Guiding High-Risk Pregnancy Care: Questions to ask your Consultant
In this blog post I explain what a high risk pregnancy is and give you some pointers for questions you might want to consider when going in to your consultant antenatal appointments!
Bringing new life in to the world is an amazing journey, filled with excitement and joy, however for some expectant mothers, the path to motherhood can be full of complexities and uncertainties.
If this is you (I imagine you wouldn’t be reading this post if it wasn’t), then I’m standing in solidarity with you! At 29 weeks pregnant on my second baby I was diagnosed with Gestational Diabetes, earning myself that heavy title of ‘high risk pregnancy’. This label comes with worry, uncertainty, stigma and what feels like a tonne of restrictions!
During my high risk pregnancy, I researched my ass off, informing myself of everything to do with my condition and importantly, everything that would be possible for my upcoming birth.
Before I go any further, let’s briefly chat about what a high risk pregnancy is.
The NICE guidelines state that a pregnancy is ‘high risk’ when the likelihood of an adverse outcome for the woman or the baby is greater than that of the ‘normal population’.
It’s important to distinguish that there IS a difference between a high risk pregnancy and a high risk labour or birth. Someone having a high risk pregnancy doesn’t necessarily mean that the risk of adverse outcomes is high for labour itself - this all depends on your individual circumstances! You can read more about high risk pregnancy in detail here: 1 (nice.org.uk)
When you have a high-risk pregnancy, you’ll be under consultant-led care and will have more antenatal appointments than someone who doesn’t have a high risk pregnancy. These appointments can be anxiety provoking! Not only is there worry over whether you and baby continue to progress well through pregnancy, but there’s also anxiety around what a high-risk pregnancy means for your birth.
I planned a home-birth with a high risk pregnancy which you can read about by clicking below!
Planning a home birth with a high risk pregnancy
Like I said, I did tonnes of research in to my condition and figured out all of the questions I needed to ask my consultant at my appointments that would allow me to make a fully informed decision about where and how I wanted to give birth.
You may not have gestational diabetes however these questions can be adapted for all high risk pregnancies as the theme is kind of the same!
Questions I asked my consultant at my high risk pregnancy antenatal appointments
What are the comparative risks associated with my pregnancy?
Asking for the comparative risks gives you an idea of how much bigger the risk is for you vs someone who didn’t have a high risk pregnancy. Sometimes consultant might use language like “the risk of x happening doubles in your condition”. However if the original risk was 0.1%, doubling this might actually not be something you consider a huge risk, so it’s important to get figures!
Does my high-risk pregnancy automatically mean a high-risk birth?
Remember that this isn’t always the case and there are still decisions you are able to make about how you give birth.
Are the recommendations you’re giving based on information you have on ME and MY high risk pregnancy? Or is this a generalised rule that applies to all women with (...e.g gestational diabetes)
Be mindful that often Consultant Obstetricians are often following hospital policies that will give a general rule for a particular type of pregnancy. Despite this, the NICE guidelines still advise maternity professionals to make decisions based on individual circumstances!
What are my options for birth?
Even if you’ve already been told you need to be induced at 38 weeks, ask the question. There are ALWAYS options, even if you haven’t been given them. Sadly if you don’t ask the right questions, you don’t get given all the information. You will have options available to you for places to give birth, whether to accept intervention, whether to wait for spontaneous labour etc etc. It’s really important that your consultant gives you this information in an unbiased way AND supports you in coming to your own, informed decision! If you are feeling pressured or coerced, speak to your community or consultant midwife for support. Mine were amazing!
A great resource for weighing up pros and cons of intervention is Dr Sara Wickham - ... information, inspiration and illumination for midwives, birth folk, women and families ... and any of her books!
I used her book ‘Inducing Labour: Making informed Decisions’ to help me make decisions in my pregnancy. Highly recommend!
5. How are you going to support me to have the birth I am aiming for?
I’m not saying that you should plan a certain type of birth and stick to it, but it’s important that you are given the opportunity to explore all of your options and that you can have as many elements of your ideal birth as possible!
A Bonus tip
Not a question, but my number one tip for going in to a consultant appointment is to trust your instincts! If you leave feeling disappointed or that you wish you had asked a follow up question, write it down and take it to your next appointment, or take it to your community midwife in between appointments. If something isn’t sitting right with you then don’t be afraid to speak up about it.
If you’re ready to get stuck in to a full hypnobirthing course with me then I would love to support you! I have a special interest in high risk pregnancy as it’s so personal to me - reach out if you want to chat about course options or click below to see what’s included.
Han xx
Resources: About AIMS | AIMS
Birthrights - your human rights during pregnancy and maternity