Traditionally, women aged 35 and over who become pregnant are considered advanced maternal age and at a higher risk for pregnancy complications. Women who get pregnant in their late 30s or 40s may experience some problems with their own health or the health of their baby.

Your healthcare provider may recommend tests or procedures in addition to routine prenatal screening to help monitor your risk factors. These may include targeted ultrasound, amniocentesis or fetal heart rate monitoring. The good news is health assessments, genetic screening and diagnostic testing options are more sophisticated than ever, allowing you to understand as much as possible about your health and pregnancy.

While the majority of pregnancies with multiples result in healthy babies, any pregnancy with twins or more is at increased risk for complications. The greatest risk if you are carrying multiple babies is that you will go into labor early. Preterm labor is labor that happens before 37 weeks of pregnancy. It is common in high-risk pregnancies and may be caused by excess amniotic fluid forming in the uterus, preeclampsia (pregnancy-induced high blood pressure), thyroid disease or other factors.

If you had problems with a previous pregnancy or delivered a baby early, your next pregnancy may be considered high-risk as a result. This doesn’t necessarily mean you will experience the same problems again, but previous problems with a pregnancy may cause your doctor to monitor your health and that of your baby more. Your obstetrician will look at things like:

• A history of miscarriage
• Past abortion
• Prior cesarean sections
• Previous preterm births (births before 37 weeks of pregnancy)
• Low birth-weight babies

A preexisting medical condition can affect your pregnancy or even be affected by your pregnancy. Having a long-term or chronic condition may cause your doctor to monitor your health more closely during pregnancy to help minimize any risk to you or your baby. It is important to continue taking any medication prescribed for your health condition unless your doctor specifically tells you to stop.

Some preexisting conditions that may result in your pregnancy being classified as high-risk include: 

• A family history of a genetic condition
• Chronic conditions like diabetes, high blood pressure or epilepsy
• Blood disorders, including anemia and sickle cell disease
• Heart disease
• Being severely overweight

Bed rest with close monitoring in the hospital may be prescribed for any number of reasons, including:

• Pregnancy-induced high blood pressure (preeclampsia)
• Cervical changes
• Carrying multiple babies
• Premature labor
• A history of premature birth or pregnancy loss

In all cases, bed rest may help increase the probability of you staying on a healthy pregnancy course.

Bed rest can be a good time to look after your emotional well-being, and to do some planning for baby. You may want to take the opportunity to discover how you can be prepared for handling an early delivery or possible complication.

There are many ways to make your bed rest a more positive experience:

• Start by making yourself at home. Have a familiar pillow or blanket on hand to make the room feel more cozy. Photos and decorations are also encouraged.
• Find new ways to connect with family members and friends. Have visitors. Keep in touch by phone, email and text. A good support system will help you get through this.
• Bed rest is common during high-risk pregnancies, so try not to spend too much time worrying.
• Bring things to do to break up the day. Engage in reading, watching a movie, learning something new or doing word games to fight boredom.
• Ask family and friends to bring you food in lieu of flowers and balloons if you tire of the hospital food. Unlike many patients in the hospital, you have an appetite and will want to maintain good nutrition. Non-perishable snacks are allowed in patient rooms, and a full-size refrigerator/freezer is available on the Antepartum Unit to store favorite items or leftovers.
• Do any exercises your healthcare provider recommends. These may include moving your legs to keep up your muscle strength and lower the risk of blood clots.
• Ask the hospital staff if there are support groups, pedicures, craft times or other ways to make the best of your bed rest. Many Texas Health hospitals offer special amenities to help make your stay more comfortable.