Safer Pregnancy, Better Outcomes: Preconception Clinic Helps Women With Chronic Conditions

Safer Pregnancy, Better Outcomes: Preconception Clinic Helps Women With Chronic Conditions

For women with a chronic illness – such as diabetes, heart disease, cancer, hypertension, autoimmune disorders and others – pregnancy can be complicated. If not managed properly, their health condition can negatively affect the baby’s development. Similarly, the pregnancy itself, at times, can worsen the mother’s illness. This does not mean that all women with a medical condition should not have a baby, but it does require special planning with a team of experts to assist them along the way. Women who need this type of highly specialized care can benefit from University Hospitals MacDonald Women’s Hospital’s Preconception Care Clinic.

“The Preconception Care Clinic allows women with a chronic illness to see a maternal fetal medicine specialist and fellowship-trained family planning specialist at the same time. Together, we evaluate a patient’s potential pregnancy risks and work with her care team to optimize her health prior to pregnancy and create an effective contraception plan while we do so,” explains Stacey Ehrenberg Buchner, MD, a maternal fetal medicine specialist at UH MacDonald Women’s Hospital. “It leads to healthier pregnancies and healthier babies.”

Importance of planning

There are many ways a chronic illness can affect a pregnancy. For example, some medications used to manage a woman’s medical condition could be harmful to a fetus. The Preconception Care Clinic works with women to find alternative medications that are safe.

Similarly, certain medical conditions pose risks to both mother and fetus during pregnancy. For example, uncontrolled diabetes increases the risk for delivery complications, as well as other complications for the mother and the fetus. The Preconception Care Clinic helps women stabilize their condition before trying to conceive, which can dramatically decrease these risks.

Whenever necessary, physicians at the clinic work closely with patients’ other medical specialists. As a team, they develop a plan to optimize the mother’s health before pregnancy. The team will then develop a cohesive plan for maintaining health during the pregnancy.

“Many women of childbearing age who have a chronic illness actually feel fine and may not realize there is any risk to pregnancy,” says Dr. Ehrenberg Buchner. “We are trying to raise awareness among women that even if they feel good, their condition can play a role in their ability to have a healthy pregnancy.”

Effective contraceptive care

Although UH MacDonald Women’s Hospital’s Preconception Care Clinic helps women achieve a successful pregnancy whenever possible, it also helps women with chronic health conditions avoid pregnancy when necessary or desired.

“Some women need time to optimize their health before getting pregnant or may want to avoid pregnancy altogether. Our goal is to have a woman become pregnant at a time when she is in the best health possible to optimize outcomes for her and for her child,” says Dr. Ehrenberg Buchner. “Dr. Lisa Perriera provides expert guidance on the type of birth control that works best for the condition and goals. Not every form of contraception is safe or effective for every woman, especially those with special health concerns.”

Patient-driven services

Dr. Ehrenberg Buchner advises women who have a chronic illness or previous pregnancy complications to make an appointment for an individualized consultation. “Our goal is to help women understand their medical conditions, the risks that may be involved with carrying a pregnancy, as well as the ways we can help them achieve the healthiest outcomes for both themselves and their baby.”

If a woman wants to have a baby and it is determined that pregnancy may be too risky, patients are referred to colleagues at University Hospitals Fertility Center to discuss other options, such as using a surrogate or adoption.

“If a woman wants to be a mother and share her life with a child, we believe she should be able to do so,” says Dr. Ehrenberg Buchner. “We help women safely achieve motherhood.”

To schedule an appointment, call 1-866-UH4-CARE (1-866-844-2273) or visit

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Stacey Ehrenberg Buchner

Maternal Fetal Medicine Specialist, UH MacDonald Women’s Hospital
Assistant Professor, Case Western Reserve University School of Medicine

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