What is a High-Risk Pregnancy?

A high-risk pregnancy is a pregnancy where there are increased health risks for the fetus, the pregnant individual, or both. High-risk pregnancies may indicate the need for increased prenatal care visits or linking with an obstetrics team of maternal-fetal medicine specialists (MFM) or other high-risk providers. About 50,000 people in the United States experience severe pregnancy complications each year. Women of color and Black women are three times more likely to die from pregnancy-related complications than White women. 

Factors Impacting High-Risk Pregnancies

Factors that may make a pregnancy high-risk include:

• Pre-existing health conditions

• Pregnancy-related health conditions

• Lifestyle factors

• Maternal Age

• Medical Discrimination

• Twin Pregnancies

• Family History

• Perinatal Mood and Anxiety Disorders

I am High-Risk; What Does This Mean for My Pregnancy and Delivery?

Studies have found that women who have high-risk pregnancies, requiring inpatient antepartum hospitalizations experience increased depression, anxiety, and isolation–often separated from family and older children. You may experience depression or anxiety due to a high-risk pregnancy. Support and treatment must consider the high-risk context in order to be effective. 

Having a high-risk pregnancy does not necessarily mean you will have a complicated delivery. Many people can experience healthy pregnancies and labor and deliveries despite having special health needs. Nonetheless, a high-risk pregnancy can bring unexpected challenges causing complex emotions related to your and your baby’s health. 

Nurture Therapy seeks to provide a safe environment to access and support the vulnerability felt during this time. Our clinicians are trained Perinatal Mental Health Therapists that are committed to your emotional well-being, as well as being a consistent source of support from pregnancy through your post-partum experience. If you or someone you know was diagnosed with a high-risk pregnancy and experiencing emotional distress, help is available. Call or email to find out more. 

Depression and Anxiety

Depression during pregnancy has been linked with preterm labor and low fetal birth weight. If you are feeling overwhelmed by anxiety and stress or low mood, you may be experiencing depression or anxiety. Symptoms of anxiety and depression during a medically complicated pregnancy or patient bedrest can be different than other symptoms of depression.

SYMPTOMS OF DEPRESSION AND ANXIETY:

• Fear

• Guilt

• Irritation

• Not feeling connected or bonded to the baby

• Doubting you can get through this

• Anger

• Self-blame

• Loneliness and isolation

• Distrust of medical providers

• Hopelessness

If you or someone you know is experiencing these symptoms, help is available. Call or email to find out more. 

Expert Support and Practical Guidance

Nurture Therapy’s team of experts provides clients with coping strategies with practical, solution-focused support that is in line with the complexities of your particular high-risk pregnancy. The goal is to quiet anxiety and calm your mind so that you can function, as best you can, during this high-stress time. Sometimes the goal is getting you through the moment (How can we make this moment more manageable?) vs. getting you through the entirety of the pregnancy as uncertainty and unpredictability about the future can cause fear, anxiety, loss of control, and depression.

Further, learning coping tools such as progressive muscle relaxation, 360-breathing, and mindfulness to manage somatic symptoms of anxiety, can help decrease your heart rate, high blood pressure, and racing thoughts during medical appointments so that you don’t get false readings of high blood pressure. 

Our providers are your experts and your advocates. They can help you to manage emotions for new or existing diagnoses, support you through your options and decisions, foster a sense of empowerment while you navigate the healthcare system, process heavy and complex emotions related to a high-risk situation, develop effective coping strategies, find your voice as an expectant or new parent, and work through birth trauma.

If you or someone you know is experiencing a medically complex or high-risk pregnancy, help is available. Call or email to find out more. 

PTSD and Birth Trauma

An estimated 1 and 3 individuals leave a birthing experience with trauma. Trauma is defined as a deeply distressing or disturbing experience, often when you feel like your life or the life of a loved one is threatened or in danger. Birth trauma can happen due to a loss of control and sense of your body. Trauma is in the eye of the beholder, which means that only the birthing individual can declare what feels traumatic for them. Examples of traumatic events during birth:

• Difficult labor with a long and painful delivery

• An unplanned cesarean section

• Emergency treatment

• Maternal life or baby’s life is threatened

• Baby’s NICU stay

• Shocking, unexpected, and traumatic experiences during birth 

What not to say to someone after a traumatic birth

Often well-meaning family and loved ones will make you feel like having a new baby makes up for any traumatic experience. They may say, “At least you have a healthy baby”— as if the end justifies the means. They may also believe that if you enjoy parenthood you will forget about a traumatic birth. But this simply isn’t true.

