Foundations of Pregnancy With Pre-Existing Conditions: Understanding the Overlap Between Chronic Health and Pregnancy

For people with pre-existing health conditions, pregnancy introduces a two-way interaction: the pregnancy affects the condition, and the condition affects the pregnancy. This dynamic — which plays out differently depending on the specific diagnosis, its degree of control, and the medications involved — is the core of what high-risk obstetric care for pre-existing conditions is designed to manage. Understanding that interaction is the foundation for navigating a medically complex pregnancy with clarity. By the end of this course you will be able to describe how common pre-existing conditions such as chronic hypertension, pre-existing diabetes, autoimmune disorders, and cardiac conditions are affected by pregnancy physiology, understand why multidisciplinary care involving specialists beyond the obstetrician is often required, identify the general principles of medication management during pregnancy for chronic conditions, and recognize why pre-conception counseling is especially important for people with pre-existing conditions. What you will learn: - How pregnancy physiology changes blood pressure, glucose metabolism, immune activity, and cardiac demand - Chronic hypertension in pregnancy: how it is distinguished from gestational hypertension and why it raises the risk of preeclampsia - Pre-existing diabetes (Type 1 and Type 2) in pregnancy: targets for glucose control, risks to the fetus, and how management differs from gestational diabetes - Autoimmune disorders in pregnancy: how conditions such as lupus, rheumatoid arthritis, and antiphospholipid syndrome affect and are affected by pregnancy - Cardiac conditions in pregnancy: why the physiological demands of pregnancy stress the cardiovascular system and which conditions require specialist involvement - Medication safety in pregnancy: the general framework for evaluating whether a chronic medication should be continued, adjusted, or switched - The role of multidisciplinary care: how an obstetrician, internist, cardiologist, rheumatologist, or endocrinologist contribute to a coordinated plan - Pre-conception counseling: what it involves and why it makes a meaningful difference for pregnancy outcomes in people with chronic conditions The course moves through each condition category with clear readings and worked examples illustrating how the same underlying principle — the two-way interaction between the chronic condition and the pregnancy — plays out differently in each case. Reflection prompts invite readers to consider how their own condition interacts with pregnancy or with questions they would bring to a pre-conception or early-pregnancy appointment. This course is designed for individuals with pre-existing health conditions who are pregnant, planning a pregnancy, or supporting someone who is. No prior medical background is required. This course is informational and educational; it does not substitute for guidance from your licensed obstetric team and the specialists managing your chronic condition.