Like most journeys in life, the pregnancy road is not always a smooth passage.
Pregnancy complications that affect your health or your baby’s health are a possibility.
The more you know what to expect ahead of time, the more equipped you will be to manage what comes your way.
And none of this info is here to freak you out.
Healthcare professionals have a good understanding of the many challenges that can arise during pregnancy.
Your team will monitor your pregnancy and provide appropriate treatments to keep you and your baby safe.
Your first prenatal check is vital.
When you’re about eight weeks pregnant, your doctor needs to have some in-depth time with you to establish a baseline understanding of you and your body and ensure everything is on track for a successful pregnancy.
As is well explained by the American Pregnancy Association, you’ll be asked about your medical history, discuss all the factors surrounding your pregnancy, and have a complete OBGYN exam.
By creating this partnership with your OBGYN, you’ll be more than equipped to manage your pregnancy as it progresses.
Once all the assessments are done, possible complications may be highlighted, and you’ll be advised on how to manage them.
With all that in mind, let’s look at the most common pregnancy complications, as well as why doctors may want to monitor some pregnancies a little more closely.
In this article: 📝
- What is a high-risk pregnancy?
- What are early signs of complications in pregnancy?
- Unusual pregnancies
- What are some common complications of pregnancy?
- Postpartum complications
- Pregnancy complications: The bottom line
What is a high-risk pregnancy?
It can be quite alarming to be told that you’re having a high-risk pregnancy ‒ or even just to think of the possibility.
But what this really means is that there is a chance that you or your baby could experience some complications.
This is usually because of a range of often overlapping factors, both physical and psychological.
Identifying any risks early means you can get the care you need as your pregnancy progresses.
Here are some common risk factors doctors check for:
- Age, specifically being under 17 or over 35
- First-time pregnancy or over five pregnancies
- Weight ‒ being either underweight or overweight
- Being pregnant with multiples
- Medical Conditions, including diabetes, high blood pressure, blood clotting disorders, epilepsy, cancer, and depression
- Complications in a previous pregnancy or a family history of complex pregnancies
- Substance abuse issues
- Abnormal amounts of stress
- Preexisting gynecological conditions, like uterine fibroids or having had uterine surgery
- Prior complications in pregnancy, like premature delivery, emergency C-sections, blood type incompatibility, or placental abruption (where the placenta pulls away from where it’s attached to the uterus)
- Having had in vitro fertilization (IVF) or intrauterine insemination (IUI), in a previous or this pregnancy
What are early signs of complications in pregnancy?
If you notice any of the following signs, it’s important to seek medical care as soon as possible:
- Vaginal bleeding
- Severe abdominal pain
- Difficulty breathing
- Severe headaches
- Blurred vision
- Swelling in your fingers, face, or legs
You may not identify with any of these symptoms ‒ if you are even just feeling off, check in with your doctor.
They’ll be able to assess where you’re at and, if necessary, get you the treatment you need sooner rather than later.
Before we talk about common pregnancy complications, let us look at some types of pregnancies that are not able to continue ‒ again, not to terrify you, but so that you can get the help you need if you need it.
A molar pregnancy is a very rare pregnancy complication that involves the unusual growth of trophoblasts (cells that nourish the embryo).
This can happen to anyone.
There are two types.
The first is called a complete molar pregnancy.
An empty egg (one that doesn’t contain any chromosomes, which are DNA molecules that carry your genes) is fertilized by sperm and starts to duplicate.
This all results in an overgrowth of a bunch of cells rather than an actual embryo forming.
The second type is known as a partial molar pregnancy, where an egg is fertilized by two sperms, meaning there are too many chromosomes from the father’s side.
This is not as severe as a complete molar pregnancy, but the pregnancy is still unable to continue.
This unusual tissue grows inside the uterus and has dangerous consequences for the mother.
If you are regular with your visits to your doctor, it will be picked up, and you will undergo treatment to remove the tissue.
It is important to ensure everything is removed so that you don’t have further complications, either at the time or later on.
