Would I be considered a high risk?

Hubby and I have now finally decided to try to conceive, but I'm concerned whether I would be considered a high risk pregnancy and what that really might mean. I won't deny at the age of 35, I am woefully lacking in knowledge about pregnancy and child birth and everything afterwards. And my body is not necessarily in the greatest of shapes.

I'm about 80lbs overweight, I have Poly Cystic Ovarian Syndrome, Multiple Sclerosis, and a high potential for developing diabetes (it runs in my paternal family). Would any of these conditions make me a high risk pregnancy, and if so, what does that mean? I don't deny I don't really understand how the midwife system works here, or when you get sent to a specialist doctor instead? What kinds of tests are available (I worry about down syndrome due to my & hubby's age) and when and are they covered by NHS?

Can anyone recommend a good reference that could help me understand not only the physical changes my body would be going through, but explain how the birthing system in the UK would work?

Oh, and before getting pregnant, should I try to get updated on my vaccinations? I haven't had any vaccs probably since high school.

I was considered a high risk pregnancy, though not for any of the reasons you listed (although I would guess that you would be treated as such as well).

All that it meant for me was a few extra appointments at the hospital with some consultants, just 2 or 3 extra, I think. Which was a bit of a pain I guess but really was just a lot of waiting around and some extra prodding.

It also meant that when I went into labour I was constantly monitored (which I hated!) and had a midwife (and student) in the room with me the whole time, which I honestly appreciated. It was nice to have *someone* there who knew what exactly was going on

If I were you I would probably go discuss with your GP, especially considering the PCOS. Ask for advice regarding vaccinations, your risk factors, etc.

Good luck to you!

The NHS actually has some useful information.  Check out the following links:

Planning for Pregnancy

Pregnancy with Existing Health problems

Pregnancy after 35

Pre Pregnancy Checkup

You'd be classed as high risk given the problems you have or could have. There's basically a checklist and the more boxes ticked, the higher your risk.

What that means is you'd be seeing both a midwife for normal checkups, and then seeing a specialist to discuss the things specific to your health conditions -- the possibility of gestational diabetes, etc. -- and make your plans for birth with them. The specialist track of care just means more visits -- you see the midwife and the consultant, not one or the other.

As far as antenatal tests go, there are tests for Down's offered at 12 weeks - a triple or quadruple-screen blood test combined with a diagnostic ultrasound - and a detailed anatomy scan around 20 weeks. This is all pretty standard and yes, they are all covered by the NHS. If these checks produce a positive result you are offered more testing -- again, yes, on the NHS -- to get a clearer diagnosis.

Get a copy of Pregnancy for Dummies (UK edition). It explains things very clearly, not only from a physical perspective but also from a care perspective. My friend gave me a copy a few years ago and it was invaluable.

Thanks for the links and the information. It makes me feel fairly stupid that I really know so little about something that's fundamental to being a woman! Having come from a small family, I just haven't been around that many pregnant women, or babies for that matter!  Let's just say, I wasn't the teen that did any babysitting.

I'm working on losing the weight, so I can only hope I can lose some of it before I (hopefully) conceive.

The Down's risk is only more significant after 40. 35 is not really considered old for conceiving anymore. I'm 33 and spoke to a specialist because I wanted to know what I'd be in for as I'm high risk, and he said that they wouldn't really start considering me an 'older mother' until 38+. Even the fertility stats that are used are actually based on 300-year-old indirect data (http://www.bbc.co.uk/news/magazine-24128176), and fertility doesn't start dropping off sharply until 40 as well. I would imagine that your MS will make you high risk, but as Gwen said, it mostly means more appointments, and I was told that I wouldn't be allowed to try for a home birth (not that I wanted one!).

