Michael Aziz, MD: Weighing the Risks of Pregnancy

July 8, 2022
Giuliana Grossi

Expert Michael Aziz discusses clinical complications that patients face when they become pregnant as well as the importance of medication management and abortion care.

Even before the Surpreme Court overturned Roe V. Wade 2 weeks ago, some state legislatures in the US had been limiting access to abortion care, or working to implement such restrictions.

While a number of states have prohibited all access to abortion since the decision, others are still attempting to. In states like Ohio, South Carolina, Florida and Georgia, that haven't entirely outlawed the practice of abortion yet, the procedure is banned from taking place as early as 6 weeks after fertilization.

To examine the health of the fetus, clinicians perform a survery ultrasound in order to collect highly detailed information on the vital organs, bones and extremeties. Because this evaluation occurs 18-20 weeks into a pregnancy, individuals living in restrictive states will have already lost their ability to make a decision by the time they're given pivotal insight into the health of their fetus.

Many Conditions are Exacerbated by Pregnancy

As a maternal-fetal medicine (MFM) specialist who cares for many high-risk pregnancy patients, and a member of the State Liaison Network for the Society for Maternal-Fetal Medicine (SMFM), Michael Aziz, MD, MPH, believes that the decision to terminate or continue a pregnancy needs to be made by the individual.

Being pregnant is a dangerous time in someone's life, even if they're in good health. The US has the highest maternal mortality rate of any developed nation.

"We've talked a lot about the risk of death, we haven't talked about the risk of illness," Aziz said.

No one is immune to pregnancy complications but the risk increases depending on the health condition a patient is living with. Cardiopulmonary issues, depression, anxiety, anemia and diabetes were some examples Aziz mentioned that "can be terribly exacerbated by pregnancy."

"Almost 50% of our patients experience anemia, and 20% experienced mood changes or brief psychiatric illness," he explained. "So, it's important to remember that even if you don't die, you can still become sick and that can have big impacts on your life and long term well being."

Pregnancy and Medication Management

A pregnant individual's autonomy is also important for medication managment.

"Whenever it comes to life threatening illness, that patient needs to have a conversation with a high risk pregnancy specialist about whether or not the risks of staying on the medication are worth the benefits," he said, "and that, again, is a personal decision."

It's crucial for an individual to consult with a doctor about their options, but when discerning between safe and unsafe medications to stop or continue while pregnant there aren't simple "yes" or "no" answers, according to Aziz.

"If there is no mother, there is no pregnancy," he said.


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