Signs of a molar pregnancy include:
- Vaginal bleeding
- Vaginal discharge that is shaped like grapes
- An enlarged uterus and feelings of discomfort in your pelvic area and abdomen
- Severe nausea and vomiting
- Feeling anxious, exhausted, and sweating a lot
- A fast or irregular heartbeat
Many of these signs are typical of pregnancy in general, so they don’t mean for sure that anything’s up.
But it’s always best to check and stay consistent with your visits to the doctor.
Sadly, a molar pregnancy means that even though an egg was fertilized, you don’t have a baby growing inside you.
The feelings of loss can be great if this happens, and it’s totally normal (and necessary) to grieve.
(Psst. There’s a whole Peanut community navigating similar issues. There is support available. You don’t have to do this alone.)
An ectopic pregnancy happens when an embryo attaches itself outside the uterus.
It happens in about 1 to 2% of pregnancies.
Most ectopic pregnancies occur in the fallopian tubes.
Regardless of where it occurs, an ectopic pregnancy is considered a medical emergency.
It is an extremely dangerous situation for the mother because only the uterus can accommodate a growing baby.
If this is a stable (meaning the mother is not experiencing any distress) ectopic pregnancy, medication can be administered to initiate an abortion.
But for an unstable (meaning the mama is in grave danger) ectopic pregnancy, you may have to face surgery to resolve the situation.
Ultimately, this is a tough situation ‒ and you are 100% allowed to feel all the things you feel about that.
The difficulty here is that it’s not always possible to tell if your pregnancy is ectopic because, apart from the location, it is a normal pregnancy.
But if you continue your routine visits with your OBGYN, it will be picked up with an ultrasound and some other key tests.
Be aware of these warning signals:
- Vaginal bleeding
- Brown, watery vaginal discharge (Read more about your vaginal health during pregnancy here.)
- Pain in your pelvic area and lower abdomen ‒ you might feel cramps after sex
- Pain in the tip of your shoulder (this is called referred pain)
- Dizziness and fainting
- Any pain when going to the bathroom
What are some common complications of pregnancy?
As your pregnancy progresses, there are many common pregnancy complications you should be aware of.
Problems with the placenta or amniotic fluid
The placenta is the connection between you and your baby.
It is responsible for delivering nutrients to your baby as they grow.
When there are complications with the placenta, you and your baby may have challenges.
We’ll take you through them the possibilities.
In about one in 200 pregnancies, the placenta is low in the uterus, covering some or all of the cervix (the bridge between the vagina and the uterus.)
This means it is at great risk of tearing away from the uterus, which can cause serious bleeding (hemorrhaging), initiate preterm delivery, and hinder the flow of nutrients to your baby.
The most common symptom of placenta previa is bright red vaginal bleeding.
So it’s really important to get medical attention as soon as possible if you experience this.
If you have placenta previa, you may have to be hospitalized or placed on bed rest.
In some cases, you may have to have an early delivery to keep you and your baby safe.
Here, the placenta separates from the inner wall of the uterus before it’s time for your baby to be born.
Like placenta previa, it can lead to your baby not getting the oxygen and nutrition they need.
The tear from the uterus causes heavy bleeding, which you may experience as vaginal bleeding, or the blood may get caught between the placenta and the uterine wall.
Either way, this is severe for both you and your baby.
If you feel intense abdominal and back pain, even with no vaginal bleeding, seek professional healthcare immediately.
You might also experience contractions that come quickly, one after the other.
This is a serious condition that leads to severe blood loss and further complications down the line.
It happens when the placenta grows through part or all of the thick muscular wall of the uterus.
This becomes a medical emergency because the placenta is supposed to detach from the uterus once you’ve given birth.
Unfortunately, you likely wouldn’t know that this has happened until delivery.
Your OBGYN team will be able to assess this when they check that all the placenta has been removed after your baby has come out.
Amniotic fluid complications
The amniotic fluid is the magical liquid inside the amniotic sac.
It does all sorts of things, including cushioning your baby and protecting the umbilical cord from getting squashed.
When assessing amniotic fluid, your doctor can see if your baby is peeing enough, which reflects your baby’s well-being.