If your GP will give it to you, you might want to get your MMR vaccine again. It's one that can wear off over time. I was being seen at a fertility center before conceiving my first and they tested me for that. I was in the "gray area", so i had to get the vaccine again. It's a live vaccine, so once you get it you have to wait one month before trying to conceive, so it's no big deal, but it can delay things. You can't get the vaccine once you are pregnant and it can be quite serious if you contract German measles while pregnant.

I wouldn't worry about your age too much. I was 37 when i had my first and i'll be 39 when i deliver my second and i've never been high risk. Your MS and the potential for diabetes would probably bump you into that catergory. It just means you're more closely monitored.

MS often goes into remission during pregnancy, so that is good.

I'm 37, by a few weeks, and wasn't high risk, but it is my only complication.

As others have said, you would be classed as high risk and would be put under consultant care along with the standard midwife care.

I was high risk for all sorts of reasons -- high BMI and bipolar were the first ones flagged, but as the pregnancy went on I would have been referred anyway because of low platelet count.

What this meant in real terms is that I had an extra appointment each month with an OB (which made it feel a bit more doctor-y in an American way, if that makes sense), and a few growth scans. Those were awesome, as it meant more chances to see the baby before he got here.

The down side of it was more blood being drawn (thanks to the platelets, and the glucose tolerance test was a must because of my BMI). I wasn't eligible to give birth at home or at a birthing centre (this didn't actually bother me, as I wanted to be in the main labour ward anyway, and ended up having an induction and emergency c-section).

I think compared to the low risk pregnancies, having a high risk here gives you more of the care you'd expect in the US, only all wonderfully covered by the NHS!!!

Hi Bookgirl,

I'm aware that often MS will calm down during pregnancy, but not always. I don't think there are official stats about this situation. However, it is also pretty common for MS to flare after giving birth, which is what I'm also pretty worried about - since we don't have much of a support base here. I don't know how we'd handle it if I couldn't take care of myself, much less a newborn!

BGL, you might find the Disabled Parents Network a source of support:

http://disabledparentsnetwork.org.uk/

What's your immigration status? Do you have ILR or know when you are entitled to apply?

I have ILE, so I'm a Perm Resident. Do I need to have that status for a particular reason?

I have ILE, so I'm a Perm Resident. Do I need to have that status for a particular reason?

Though not a parent myself, I ask as I am a disabled social worker in the disability field and my MA thesis in Disability Studies centred the experience of services for pregnant disabled parents or soon-to-be parents. So both a personal and professional interest to ensure disabled people have access to knowledge about what may be available to them.

If you have indefinite leave to enter and there is no restrictions on you, such as no recourse to public funds, then you should likely be eligible as a disabled person to request a community care assessment by a social worker for direct payments / self-directed support, to see if you are eligible for services from the council. If you are, you can get cash in lieu of services to pay for those services.

You may also wish to consider an occupational therapy assessment from your council to determine if you need any aids and adaptations to improve access to your home.

Both are likely to be subject to a financial assessment.

These assessments are regarding your daily living needs and how your conditions impact you.  

Community Care Information
http://www.nhs.uk/CarersDirect/guide/assessments/Pages/Communitycareassessments.aspx

Occupational Therapy Assessment
http://www.nhs.uk/Conditions/occupational-therapy/Pages/accessing-occupational-therapy.aspx

Find your local authority:
http://local.direct.gov.uk/LDGRedirect/Start.do?mode=1

For independent disability advice:

DIAL Network
http://www.scope.org.uk/dial

Disabled Living Centres:
http://www.ms-uk.org/choicesdlc

Condition specific support:
http://www.mssociety.org.uk/ms-support/practical-and-financial-help/care/social-care

Hope that helps and congrats, BTW!  

ETA: Where are you based? May be able to give you more specific information - PM, if you'd prefer.  

ETA2: You might be interested in http://dppi.org.uk/

DPPI publishes information and stories that draw attention to the concerns of disabled parents and to relevant sources of information. We stimulate debate about parenting issues and promote the expertise of disabled parents.

And parenting articles here:
http://disability-studies.leeds.ac.uk/library/