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DESCRIPTION
Because of medical advances and availability of alternative therapies, successful pregnancies are possible for women who in the past might not have been able to have children. However, virtually any maternal medical condition can complicate the course of a pregnancy.
A woman with any chronic medical condition should consult with a midwife or health care provider before she becomes pregnant. By doing so, she can be instructed on how to help herself attain the best physical and emotional levels possible, control the symptoms of the disorder, and be prescribed medications or therapies that are least likely to cause any harm to the unborn child.
Information covered in this instructional page is a review of various items you need to consider about a chronic disorder and pregnancy. Understanding, counseling and monitoring of these conditions reduces the impact of the pregnancy on your health and increases the chances of your having a healthy, full-term baby. Being well-informed is especially important because mothers-to-be with chronic disorders face more risks than those that are healthy.
FREQUENT SIGNS & SYMPTOMS
Know the signs and symptoms that can be caused by your disorder. Be able to recognize worsening symptoms. If there are not obvious symptoms (e.g., high blood pressure may only be recognized during a physical examination), find out what you can do to monitor the disorder.
Know the signs and symptoms caused by a pregnancy - fatigue, nausea, lack of appetite, heartburn, frequent urination, tender and swollen breasts, changes in menstrual flow or no period. Often the pregnancy symptoms may duplicate those of the disorder.
CAUSES
Learn and understand the history and cause of your chronic disorder.
Determine if the disorder is hereditary. If so, find out what risks there are to the fetus and what prenatal testing can be done.
Seek genetic counseling if needed.
RISK
Learn what special risks exist for you as far as the pregnancy and delivery are concerned. Learn what special risks may exist for your baby before and/or after the birth.
Determine how the pregnancy will impact on your disorder. Does it worsen the problem, improve it, or have no effect?
Determine how the disorder will impact on the pregnancy and if any special precautions are necessary.
PREVENTIVE MEASURES
What preventive steps can be taken to assure a safe pregnancy and a healthy baby?
Don't smoke, use recreational drugs of any kind or consume alcohol whatever the disorder is.
Make sure your dietary consumption is optimal. If you have a chronic condition with a special diet, make sure you follow your dietary plan carefully. Use dietary and nutritional supplements as instructed by your midwife or health care provider.
EXPECTED OUTCOME
Learn what the chances are for an uncomplicated pregnancy and delivery of a healthy baby.
POSSIBLE COMPLICATIONS
Determine the type of complications that may occur during a pregnancy, risk of miscarriage, risk to the fetus and to the newborn.
TREATMENT
GENERAL MEASURES
Keep all medical appointments and follow your midwife's or health care provider's instructions carefully. Supplemental medical tests may be recommended. The tests help evaluate the status of the disorder, the pregnancy and fetus, and determine the optimum time for delivery.
Your medical care during pregnancy will often involve both your midwife and the health care provider treating the chronic disorder.
Wear a medical alert type bracelet or pendant that identifies your disorder and medications or treatments being used.
The emotional aspects of pregnancy (combined with a chronic disorder) may include fear, guilt, pressure, stress and inadequacy. Seek help and support from family, friends, or counseling.
Avoid people who have colds or other infections. Wash hands frequently. Infections are more likely to occur in pregnant women with a chronic disorder. Seek medical treatment for any infection. Don't try to treat yourself.
Find out what childbirth options you may have and if a normal delivery is possible. You may not be able to have a homebirth, depending upon the chronic condition, its severity and the availability, experience or training your midwife may have, but she may be able to help you find another health care provider that will be able to assist you in having as normal a birth experience as possible and provide important information about nutritional guidelines and emotional support during your pregnancy and during your birth, even if it does have to occur in a hospital setting.
Weeks or months in bed may be necessary. Hospitalization is sometimes required as a precaution during one or more stages of the pregnancy.
Elective early delivery is sometimes the recommendation due to complications or to prevent them. The major concern is that the baby's lungs are developed sufficiently and this can be determined by diagnostic tests. Labor may be induced or a cesarean section performed. As a precaution, the newborn is often placed in an incubator.
MEDICATION
Most chronic disorders require continuous monitoring, medications or therapies to control the symptoms. Some of these medications carry known risks to the fetus while for others, the safety is not established, and for some there is not known risk or the risks are remote. For any medication prescribed, learn the risks and benefits, follow all instructions for proper use, and know its side effects.
ACTIVITY
Expectant mothers with a chronic disorder are often able to exercise throughout the pregnancy. Exercise programs will need to be reviewed with your midwife or health care provider.
For some disorders, limitations on activities may be required.
Always ask your midwife or health care provider before doing any traveling.
In some cases, sexual intercourse will be restricted.
Adequate rest, particularly in the third trimester, is important.
DIET
Eat a well balanced diet. Your midwife may give you some Nutritional Guidelines to follow. If you require a special diet, one will be designed for your needs. Your adherence to your diet is important.
A sensible weight gain is important in any pregnancy, usually 25 to 35 pounds during the 9 months. Don't restrict your diet unless advised to do so by your midwife or a nutritional consultant. Many health care providers do not have the training or knowledge to properly design a nutritional program for an expectant mother. Nutritional supplements may be required to assist you in obtaining optimum nutritional requirements.
You may be nutritionally monitored on your day to day consumption of required foods. If you are lacking in needed nutritional elements, then your midwife will help you with recommendations on how to improve your diet. Changes or alterations to your dietary plan may be made as the pregnancy progresses.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has a chronic disorder and is pregnant or planning a pregnancy and would like additional information.
You want to stop using drugs, stop smoking and/or stop drinking alcohol and need help in coping.
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