Pregnancy is a complex physiological process that begins with fertilization and ends in childbirth. It involves multiple physical changes and potential risks, requiring careful monitoring throughout the gestational period.

Effective pregnancy planning includes discussing interpregnancy intervals, preconception care, and fertility awareness methods. The recommended spacing between pregnancies, known as the interpregnancy interval, is at least 18 to 24 months, allowing the mother's body time to recover from the previous pregnancy [1, 2]. Adequate spacing reduces risks like preterm birth and low birth weight. Additionally, replenishing essential nutrients, particularly folic acid, is vital to prevent neural tube defects and other nutrient-related birth defects [1, 2].

Regular monitoring during pregnancy is crucial for identifying and managing health complications, tracking fetal growth, and planning safe delivery. Techniques such as ultrasound scans, fetal heart rate monitoring, and non-stress tests provide essential data for maternal and fetal health, enabling timely interventions when necessary [3, 4]. 

Fetalmonitoring is particularly important in high-risk pregnancies involving conditions like fetal growth restriction, hypertension, or (gestational) diabetes, requiring increased attention and proactive management [5-7]. Effective communication and education from healthcare providers help empower expectant mothers, fostering collaboration in prenatal care [4]. 

Controversies surrounding pregnancy monitoring often relate to disparities in healthcare access and provider practices. Challenges such as obstetrician shortages in rural areas, systemic inequalities in maternal healthcare, and the growing emphasis on community-based support underscore difficulties expectant mothers face in accessing prenatal care [8].

Pregnancy complications are health issues that arise during pregnancy and can affect the expectant mother, the fetus, or both. These issues can develop at various stages and lead to significant morbidity and mortality without proper management.

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in a fallopian tube. This condition can cause severe complications and requires immediate medical attention to avoid life-threatening outcomes [9].

Gestational diabetes is characterized by high blood sugar levels that develop during pregnancy. This condition greatly increases risks for maternal and fetal complications. Effective management typically involves a multidisciplinary approach, including monitoring blood-glucose levels, dietary modifications, lifestyle changes, and potentially medications such as insulin [10].

Pre-eclampsia is a serious condition usually occurring after 20 weeks of pregnancy, characterized by high blood pressure and protein in the urine. Symptoms can progress to severe conditions like eclampsia (seizures) and HELLP syndrome, significantly affecting maternal health [11]. Pre-eclampsia also increases fetal complications, such as restricted fetal growth and preterm birth.

Fetal growth restriction (FGR) is a pregnancy complication characterized by inadequate fetal growth. It is typically diagnosed when the estimated fetal weight falls below the 10th percentile for gestational age or when there is a significant decrease in fetal growth velocity. Placental dysfunction is the leading cause, resulting in chronic fetal hypoxia and limited nutrient supply. FGR is strongly linked to maternal factors such as underlying health conditions, poor dietary habits, and environmental exposures [12,13].

Pregnant women are more susceptible to infections due to changes in immune response and other physiological adaptations during pregnancy. Some infections can be transmitted vertically to the fetus, increasing health risks. In low- and middle-income countries, infections such as influenza, hepatitis E, and malaria pose significant threats and can lead to more severe outcomes in pregnant individuals. In high-income countries, concerns center around parvovirus B19 and cytomegalovirus (CMV), which may also impact fetal health [10]. Additionally, mastitis, an inflammation of the breast, affects about 20% of lactating mothers, emphasizing the need for monitoring postpartum as well [10].

Preterm labor involves regular contractions that lead to cervical changes before 37 weeks of pregnancy but does not always result in preterm birth. While preterm labor can be uncomfortable for the mother, it does not pose health risks to the baby unless it leads to early delivery. However, if birth occurs preterm, the baby may face long-term health complications [10]. Management typically aims to delay rather than fully prevent delivery, incorporating lifestyle changes and medical treatments to address underlying health conditions.

Miscarriage, especially before 12 weeks of pregnancy, significantly influences the risk of subsequent preterm births. Studies suggest that women who experience miscarriage may have increased risks for adverse pregnancy outcomes in future pregnancies, including preterm birth [14]. It is recommended to wait at least six months after miscarriage before attempting another pregnancy to optimize outcomes and reduce risks such as preterm birth [15, 16].

Pregnancy in low-resource, low-income settings poses significant challenges contributing to high maternal and neonatal mortality rates, estimated to be 50 to 100 times greater than in high-income countries [17]. Key factors driving these adverse outcomes include limited access to quality healthcare, socio-economic inequalities, and cultural factors affecting health behaviors and healthcare-seeking practices [17, 18]. 

Social determinants of health (SDOH), such as poverty, limited education, and inadequate nutrition, further complicate pregnancy risks in these settings [19]. Traditional birth attendants often replace skilled healthcare providers, increasing childbirth risks [17]. Antenatal care quality frequently remains insufficient, and many women miss essential screenings for pregnancy complications [20]. 

Maternal mortality remains a pressing global issue, with hemorrhage, hypertensive disorders, and infections identified as leading causes [18]. Regions like sub-Saharan Africa anticipate non-communicable diseases becoming major maternal health challenges by 2050, complicating current maternal health efforts [20]. 

Improving maternal outcomes in low-resource settings requires targeted interventions and investments in healthcare infrastructure. Barriers to effective care persist, necessitating sustained policy attention and community involvement [21, 22]. Addressing pregnancy challenges in these environments demands a multifaceted approach, including enhanced education, improved healthcare access, and culturally competent care to mitigate risks and improve maternal and child health outcomes [23].