A Guide to High-Risk Pregnancy

Oh, that feeling of seeing a positive pregnancy test!

If you’ve been wanting a baby for a while, there’s nothing quite like the euphoria of realizing… YOU’RE PREGNANT. Woohoo!

Once you get into the routine of “Oh yeah. I’m pregnant.” it’s time to get down to business and start focusing on being healthy.

While most pregnancies are super healthy and stay “normal” throughout the process, sometimes things go down a different path and a pregnant person ends up getting labeled “high-risk.”

a guide to high-risk pregnancy

What does high-risk mean?

Generally, high-risk means that you’ve got some condition or factor that could lead your pregnancy toward a possible problem down the road. It also means that healthcare providers have to spend more time testing, monitoring, and evaluating your pregnancy so that things don’t get dangerous.

Not every high-risk pregnancy ends up with issues. With proper management and care, the majority end up healthy and happy.

But it’s good to be aware of what might classify you as “high-risk.” Here are the most common reasons.


  • Teen (under 17 years old) - If you’re pretty young, you and your baby can be at risk for issues like low birth weight and complications. The best bet is to get to your healthcare provider for care as soon as you know you’re pregnant (I know that can be tricky - do your best). Prenatal care can make all the difference.

  • Older first-time parent (over 35 years old) - Generally, you’re at risk for a higher c-section rate, prolonged or stalled labor, and issues with delivery. There is also the potential for genetic issues with the baby, such as Down Syndrome. But you can have an awesome birth (don’t forget it).


  • Smoking - This can cause low birth weight, preterm labor, and has been linked to Sudden Infant Death Syndrome (SIDS). Quitting is hard, I know. Find the support you need and do your best.

  • Alcohol - Since alcohol crosses the placental barrier and goes into the baby’s umbilical cord, it can cause birth defects and other issues with baby. It’s also a cause of Fetal Alcohol Spectrum Disorder (FASD). Might want to just be safe and avoid it until your little tenant has moved out into the big world.

Health Conditions

  • Diabetes - Uncontrolled diabetes can wreak havoc on a pregnancy, leading to more serious issues. But when you keep your blood sugar in check and work with your provider to manage it, it can work out just fine. (I know you’ve got this.)

  • High blood pressure - Can lead to kidney damage, low birth weight, and preeclampsia. Plenty of medical support to manage this though. (Did I mention prenatal care is awesome?)

  • HIV - Is transmittable to the baby, but there are a ton of ways to manage it that drastically lessens the transmission rate. (Modern medicine is fabulous stuff.)

  • Autoimmune diseases - Symptoms of these issues vary and they can either get worse, better, or stay the same throughout a pregnancy. Each one needs managing in a specific way.

  • Obesity - This can cause issues, lead to gestational diabetes, and make delivery tricky for some. It can also cause heart issues in the baby. New studies show that you can gain less weight than is recommended to reduce risk (your doctor can guide you on how to stay healthy during pregnancy while dealing with obesity).

Pregnancy Conditions

  • Multiples - If you are blessed with more than one baby (especially more than two), you are considered high-risk. Preterm birth and low birth weights mean that multiples need extra care to get and stay healthy.

  • Preeclampsia - This condition develops during pregnancy and can be fatal. Symptoms can be completely absent (making it dangerous), but they can also include sudden high blood pressure, swelling, nausea/vomiting, headaches, stomach/low back pain, shortness of breath, and/or anxiety. If you suddenly feel really “weird” or have any of these symptoms at a later stage in pregnancy, call your doctor and consider going to the emergency room. It’s that serious.

  • Gestational diabetes - This is basically diabetes that shows up during pregnancy (and then usually goes away after birth). It’s important to take care of immediately to prevent further problems. It is manageable.

There are other issues that could classify you as high-risk, but these are the most common.

What happens when I’m high-risk?

Generally speaking, once you’re classified as high-risk you are no longer eligible for home birth and sometimes not even birth center birth. (Don’t forget you can still have an awesome birth in the hospital!)

You’ll probably need to undergo several tests to rule out issues and to pinpoint the problems that are occurring. Then you’ll have regular appointments with a doctor to check on your symptoms to make sure everything is under control.

Yes, having a high-risk pregnancy can be stressful. But modern science has found ways to manage so many pregnancy issues, so under the care of a compassionate care provider, you will still be able to have a great, supportive experience.

You can still have an amazing birth and a healthy baby!

How do I prevent a high-risk pregnancy?

The truth is sometimes you can’t prevent it. Pregnancy is often about lots of self-care and lots of rolling with the punches.

The constant lesson in pregnancy and birth is all about letting go and learning patience in challenging processes. (I know. Collective groan…)

But there are some things you can do to reduce your risk.

Months before you get pregnant, you can start to work on health issues to increase your wellness.

  • If you’re on medicine to manage conditions, visit a doctor to discuss what you’d need to do with those medicines to prepare for pregnancy.

  • If you’re overweight, work with a specialist who can help you determine if it’s an issue and suggest ways to get healthier before becoming pregnant.

  • Work on cleaning up your diet and slowly removing foods and drinks that you know aren’t great for you. Work toward a whole foods diet (but don’t get too extreme or anxious about it - moderation!). If you’ve got health conditions, work with a dietician to make sure you are eating well for you.

  • If you’re a smoker or heavy drinker, find something and/or someone that will help you wean off and get healthier in that area.

  • If you’ve got a chronic health condition, chat with your healthcare provider to find out how you would need to manage it while pregnant.

If you’re already pregnant? Get on those prenatal appointments, find a high-quality prenatal supplement, and start replacing unhealthy foods with nutritious ones. Walk lots, if you can. Squat every day, if you can. (Seems silly, I know… But your pelvis and pelvic floor will thank you.)

Take Care of You

And spend plenty of time doing self-care, whatever that looks like for you. Pregnancy can be really stressful at times. Develop a daily practice of letting go, giving yourself self-love, and doing positive talk/visualizations/affirmations (whatever works for you).

Everyone goes on a unique journey when they’re pregnant and when they give birth.

Educate yourself, ask plenty of questions at your prenatal appointments, find a healthcare provider that you trust and is a great fit for you… Then focus on being adaptable, forgiving yourself when you don’t do things perfectly, and laughing as much as you can. Crying when you need to is also essential.


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Sarah BraunComment