This has been medically reviewed by Yaneve Fonge, MD, MPH, maternal and fetal medicine at Allina Health.
Every parent-to-be is hoping for a smooth pregnancy, so it’s understandable if you’re feeling worried because you’ve been told you have a high-risk pregnancy by your care provider. This does not mean your pregnancy will automatically be difficult – and many people have high-risk pregnancies that end with the arrival of a healthy baby. When a pregnancy is high risk, it means there are increased health risks for you, the fetus or both.
If you’re wondering what makes a pregnancy high-risk, the list contains a range of factors, such as the mother’s health, age and lifestyle, or a medical condition that develops during pregnancy. Even carrying twins (or more) is considered a high-risk pregnancy. We’re here to explain how to navigate a high-risk pregnancy so you can make good health choices for you and your baby.
If your primary care provider, obstetrician or other specialist has a concern regarding your pregnancy, you may be referred to a maternal-fetal medicine specialist, which is a health care provider who specializes in caring for those with high-risk pregnancies and babies with complex needs.
Expert care for high-risk pregnancies starts with the right support. Talk with a trusted provider at The Mother Baby Center for personalized guidance and specialized care throughout your pregnancy.
What is a high-risk pregnancy?
It’s important to clarify what is considered a high-risk pregnancy because it doesn’t mean there is definitely something wrong with you or your baby. High-risk pregnancies mean there’s a higher-than-average risk of the mother, baby, or both of you experiencing a complication at some point during the pregnancy. Some pregnancies begin as high risk, and others become high risk during the pregnancy.
During a high-risk pregnancy, your pregnancy team will monitor you and your baby more closely, and you will likely have extra exams and tests to help reduce the possibility and severity of any complications.
How common are high-risk pregnancies?
In the U.S., the average age of childbirth is now 30 years old, which increases the likelihood of pregnancy risks. Between 6-8% of pregnant people in the U.S have high-risk pregnancies every year.
If your primary care provider, obstetrician or other specialist has a concern regarding your pregnancy, you may be referred to a perinatologist or a maternal-fetal medicine specialist, which is a health care provider who specializes in caring for those with high-risk pregnancies and babies with complex needs. Remember, routine prenatal care can help ensure your pregnancy is safe, even if it’s high-risk.
List of high-risk pregnancy conditions
Sometimes a medical condition arises for you or the fetus during the pregnancy that increases the risk of pregnancy concerns. Or you might already know about a preexisting medical condition that will require extra appointments during your pregnancy. Pregnancy risk factors might not have anything to do with medical conditions initially but instead with the mother’s age or lifestyle choices.
Factors that can lead to a high-risk pregnancy include:
- Mother’s age is 35 years or older, or 17 years or younger.
- Pregnancy with multiple babies.
- Problems with a previous pregnancy like preterm birth.
- Any preexisting conditions like a heart condition, diabetes, and epilepsy.
- Pregnancy-related health conditions that can develop, including gestational diabetes, low birth weight, and preeclampsia.
- Lifestyle habits, including smoking, drug use and alcohol use.
Pre-existing maternal health conditions
If you manage a chronic health issue, you might already be aware of the list of high-risk pregnancy conditions that could develop or worsen during your pregnancy. Preconception care with your health care providers, such as adjusting medications that may be harmful to a fetus and addressing other factors like diet and weight, can significantly improve pregnancy outcomes.
Some chronic conditions that may require preconception care and ongoing medical management during pregnancy include:
- Heart conditions
- Blood disorders
- Diabetes
- Epilepsy
- High blood pressure
- Thyroid disease
- Autoimmune diseases
- Obesity
- Mental health disorders
Additionally, it’s a good idea to coordinate your care between your primary care providers and your pregnancy care team so everyone can communicate with each other about the needs of you and your baby.
Conditions developed during pregnancy
Once you’re pregnant, there are some conditions that can arise that will make it a high-risk pregnancy. Again, don’t panic; most of these conditions can be managed and monitored with extra care and treatment plans.
Some of the high-risk pregnancy conditions that can develop during pregnancy include:
- Gestational diabetes
- Preeclampsia, gestational hypertension
- Blood clots
- Hyperemesis
- Cholestasis of pregnancy
Identifying pregnancy risk factors is a way for your care team to watch for potential complications so they can keep you and your baby safe during your pregnancy and delivery.
Fetal and pregnancy-specific conditions
When a pregnancy is high-risk because of issues directly related to the fetus, that can include the following pregnancy risk factors:
- Multiples (twins, triplets, etc.)
- Low birth weight
- Placental conditions
- Too much or too little amniotic fluid
- Abnormal fetal conditions, growth restrictions, and congenital diseases
Potential pregnancy concerns your care provider will watch for if you are pregnant with twins, triplets (or more!) include premature birth or the need for cesarean section delivery. Prematurely born infants have an increased chance of difficulty breathing, and twins and triplets are more likely to be smaller than single infants. If health problems with your baby are detected while in the womb, the pregnancy might be called high-risk if treatments or surgical repairs are needed before the baby is born.
