"While a woman in her late thirties or early forties is considered young by many standards, when it comes to reproduction, she is considered high-risk," says perinatologist Annette Bond, MD, director of maternal-fetal medicine at Greenwich Hospital.

Dr. Bond says that along with the growing number of first-time "older" moms, she is also seeing a shift toward larger families, with women in their 40s having their third or fourth child. Other factors for a high-risk pregnancy include multiple miscarriages, carrying multiples such as twins or triplets, high blood pressure, diabetes, lupus and obesity, which is more common in older mothers.

Maternal-fetal medicine, also known as perinatology, is the medical specialty that provides care for mothers and unborn babies considered at higher risk for complications. Services often begin before a woman becomes pregnant to identify and prepare for issues that might occur. For example, Dr. Bond and her team often see patients who are exploring in vitro fertilization and other assisted reproductive technologies.

When a woman becomes pregnant, there are now numerous less invasive screenings to monitor the health of an unborn baby. Drawing blood from a pregnant woman allows for analysis of fetal genetic material (DNA) to detect chromosomal abnormalities as early as 10 weeks gestation. These tests are far less intrusive and can take place earlier in the pregnancy than the more standard amniocentesis. Tests involving the body's circulatory, or vascular, function help determine the health of the placenta.

3D ultrasound may allow a physician to diagnose abnormalities in an early stage while allowing families to better understand certain fetal irregularities. 4D ultrasound, while usually not necessary for medical diagnostic purposes, can provide parents with a series of still images that appear as a moving video.

Greenwich Hospital's maternal-fetal medicine team includes board certified perinatologists and neonatologists, as well as sonographers, genetic counselors and nurse educators.

"A large part of what we do is help women decrease the amount of anxiety that comes with a high risk pregnancy," explains Dr. Bond. "The size of the hospital allows us to deliver more personal care. Greenwich Hospital is a unique place where the staff members go that extra mile," Bond adds.

Greenwich Hospital's track record of service excellence is apparent at every single level, including a level 3 neonatal intensive care unit for tiny and sick newborn babies. Affiliation with the Yale New Haven Health System provides access to advanced subspecialty care for babies with significant health problems, such as a medical genetics issue, cardiac irregularities or for an infant born very prematurely.

"Women want a clear understanding of what it will take to have a healthy baby," says Dr. Bond, adding, "The goal, of course, is to help each woman achieve success despite her risk factors."