Sometimes, there is too much amniotic fluid (a condition called polyhydramnios) or too little (oligohydramnios).
Both of these can cause serious complications.
Polyhydramnios can lead to:
- Your baby not growing enough
- Teratogenic birth differences (physical malformations)
- The umbilical cord sinking through your cervix
- Tour baby being in the wrong position
- Uterine contractions (before it’s time)
- Preterm labor
While the symptoms won’t be the same for everyone, if you have polyhydramnios, your uterus may grow very quickly, causing considerable pain and discomfort in your abdominal area.
Your medical team will treat you based on the underlying cause, and in extreme cases, they may need to drain some fluid.
Oligohydramnios has many causes. The most common are:
- Issues with your baby’s kidney development
- Intrauterine infections
- Twin-to-twin transfusion syndrome (where there isn’t equal blood flow between twins that share a placenta)
- Placental insufficiency
- Post-term pregnancies
- Premature rupture of the membranes (where the amniotic sac breaks open before labor begins)
Hypertension pregnancy disorder
Hypertension, or high blood pressure (≥ 140/90 mmHg), is defined as your blood vessels being under long-term raised pressure because of the force of blood flowing through them.
Your blood pressure will always be measured at least twice, four hours apart, before you are given a diagnosis of hypertension.
In a nutshell, hypertension gives medical professionals room for concern in pregnancy because it can lead to all types of complications which put both you and your baby in danger.
So it’s really important that these conditions are closely monitored and managed by your doctor.
We’ve outlined the three main types of hypertension pregnancy disorders here.
This means you are diagnosed with hypertension either before you fall pregnant or in the first 20 weeks of pregnancy.
Management of this includes lifestyle changes and antihypertensive medications.
Throughout your pregnancy, you will be monitored to see that the medications are keeping your blood pressure within a good range and that there is no protein in your urine.
This is the most common form of hypertension in pregnancy.
It occurs after 20 weeks gestation in mamas-to-be that don’t have a previous history of hypertension.
The good news is that it goes away by three months postpartum.
Your blood pressure will be measured weekly to monitor you for any signs of preeclampsia (more on this below).
If lifestyle changes aren’t enough to manage your gestational hypertension, you may be put on medication until it is resolved.
Also, you will be advised to deliver earlier but not prematurely.
Preeclampsia is a serious medical condition where existing or new-onset hypertension starts causing distress for both you and your baby.
There are typically high levels of protein in your urine which is a clear indicator of kidney damage.
You will need urgent treatment and close monitoring.
If the diagnosis is preeclampsia with severe features (previously called severe preeclampsia), your doctor will recommend that you deliver your baby once the condition is stabilized.
Signs of preeclampsia include:
- Swelling in the hands and face
- Stomach pain
- Dizziness and headaches
- Blurred vision
- Heart racing
With preeclampsia, they’ll monitor your baby very closely.
And any distress is a signal for immediate delivery, regardless of how far along you are in your pregnancy.
Scary stuff, but it is good to know you will be carefully observed so that the condition can be managed.
HELLP stands for hemolysis, elevated liver enzymes, and low platelets.
This syndrome is considered an emergency as it can cause severe blood and liver issues.
Preeclampsia often progresses to this condition, although you may not have hypertension and protein in your urine with HELLP.
Eclampsia is a hypertensive pregnancy disorder where you start having new-onset seizures unrelated to previous health issues.
You may not even have protein in your urine.
The only solution is to terminate the pregnancy once the seizures have been controlled.
The good news is that by adhering to your routine prenatal visits and monitoring your hypertension closely, you should hopefully be able to avoid these urgent hypertensive emergencies.
Basically, this is diabetes that develops during pregnancy in people who don’t otherwise have diabetes.
According to the American Diabetes Association, gestational diabetes occurs in almost 10% of pregnancies in the United States.
It happens when your body has trouble processing sugar, which may affect your health but definitely has huge consequences for your baby’s health.
Luckily, there’s a lot that you can do to manage it, including diet, exercise, and (in some cases) medication.
