high risk pregnancy consultation

[Lorelai-Tries]

Hello, I'm new here. I have some health issues and I'm in my late 30s. I've never been pregnant. I have an appointment on Thursday with a high risk pregnancy specialist.

We are going to discuss the risks for me if I conceive. I'm not ready to have a baby financially, but because of my age I'd like to make an action plan.

Do you have any suggestions for questions I should ask her? Or anything I should read? I have chosen not to talk to any of my friends about it yet. I'm worried that I'll be told I shouldn't attempt a pregnancy.

Also, is this the right section to ask this question?

[MeepyCat]

I don't think that the question really fits here (it seems like more of a TTC question), but it's not a crisis. The mods can move it.

Without knowing what your health issues are, or why you've been referred to the specialist, it's really hard to say what you should ask. Obviously, if you're on any medications, you'll need to know how those would affect a pregnancy (and if you can stay on them while pregnant). You'd want to discuss how your condition is likely to change with age, and how the interaction of age and pregnancy risk might affect your plans.

Lots of doctors are all in favor of women having babies younger, so while you may be told you shouldn't attempt a pregnancy (this doesn't seem like likely advice, but I don't know anything about your health), you may be told that if you want to get pregnant, you should be trying NOW.

[Lorelai-Tries]

Thanks! I have SLE, so I could get really sick with hormonal changes.

I spoke with my family doctor about it, there's one medication I take that I will have to change and it will take a few months to get it out of my system.

[Mosaic]

Moving to TTC for you...

[Steph152]

During my own high risk consultation I learned about the risks of pregnancy for me and the baby due to my health condition and due to my medication. I asked about outcomes for other women in the same situation. Obviously you'll want to find out just HOW high risk you are. I'm not familiar with your particular health condition, but you should probably find out at what point your being sick due to the pregnancy would be considered a threat to you or the baby and how it would be treated. Make sure that any medication you are planning to take during pregnancy would be fine to use while breastfeeding as well. Ask what tests/procedures are recommended above and beyond what one might expect with a "normal" pregnancy. When you go over risks of medication, try to find out what possible effects have actually been proven as well as others that might be anecdotal. Most medications aren't tested much on pregnant women due to ethical concerns. For example, one of my meds had only been in one small study, and it was only found to increase the risk of clefting by a fraction of a percent, but other VERY SIMILAR meds had been shown to increase the risk of neural tube defects. Just some suggestions. Good luck!

[karmab]

with sle, there are risks for you and for a baby, but it's not impossible at all. sle can be tricky, especially if you have the antibodies like the anti-phospholipids and the anti cardiolipin, the ana screen stuff. you are at risk for clotting problems and flares, you'd have an increased m/c and fetal loss risk, baby's sometimes have a heart problem called heart block in utero, which may or may not cause problems for the baby. there's a lot that could happen, or you could have an easy time.

it's hard on a forum like this to try to get into specific medical issues, you do need to talk with a perinatologist. there will be a lot to hear. take heart that a pregnancy is not out of the question if that's what you want, women with sle get pregnant all the time, but you would be high-risk, so you are doing the right thing to think about it ahead of time, go and talk, plan, and weigh the options.

best wishes!!!

[Lorelai-Tries]

Hi, thanks for replies!

Maybe I'm just asking if there's something I should do in my appointment, I've waited so long for it and doctors are always so busy. Is there something you know in retrospect that you wish you'd asked or said at your consult?

My SLE is in remission and I feel pretty good! I like all my specialists so I won't mind keeping up all the communication necessary for a high risk pregnancy.

My mood goes up and down about it, some moments I feel really optimistic that I down I can do this without getting sick or having a sick baby (emergency early c-section is a risk, if I get sick while pregnant) but then other moments I worry that she'll tell me it's not worth the risk. And then other moments I think about how common miscarriage is, even in younger, healthier women. But then I see a cute baby on the subway or cute baby clothes and I'm happy.... you probably know what I'm talking about!

Another concern: telling my guy, if the news is bad. He really wants to have a kid, he's been talking about it since a couple weeks after we got together. But over time he's opened up a bit about the idea of adopting. I'm cool with that too.

[karmab]

the perinatologist will have lots of answers for you, you likely will think of the questions as they explain more about it to you. just as background, i think the chances of having a successful pregnancy with the least risk to you or the baby have to do with whether or not you are in a nice remission period when you do decide to try, whether or not your kidneys are involved, and what specific antibodies you have, because different ones have different effects. they might suggest blood work or tests, and then talk to you about the results again after that is done maybe? being in remission is big. take good care of yourself!!! i'll be thinking of you!

[Lorelai-Tries]

I do have kidney involvement, it's been really bad a few times but nothing serious since 2004. I've been trying to be extra-good to my body, in hopes of having fantastic results when she orders all the blood tests.

I hope the doctor is nice, I've been waiting so long to see her and I will probably start crying. All my doctors have been kind when the topic came up, they just keep affirming that I have to plan my pregnancy and keep up the good communication with all of them.

[karmab]

my fingers are crossed for you. things are a lot more optimistic these days than they used to be. the specialists have gotten real good at managing all kinds of high-risk situations, including sle. you will come to the right decision for you, im sure!