High-risk pregnancies are on the rise. A Blue Cross Blue Shield study from 2020 found while 80% of women have healthy pregnancies, rates of complications are rising, due in part to more mothers with pre-existing medical conditions.
"One of the ways to tackle our increasing number of premature births...is to make sure again mom is taken care of, " said Dr. Sean Daneshmand, medical director for Scripps Health's perinatology program, which was started in 2018 and has been expanding.
"Complications are on the rise," Daneshmand said. "We’ve got more women who are gaining more weight pre-pregnancy, diabetes is on the rise, hypertension is on the rise and something we forget — depression and anxiety — is on the rise and therefore, in order to address all these issues, Scripps decided to bring on a team."
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Daneshmand said the best way to address underlying conditions is to talk to a specialist before getting pregnant, because it could save the both the mother's or baby’s life.
"We talk to the patient," he said. "We educate them. We refer them to our colleagues for our diabetes and pregnancy program to undergo nutritional counseling, dietary counseling, learn if they need to be on medication, how to take that medication."
Daneshmand said one of the hardest conversations is telling a mother with pre-existing conditions that she maybe shouldn’t try to get pregnant right away.
"Let's say she has had a recent stroke for example. A year later she wants to have a child or she has had a recent heart attack or has cancer or again some co-morbidities that are not conducive to a health pregnancy — and it’s very difficult for women to hear they shouldn't’ have children."
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For San Marcos residents Megan and Ricky Miller, news that their baby might have a genetic disorder and had a large hole in the heart caught them off guard, especially because Megan had no known pre-existing conditions.
"We just decided early on that we’re not going to let this steal our joy because you can just have fear and be worried the entire time or you can say, 'No I’m not going to have fear. I’m going to be joyful and believe that this is going to turn out well and we’re doing everything we can,'" Megan said.
The Millers decided two years into marriage it was time to try for a baby. After getting pregnant, everything was going well until around 19 weeks when the couple went in to see the child's gender.
"Her head was on track but her limbs were a little bit smaller than they should be and that got the concern going that maybe it’s in line with a genetic disorder," Megan said.
Her husband, Ricky, said it was not easy news to take.
"Definitely was scary. It was the same day we found out the gender," he said. "It was a huge, happy day. We were stoked. We did the gender reveal and then literally half an hour later they called and said something was off."
Megan said her big worry was if the child was going to be OK.
"Having a genetic disorder is not the worst thing but there’s a lot of complications like stillbirth so that was more my fear if the baby was going to make it or not," she said.
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The couple was told they might have their baby delivered at 25 weeks old, which would have required months of intensive care. Megan had to spend nearly a week in the hospital during the pregnancy as well. But their baby, Galilee Ryan, was delivered at 36 weeks, weighing in at just three pounds two ounces. The large hole in her heart had also gone away.
"That’s healed and they saw some narrowing of the aortic arch that’s not there — so it’s just really a miracle baby," Megan said.
The Millers now spend most of their time at Scripps La Jolla’s neonatal intensive care unit where Galilee is expected to be for at least a couple more weeks.
"Pretty much 10 to 12 hours a day we spend there," Megan said. "She’s eating about 50% by bottle right now and the rest they are putting through a tube so that’s increasing everyday. She’s eating more and more everyday and having more strength. She’s starting to cry and fuss."
Megan said overall, while stressful, she is grateful for the care of the specialists who helped deliver her baby. Results from testing just found Galilee has no genetic disorder and there are plans for more kids soon.
"We want lots," Megan said with a laugh. "I don't know five or seven, we’ll see."
Health officials suggest, especially for women with pre-existing conditions, to reach out to their doctor before getting pregnant to see if something can be done to limit the chance of complications during or after pregnancy.