And it often goes away after delivery.
(You may just have a higher risk of developing Type 2 diabetes in the future.)
As for knowing if you have it, well, it’s a tricky one because you may have no symptoms at all.
In some cases, you’ll feel really hungry, thirsty, and tired or need to pee more often.
But all of these are also regular pregnancy symptoms, so it can be tough to tell.
If you’re concerned, the best solution is to stick to your routine prenatal checks.
Between 24 and 28 weeks, your doctor measures your sugars.
If they are high, you will be advised on how to proceed.
Tight management means lower risks of long-term complications for both you and your baby.
Bacterial, viral, and parasitic infections can hit you harder when you’re pregnant.
And they are more difficult to treat because you don’t want to expose your baby to drugs that could be harmful.
Stomach bugs when you’re pregnant are quite common.
This study from Sweden showed that as many as one in three pregnancies are hit by the dreaded gastroenteritis (fancy term for stomach bug).
The symptoms of stomach bugs during pregnancy are the same as they would be at any other time ‒ diarrhea, nausea and vomiting, fever, and fatigue.
Watch out for blood in your poop or black poop because this could be more serious.
These symptoms can put you at greater risk for dehydration.
And if they are very severe, they could lead to preterm labor.
Food poisoning when pregnant is more likely than at other times in your life ‒ and can be more dangerous, particularly in the first three months.
That’s why there are all those rules about not eating raw fish, deli meats, and unpasteurized dairy.
(Here’s a list of what to avoid during pregnancy to keep yourself safe.)
If symptoms like diarrhea and vomiting don’t go away, or if you have signs of dehydration, like excessive thirst or dizziness, it’s important to see a doctor.
And while hot flashes during pregnancy are sometimes par for the course, a fever over 101 ℉ is a sign that it’s time to get checked.
You may have heard of TORCH infections.
These are infections transmitted from mama to baby during pregnancy (transplacentally) or delivery (peripartum) that can result in major complications for your baby.
TORCH is an acronym that stands for:
- Toxoplasma gondii (that’s why it’s important to not handle cat litter while pregnant)
- Others – These include Treponema pallidum (which causes syphilis), Listeria (that’s why unpasteurised cheeses and deli meats are off the menu), varicella zoster (shingles), and parvovirus B19 (which leads to hydrops fetalis where baby develops extensive swelling due to large amounts of fluid in their organs and tissues)
- Rubella (German Measles),
- Cytomegalovirus (or CMV, which is closely related to the viruses that cause chickenpox and mono)
- Herpes (HSV)
Other possible infections include:
Group B strep
This bacterial infection can be serious for newborn babies.
That’s why the CDC advises that you are tested for Group B Strep in weeks 36 or 37 of pregnancy.
If you test positive, your doctor is able to give you penicillin when you go into labor to prevent your baby from contracting this.
Covid-19 can have varying effects during pregnancy.
Some women may have mild or no symptoms, while others may develop severe illness that requires hospitalization.
The most common symptoms of Covid-19 in pregnancy are fever, cough, and difficulty breathing, which can affect the health of both you and baby.
For you, Covid-19 may increase the risk of pregnancy complications such as preterm birth, preeclampsia, and C-section delivery.
Also, pregnant women with Covid-19 may be at a higher risk of developing severe illness, requiring admission to the intensive care unit (ICU), and being put on a ventilator.
For baby, there is a potential risk of preterm birth and low birth weight if you have severe Covid-19.
There is also a small chance of transmission of the virus from you to the baby during delivery or after birth.
If you have Covid during pregnancy, it’s always worth checking in with your doctor (safely).
Some STIs can cross the placenta and infect your baby.
Others can pass on to your baby when going through the birth process.
So it’s best to get screened regularly.
Nausea and vomiting of pregnancy (the condition previously known as morning sickness) is an infamous first-trimester experience.
For some, it sticks around into the second trimester, and for others, it stays for the entire pregnancy.
Hyperemesis gravidarum is the extreme version of this.