At Nurture Therapy, we believe that we can hold both things at the same time. So, you can experience a traumatic birth and have a healthy baby. A birthing person may be healing from trauma and enjoying parenthood. It is okay to feel disappointed that childbirth was not the experience that you were hoping for. It is also okay to feel angry with medical staff if you felt that the delivery was not handled well AND you can still be a loving, great parent.

Traumatic experiences can have a negative effect on your relationship with your baby and the people around you. It may make you distrust the medical profession and be hesitant to seek care related to your health. Your past experience may make you feel anxious about any future pregnancies or delivery. Trauma is treatable, and it is important to be able to recognize the signs of trauma. Call or email to find out more. 

Signs and Symptoms of Trauma

Unlike other events someone may have experienced, birth trauma may not include a cohesive story. Often times this type of trauma is visceral, meaning that a certain sound, smell, or sensation can bring you back to that paralyzing moment.

RE-LIVING ASPECTS OF THE TRAUMA

• Flashbacks

• Feeling as though you are reliving the traumatic moment

• Intrusive thoughts

• Repetitive intrusive images

• Nightmares

• Intense distress

• Constant reminders of the trauma

• Physical sensations, such as pain, sweating, nausea, shaking

HYPERVIGILANCE

• Alertness or feeling on edge

• Panic symptoms when reminded of the event

• Easily upset

• Irritability

• Extreme alertness

• Difficulty sleeping

• Aggressive behavior

• Difficulty concentrating

• Easily startled

• Self-destructive

• Anxiety and panic

AVOIDANCE

• Avoiding situations that remind you of the trauma

• Feeling numb

• Feeling cut off from feelings

• Detachment from your body

• Dissociations

• Using drugs or alcohol to avoid painful memories

DIFFICULT BELIEFS AND FEELINGS

• Distrust of the medical system

• Distrust of loved ones

• Not feeling safe

• Feeling like no one understands

• Negative cognitions or beliefs about self

• Self-blame

• Taking on responsibility

• Overwhelming feelings of anger, sadness, guilt, or shame

If you or someone you know is experiencing the above symptoms of trauma, help is available. Call or email to find out more. 

When do I need professional help?

Of course, it is natural and expected for you to feel fearful with a medically complicated pregnancy or anxious and sad after a traumatic birth. These feelings can be uncomfortable. If you are feeling stuck in your sadness, anxiety, grief, anger, or guilt therapy can help. Ask yourself these questions:

• Have you been consumed with fear, worry, or anxiety?

• Are your emotional experiences interfering with your ability to work, take care of yourself or your other children, or engage in basic self-care?

• Are you having frequent and intrusive flashbacks or nightmares about the delivery?

• Do you have any intent to act on suicidal thoughts or do you plan to harm yourself?

• Are you engaging in any other self-destructive acts?

How can therapy help me?

Therapy provides the space to help you get through your sadness and other intense feelings. As a therapist, we will guide you through this time in a way that feels safe and effective.

• Helping you to heal faster

• Regaining control of your emotions

• Preparing for triggers that may elicit PTSD

• Encouraging communication with your partner to support each

• Ensuring that your relationship survives by understanding and unification

• Feeling like yourself again

• Promoting hope and confidence to experience another pregnancy one day, should you desire

Trauma Healing and Treatment

Living with the effects of a traumatic birth can feel very challenging, especially during early parenting. Here are some ways that you can help yourself.

KNOW YOUR TRIGGERS

You might find that certain experiences, situations, or people seem to trigger flashbacks or other trauma symptoms. Often with birth trauma, it may be an image, sound, or smell that brings you back to the traumatic moment or event. Other times significant dates may be triggering, like the anniversary of a traumatic experience, such as a child's birthday.

TELL SOMEONE

If you experienced a trauma or you are having postpartum PTSD symptoms, it may be hard to open up or trust others. This may be because you feel unable to talk about what has happened to you. You don't need to be able to describe the trauma to tell someone how you are currently feeling. It can be helpful to talk to a partner, family member, friend, therapist, or another support person so that you feel less alone.

TIME CAN BE HEALING

Everyone has their own response to trauma and it's important to take things at your own pace. It may not be helpful to talk about your experiences before you feel ready. If this is the case, talk to someone about coping skills to help decrease trauma symptoms before talking about the actual trauma.

PEER SUPPORT

It can be so comforting to know that you are not alone. When everyone is talking about healthy pregnancies or happy delivery experiences, you might feel alone and isolated. Talking to a peer with a similar experience or story can be very helpful and healing. Consider sharing your story with a close friend or confident—you may be surprised by what you learn. Or find group support to help process and heal from trauma.