“Life is empty without a mother” a saying by Swami Vivekananda. But can someone imagine a mother without a baby′s birth! To become mother is every lady′s birth right.

With advanced medical sciences, we have solutions to many problems and there are many survivors of critical and chronic ailments. We also have overcome infertility. But there are many diseases which make women unfit to tolerate pregnancy. For such women, motherhood can be difficult, but certainly not impossible.

Nowadays, we are facing lifestyle changes, prolonged educational years, increasing stress levels, growing parental ages and weights, and more evident psychological disorders. All of these have a major impact on conception, pregnancy through delivery. This requires timely intervention and appropriate management.

Hypertension, diabetes, thyroid etc common disorders have effects on growing fetus. They need early detection and normalization prior to conception along with routine monitoring and adequate dosing modifications till delivery.

Diseases like epilepsy, diabetes, arthritis, etc and their medications have adverse effects on fetal growth; but we cannot discontinue the treatment. We need to find appropriate options and continue at doses safe in pregnancy. Varied complications are followed in women with kidney, liver, chest and gastrointestinal disorders.

Heart diseases like valvular problems and septal defects make women unfit for pregnancy in some complex conditions. This needs a plan to stabilize the disease condition and prolong pregnancy as long as safely tolerated. Then baby is born with a patient specific plan for mode of delivery and anaesthesia.

In women with blood disorders such as thalassemia, sickle cell disease and clotting disorders, blood/component transfusion becomes a duel edged sword and precision of decisions is of utmost importance. With advances and experiences, pregnancy has also been possible in cancer and organ transplant survivors. Now, it has also been possible to prevent mother to child transmission (PMTCT) in infectious diseases like HIV, Hepatitis B, etc.

My work has wide spectrum in various disorders, ranging from pre-conceptional counselling, monitoring of disease activity prior to conception, throughout pregnancy till delivery, taking appropriate superspecialist advises and implementing them, predicting related complications and implementing preventive measures. I have to work meticulously to suggest appropriate mode and time of delivery and anaesthesia, appropriate set-up with required back-ups, etc. I also help in postpartum medication changes safe during lactation, appropriate contraception, vaccination and further pregnancy advises.