This is dangerous, and you will likely be hospitalized so that they can administer both antiemetics (anti-nausea drugs) and fluids through an IV.
With this condition, you will be assessed on two things.
First, they will look for ketones in your urine.
(When your body can’t get enough sugars, it breaks down fats for energy. Ketones are the result of this process.)
Second, they will look to see if you’ve lost a significant weight loss (>5% prepregnancy weight).
If your vomiting is severe and you are losing weight while pregnant, it’s important to get medical care.
Watch out for signs of dehydration, like dizziness and infrequent peeing.
Luckily, there is help available for hyperemesis gravidarum.
The American College of Obstetricians and Gynecologists recommends pyridoxine (vitamin B6), either with or without an antihistamine called doxylamine.
(You might know doxylamine as its brand name Unisom.)
Always consult your healthcare practitioner before taking any medication, especially when you are pregnant.
Lifestyle changes and alternative therapies like acupuncture have also proven to be successful for some pregnant people.
But it’s important to do your research when looking for reputable practitioners.
Chat with your doctor about what might be the best option for you.
And chances are, your doctor will speak to you about nausea and vomiting at your first prenatal visit.
Cholestasis of pregnancy
This liver condition causes extreme itchiness, particularly on the hands and feet.
You might also notice a yellowy color to your skin and eyes, belly pain, and rarely fatty, light-colored poop.
This condition happens in the second and third trimesters.
Simply put, Cholestasis of pregnancy occurs because pregnancy hormones (estrogen and progesterone) can put extra stress on the liver.
The liver then struggles to efficiently transport the bile to the gallbladder and intestines, resulting in it seeping into the bloodstream.
And bile in your blood makes you itchy.
(No rash, just very itchy!)
If this occurs, your doctor will do liver function tests.
They might give you medication and/or monitor you and your baby very closely.
In some cases, it may be the best course of action to deliver your baby early.
Cholestasis of pregnancy can get in the way of your baby getting oxygen, which means your baby can stop growing inside you.
There could be meconium in your baby’s amniotic fluid (basically, they poop before leaving the womb) and you could face a preterm birth.
Also, your baby would need to be monitored closely throughout labor and birth to avoid stillbirth.
The most important thing here is if you have severe itching while pregnant, check in with your healthcare provider so you get the help you need in time.
Luckily, the complication is fully reversible after pregnancy.
Mental health challenges during pregnancy
Pregnancy comes with all sorts of unique stressors ‒ so even if you’re generally happy to be pregnant, it is completely normal to have some downer feelings.
But that doesn’t mean you simply have to grit your teeth and bare it.
In some cases, you might need treatment for your mental health in the form of medication, talk therapy, and lifestyle interventions.
Wherever you’re at, know that help is available.
We take you through the details of how to deal with anxiety during pregnancy here.
And here, we talk about depression during pregnancy.
And if you need support, we’ve put together a list of resources to help you find the help you need.
Preterm labor is defined as labor that starts before week 37 of pregnancy.
While it’s definitely possible to have a healthy baby that’s born early, there are some risks.
Because your baby is still putting the finishing touches on some organs ‒ most importantly, the lungs are still getting ready for the outside world right until those final weeks ‒ babies born early are at higher risk of complications.
But luckily, there are a number of interventions that result in successful preterm births.
More and more accounts are being documented of babies born as early as 28 weeks who are growing into healthy adults.
There’s always ongoing research on this topic, like this promising paper on the effects of progesterone in helping prevent preterm births.
(Speaking of premature labor, let’s answer a frequently asked question: If you have a low-risk pregnancy, there is no proven link between having a pregnancy orgasm and preterm labor. Provided your doctor hasn’t put you on pelvic rest, you’re good to go.)
Precipitous labor is when your baby comes out very quickly ‒ as in less than three hours from the time your contractions start.
And while this may sound like a dream, it can actually be very challenging for mama and baby alike.
If you experience very intense contractions coming at a rapid pace, it can leave you feeling as though you can’t catch a break.
It may also put you more at risk for hemorrhaging and tearing of your vaginal area, as well as cause health issues for your baby.
