GUIDE
A high-risk pregnancy means you or your baby have a higher chance of complications, requiring extra monitoring and specialist care. About 6 to 8 percent of pregnancies are classified as high-risk.
Being labeled high-risk can feel frightening, but it actually means you are getting more attention — not less. The additional monitoring and specialist involvement are designed to catch problems early and give you and your baby the best possible outcome.
Be prepared from day one
A high-risk pregnancy simply means that certain factors increase the chance of complications for you, your baby, or both — and your care team will provide additional monitoring and interventions to manage those risks. It does not mean that something bad will definitely happen.
The label can feel alarming, but think of it as a sign that you are getting a higher level of care. Your providers are being proactive — watching more closely, testing more frequently, and intervening earlier if needed. This approach leads to better outcomes.
High-risk status can be determined at the beginning of pregnancy (based on your medical history, age, or pre-existing conditions) or it can develop during pregnancy (if you develop gestational diabetes, preeclampsia, or other complications).
This is not an exhaustive list. Your provider evaluates your individual combination of risk factors to determine your care plan.
A referral to a maternal-fetal medicine (MFM) specialist — also called a perinatologist — does not mean something is wrong. It means your pregnancy benefits from the expertise of a physician with advanced training in managing complex pregnancies.
MFM specialists typically have 3 additional years of fellowship training beyond obstetrics and gynecology residency. They specialize in advanced ultrasound interpretation, genetic counseling, managing chronic conditions during pregnancy, and coordinating multidisciplinary care.
In many cases, the MFM works alongside your regular OB or midwife. The MFM handles the high-risk aspects (specialized ultrasounds, condition management, delivery planning), while your OB manages routine prenatal care. Some people see their MFM only a few times during pregnancy; others see them frequently. It depends on the complexity of your case.
The specific monitoring you receive depends on your risk factors. Not everyone on this list applies to every high-risk pregnancy.
High-risk is a broad category. Ask your provider to explain exactly what makes your pregnancy high-risk, what complications they are watching for, and what the actual likelihood is. Understanding the specific concerns — rather than carrying a vague sense of danger — helps you focus your energy on what matters and reduces anxiety about things that are not relevant to your situation.
Your care team may include your OB, a maternal-fetal medicine specialist, a nutritionist, a mental health provider, and other specialists depending on your conditions. Make sure all your providers communicate with each other. Keep a list of contact numbers handy — including after-hours and emergency contacts for your MFM and OB.
Anxiety is one of the most common and least discussed aspects of a high-risk pregnancy. The constant monitoring, extra appointments, and weight of worry can be exhausting. Consider therapy, support groups, mindfulness practices, or journaling. Talk to your partner about how you are both coping. It is normal to feel anxious — and it is also important to find strategies to manage that anxiety so it does not overwhelm your daily life.
High-risk pregnancies may require adjustments to your ideal birth plan — earlier delivery, cesarean section, hospital birth instead of a birth center, or specific monitoring during labor. Rather than viewing this as a loss, focus on the goal: a safe delivery for you and your baby. Discuss contingency plans with your provider so you are prepared for different scenarios.
Keep a daily log of fetal movement (kick counts starting around 28 weeks), blood pressure readings if you have a home cuff, blood sugar levels if applicable, and any symptoms. This information helps your provider make better decisions at each visit. A baby tracking app like tinylog can be a valuable tool for staying organized.
In a high-risk pregnancy, it is always better to call and be reassured than to wait and worry. Your care team expects and welcomes your calls.
The emotional weight of a high-risk pregnancy is real. The extra appointments, the tests, the waiting for results, the awareness that something could go wrong — it all takes a toll. Studies show that people with high-risk pregnancies have higher rates of anxiety, depression, and post-traumatic stress compared to those with uncomplicated pregnancies.
This is why mental health support is not a luxury — it is a critical part of your care. Ask your provider for a referral to a therapist experienced in perinatal mental health. Join a support group (online or in person) for people navigating high-risk pregnancies. Talk openly with your partner about fears and coping strategies.
At the same time, try to find moments of joy in your pregnancy. The extra ultrasounds mean you get to see your baby more often. The close monitoring means your care team knows your baby inside and out. Many people with high-risk pregnancies look back and feel grateful for the level of care they received.
Depending on your specific risk factors, you may find these guides helpful: gestational diabetes, preeclampsia, placenta previa, placenta accreta, cervical insufficiency, low amniotic fluid, cholestasis of pregnancy, pregnancy after miscarriage, and prenatal visit schedule. Each provides detailed, condition-specific information to help you understand what to expect and how to advocate for yourself and your baby.
This guide is for informational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider with any questions about your pregnancy.
