfusion on a baby who was anemic. I remember thinking it miraculous that you could transfuse and save a baby in utero, and I was immediately hooked,” Dr. Rebarber says.
“We recommend that women with chronic health conditions like lupus, diabetes, and chronic hypertension ask their OBGYNs for a referral for a preconception consultation with us, so we can review their medical history, get them on a folic acid regimen, and optimize their health so as to minimize risk during pregnancy,” Dr. Rebarber says.
Women with chronic health conditions may require more frequent appointments with their pregnancy care providers during gestation. Those with diabetes, for example, are at higher risk for structural birth defects in pregnancy and may find that the daily growth of their fetus makes their sugar levels erratic. For this reason, regular appointments to track sugar levels, adjust dosages, and monitor the fetus may be recommended.
At Englewood Health, Dr. Fox and Dr. Rebarber work alongside nutritionists, endocrinologists, genetic counselors, and a team of other specialists to promote the well-being of mothers-to-be with chronic health conditions, and to perform comprehensive testing on all women who are interested in learning more about their pregnancy.
“Today, prenatal testing can be done earlier in gestation than ever before—blood tests can measure hormone levels in the placenta during the first trimester to identify conditions such as Down syndrome. At 10–12 weeks, we can do a procedure called chorionic villus sampling to detect birth defects and a wide array of genetic diseases that are age dependent. We also have enhanced genetic analysis that detects genetic syndromes that are not age dependent,” says Dr. Rebarber.
The American College of Obstetricians and Gynecologists currently recommends that all women be offered the option of noninvasive testing (blood tests and ultrasounds), as well as the option of invasive testing (chorionic villus sampling and amniocentesis), during pregnancy—all of which can be done at Englewood Health.
“We prioritize building relationships and connecting with our patients,” says Dr. Fox. “We find that when our patients have good reason to trust us, they are calmer throughout the whole pregnancy. We are there both to help improve outcomes for women and their babies, and also to support them if and when complications arise.”
Dr. Fox emphasizes that maternal-fetal medicine specialists are also the experts in ultrasound for all pregnancies, both high- and low-risk. So all mothers-to-be can take comfort in knowing they will likely interact with these specialists as familiar faces during their pregnancies, even if only for routine ultrasounds.
Whether you’re a woman who knows her risk factors and wants to get pregnant, an otherwise healthy woman who is having an unexpectedly complicated pregnancy, or a woman who is just interested in learning more about her pregnancy, a consultation with a maternal-fetal medicine specialist is a great way to prepare yourself with the information you need to make the best choices for yourself and your pregnancy.