So yes, it may sound idyllic but it could be quite traumatic.
Luckily, precipitous labor is rare and doesn’t guarantee complications for mama and baby.
So if your labor seems to be going very quickly, don’t panic.
It’s important to note, though, if you had it with a previous pregnancy, it’s wise to expect it this time around, too.
The best thing to do is talk with your doctor ahead of time about your game plan for getting to the hospital when labor starts.
That way, even if things go much more quickly than planned, you’ll be in good hands.
Now let’s talk about an unusual form of pregnancy.
Also called a stealth pregnancy, this type of pregnancy is an unusual one ‒ it’s about not knowing that you’re pregnant at all.
Most people usually find out they’re pregnant somewhere in the first few months of being pregnant because they either feel pregnant or their periods stop.
Those who have a cryptic pregnancy only find out much later, sometimes only when they go into labor.
Seems impossible ‒ but it actually happens more often than you think (at 20 weeks, it’s about 1 in 475 pregnancies).
It’s more likely if you have irregular periods, as it’s harder to see when you’ve skipped one.
So health conditions that affect your period, like Polycystic Ovarian Syndrome (PCOS) and endometriosis, can make this a more likely possibility.
Similarly, some birth control treatments lead to you not having regular periods.
So because you are not monitoring your periods and you are not expecting to fall pregnant, an unexpected pregnancy would be the last thing you’d be thinking about.
Being on certain medications can also mean irregular periods and unexpected pregnancy.
A cryptic pregnancy is also more likely when you’re in perimenopause, as you may think it’s no longer possible to get pregnant.
As for the bump, well, in a cryptic pregnancy, it may not be that noticeable ‒ and this can happen for many reasons, including having tight abdominal muscles or having been recently pregnant.
While it’s totally possible to carry a cryptic pregnancy to term, there are some risk factors to be aware of here.
The most important one is that you miss out on your prenatal care.
Not knowing you’re pregnant also means you may not be following all the dos and don’ts, like not smoking, drinking alcohol, or eating unsafe foods.
Added to this, the surprise of cryptic pregnancy can take a serious psychological toll.
There’s a lot of mental prep work that goes into having a baby ‒ not to mention all the logistics that need to be arranged for your new arrival.
So not being given a heads-up about all this can leave you feeling unprepared.
But the good news is you can still bring a healthy baby into the world.
Check out this case study ‒ it can happen!
The postpartum period is often referred to as the fourth trimester.
Seeing it as a chapter of your pregnancy can be part of treating your body with the care it needs over this time.
Potential postpartum complications include:
- Uterine endometritis (where the lining and/or muscles of your uterus become inflamed)
- Your uterus becoming soft and weak because the muscles have not gone back into position
- Retained placenta
- Diastasis Recti (a separation of muscles that causes your abdominal organs to protrude)
- Pubic Symphysis Diastasis (a rare widening of the area between your pelvic bones)
- Infections in the reproductive or urinary tract
- Infections at the surgical site for cesarean births
- Excessive bleeding
- Rare inflammation and/or blood clots in your pelvic area
- Postpartum depression, anxiety, and psychosis
- Postpartum preeclampsia
- Postpartum hemorrhage
- Breastfeeding challenges
- Lack of sex drive
- Postpartum urinary retention
If you experience any excessive bleeding, high fevers, or severe pain, it’s important to get medical attention as soon as you can.
We take you through all the details of possible postpartum complications here, as well as what symptoms to watch out for.
Very rarely, new mamas experience heart and lung conditions like strokes and pulmonary embolisms.
The chances of this happening are very slight ‒ but if you experience any symptoms, like dizziness or numbness, soon after delivery, don’t wait to get help.
Pregnancy complications: The bottom line
As much as we prep and plan, life just doesn’t always go as planned.
And pregnancy is no exception to this often frustrating rule.
But the more we know about the possible twists and turns pregnancy can take, the better we can manage what comes our way.
We’re firm believers in navigating this journey together with those who are where you’re at.
Join us on Peanut ‒ that’s exactly what we’re up to. ❤️