These examples aren’t meant to scare you – quite the opposite, in fact! Expert care teams are ready to care for you and your baby to make sure you have the safest, healthiest pregnancy possible, even if it’s high-risk.
Other pregnancy risk factors
There are a few other pregnancy risk factors that can lead to a high-risk pregnancy – some you can’t do much about, but some you can.
- Maternal age may (or may not) be a factor. Generally speaking, pregnancy risks increase after age 35, including greater chances of gestational diabetes and high blood pressure, delivery complications, and genetic disorders in the baby (e.g., Down syndrome). That said, age alone isn’t a determining factor in a high-risk pregnancy. Many women have healthy babies after age 35.
- Teen pregnancies can also be high-risk. Their chances are greater for developing high blood pressure, anemia, and preterm birth. Also, many teens don’t get the care they need to have a healthy pregnancy.
- Avoid smoking, alcohol and recreational drug use. These substances will cause harm to the fetus with effects ranging from mild to severe, and possibly miscarriage or stillbirth.
- Manage preexisting health conditions. Work with your health care providers to identify potential risks (e.g., switch medications that could harm the fetus) and other opportunities to prepare for a healthy pregnancy.
- Consider your overall health – and act – before getting pregnant. Lose or gain weight, get support for your mental health, quit smoking, etc.
High-risk pregnancy complications
When you’re talking with friends and family about what a high-risk pregnancy is, they might ask about the potential complications. As we keep saying, it’s important to remember that with proper monitoring and care, it’s often possible to reduce the risk or severity of having these or other complications.
Some of the most common high-risk pregnancy complications include:
- Preeclampsia disorders
- Gestational diabetes
- Placental issues
- Preterm labor (before 37 weeks)
- Cesarean delivery
- Excessive bleeding during labor and delivery or after birth
- Low birth weight
- Birth defects or congenital conditions
- Miscarriage or stillbirth
Types of testing and care for high-risk pregnancies
Most patients with a high-risk pregnancy can continue to see their primary care provider while the perinatologist works with their provider as a consultant. Some patients, based on medical history or pregnancy course, may be recommended to be transferred to a maternal-fetal medicine specialist.
Minnesota Perinatal Physicians provides high-risk pregnancy care for those in the five-state region. Our perinatologists care for mothers and their babies while they are in utero (in the womb). Minnesota Perinatal Physicians has 5 high-risk pregnancy center locations in the Twin Cities. Meet our perinatologists.
Midwest Fetal Care Center maternal-fetal medicine experts diagnose and treat potentially life-threatening conditions in babies before they are born. Our fetal surgeons are skilled in procedures such as fetal transfusion for anemia, fetal surgery for twin-to-twin transfusion syndrome, and more. Meet our care team.
Have more questions about testing, care, or what to expect next? Visit our Pregnancy FAQ page for clear answers and helpful guidance.
How to have a healthy pregnancy
The best way to manage a high-risk pregnancy is to get prenatal care as soon as you know you’re pregnant. If you have a chronic health condition or other health issue, you might have started with preconception care to switch to medications that are safe for a fetus or do other things like stop smoking or lose weight. These are all great steps toward managing a high-risk pregnancy. Be sure to tell your pregnancy care provider about your complete health history and any past pregnancies.
So much of pregnancy is out of your control, and hearing that your pregnancy has extra risk factors can be scary. Remember, your pregnancy care team is doing what’s best for you and your baby, so you can trust them.
Here are some things you can do to take care of yourself:
- Focus on healthy habits. Get enough sleep, eat nutritious foods, and get some light exercise every day. These are all important priorities for you and your growing baby.
- Make time for self-care. Take some quiet moments of relaxation or meditation. Do things you enjoy that will lift your mood.
- Build a support system. Friends, family, or support groups can help you – and you should let them! Also, tell your provider if you want to talk to a psychologist or genetic counselor as you navigate your pregnancy. It is perfectly normal to have a lot of emotions and questions during pregnancy, especially if there could be complications.
- Go to your appointments. It might sound obvious, but you really need to go to all of your prenatal appointments and screening tests. This is the best way to have the best outcome when a pregnancy is high-risk.
Find a trusted Minnesota provider at The Mother Baby Center
We’ll say it one more time: most of the time – and with great care during the pregnancy – a high-risk pregnancy ends with a healthy baby and mom. Understandably, hearing the words “high-risk” can feel scary, but hopefully you now understand that you have some great options to navigate a pregnancy that needs special monitoring and care.
You are the best advocate for you and your baby, so don’t be afraid to speak up and ask questions. Your entire care team should be on the same page with you during your prenatal care.
We are ready to be your partner and provide the best specialized care for you and your baby at The Mother Baby Center.