High-risk pregnancy

A high-risk pregnancy can sound scary. But being high risk doesn’t mean something will go wrong. It means you or your baby may need closer monitoring before, during or after delivery.

If you think you might be high risk, your first step is to schedule an appointment with your OB-Gyn or another pregnancy care provider. They can confirm your pregnancy, review your health history and help you understand what to expect. Part of your initial conversation should include whether your pregnancy may include high risk features.

If it is, don’t worry. Most people with high-risk pregnancies have healthy pregnancies and healthy babies. It will be important to keep your prenatal visits, and follow your care plan as well as to monitor your symptoms between appointments.

What is a high-risk pregnancy?

Every pregnancy carries some risk. But a high-risk pregnancy means there is a greater chance of health concerns for the pregnant person, baby or both. That may mean you need extra care before birth, during labor and delivery, or after your baby is born.

Some high-risk pregnancies require only a few extra appointments or tests. Others may need more frequent monitoring, fetal monitoring or care from a maternal-fetal medicine specialist. Depending on your health and your baby’s health, a high-risk pregnancy may increase the chance of complications such as preterm delivery, Cesarean delivery, low birth weight, bleeding or other serious concerns.

What makes a pregnancy high risk?

Your pregnancy may be considered high risk from the beginning, or you may develop a high-risk condition during pregnancy. Many factors can contribute, including health conditions you had before pregnancy, conditions that develop during pregnancy and sometimes lifestyle or environmental factors.

Health conditions that may increase pregnancy risk include autoimmune diseases, blood-clotting disorders, diabetes, fibroids, high blood pressure, HIV/AIDS, kidney disease, mental health conditions, obesity, polyendocrine metabolic ovarian syndrome (PMOS) and thyroid disease.

Conditions that develop during pregnancy can also increase risk. These may include gestational diabetes, gestational hypertension, preeclampsia, eclampsia, placental conditions, multiple gestation, or too much or too little amniotic fluid.

Smoking, substance use disorder, alcohol use disorder and exposure to certain toxins can also increase pregnancy risks.

When to get help during pregnancy or after birth

If you have a high-risk pregnancy, it’s especially important to keep all your prenatal appointments. It also helps to know what’s normal for your body and what changes could signal a problem.

Call your doctor right away if you notice symptoms that feel different from what you’ve been told to expect. Your care team will help you decide whether you need care in the office, urgent care or the emergency room.

Some symptoms need immediate medical care during pregnancy or after birth. Seek immediate care if you have:

• Chest pain, a fast-beating heart or trouble breathing
• Dizziness, fainting or weakness that doesn’t improve
• Severe abdominal or pelvic pain
• Severe headache, blurry vision or other vision changes
• Sudden or severe swelling in your face, hands or fingers
• Thoughts of harming yourself or your baby
• Vaginal bleeding or fluid leaking from the vagina
• Vomiting or nausea that is severe or won’t stop 

During pregnancy, you should also call your care team right away if your baby is moving less than usual.

After birth, call your doctor right away if you notice symptoms of infection, such as fever, chills, abdominal pain or tenderness, or foul-smelling vaginal discharge. You should also call if you have pain or burning when you pee, worsening sadness or anxiety, or worry that feels so intense it’s hard to get through your daily activities.

Can preeclampsia happen after birth?

Preeclampsia is a serious blood pressure condition that can happen during pregnancy or after delivery. Preeclampsia symptoms can include severe headaches, vision changes, swelling in the face or hands, nausea or vomiting, stomach pain, chest pain or trouble breathing.

Because preeclampsia can become serious quickly, don’t wait to get help if you notice these symptoms before or after giving birth. Call your doctor, call 911 or go to the emergency room, depending on how severe your symptoms are.