What is Considered a High-Risk Pregnancy?

Finding out you’re pregnant can be an incredibly exciting moment, but there are times when seeing those two lines might fill you with apprehension.

Especially if you’re concerned about having a high-risk pregnancy.

And if you have an existing health condition or find yourself at high-risk pregnancy age (more on this below), that concern is valid.

Unfortunately, it’s not just a feeling restricted to physical health.

Black women are three times more likely to die from pregnancy complications than white women.

And when statistics show that 80% of pregnancy-related deaths are preventable, the need for any woman to add implicit bias and racism to their list of risk factors is unacceptable.

Whether you’re over the age of 35 or at a higher risk of being overlooked or undervalued, your concerns for your maternal health are valid.

Here’s everything you need to know about pregnancy risks, including what is a high risk pregnancy, how to spot it, and what sufficient support looks like.

Basically, all the info you need to better advocate for yourself during pregnancy. 📣

Because you may just have to.

Let’s get you informed and empowered. ❤️

In this article: 📝

What is a high-risk pregnancy?

Simply put, the definition of high-risk pregnancy is is one where the health of the baby or mama-to-be is at a higher chance of experiencing pregnancy-related complications.

Some women may be at risk before they even conceive—for a variety of reasons listed further down—and others can become more at risk of pregnancy complications as they progress.

Most importantly, a high-risk pregnancy is one that requires extra prenatal care early and consistently—no exceptions.

What makes a pregnancy high-risk?

So, when you go for your first prenatal appointment, you’ll be asked questions about your medical history to determine whether yours is a high-risk pregnancy.

This helps the professionals assess your situation and give you the appropriate advice tailored to your circumstances.

But according to this 2022 study on severe maternal morbidity (SMM), patients with high-risk pregnancies were more likely to be over 35, non-Hispanic Black, significantly overweight, and lack insurance coverage (!).

So, what makes a pregnancy high-risk is not always related to physical health—though it forms a core part of it.

The same study revealed that two-thirds of SMM were preventable, with clinician factors contributing to 31.3% of these.

And while non-Hispanic Black and Hispanic women had a higher risk of pregnancy complications, non-Hispanic White patients had a higher proportion of preventable cases. 🤯

It’s a lot but all of this is simply to highlight the importance of listening to your body throughout your pregnancy and advocating when you know it’s necessary.

How many pregnancies are considered high-risk?

It’s hard to calculate exactly how many pregnancies are considered high-risk, because of the range of reasons and factors that can contribute to a high-risk pregnancy.

However, according to the University of California San Francisco, high-risk pregnancies could be as many as 6-8% of all pregnancies.

And according to the Cleveland Clinic, around 50,000 people have high-risk pregnancies each year.

What is a high-risk OB called?

So what are high-risk pregnancy doctors called?

They’re known as perinatologists.

If you’re not sure when to see a perinatologist, don’t worry—your doctor will refer you if they think you may have a high-risk pregnancy.

What qualifies as a high-risk pregnancy?

Typically, when assessing for a high-risk pregnancy, doctors will look for a range of factors, including:

• A heart condition or any blood clotting disorder.
  
• Pre-existing health conditions like diabetes, kidney diseases, epilepsy, autoimmune disorders, high blood pressure, asthma, and obesity
  
• Family history of genetic conditions
  
• BMI, whether low body weight or obesity
  
• A history of complicated pregnancies, including any miscarriages, preterm labor, c-section or complex delivery, or having a child with a birth difference
  
• Your age during the pregnancy

It’s all down to you and your pregnancy journey.

At what weight are you considered a high-risk pregnancy?

A high-risk pregnancy due to weight could be a BMI (body mass index) of over 30 or under 18.5.

A 2015 study showed that obese women are more at risk of gestational diabetes, gestational hypertension, pre-eclampsia, and preterm birth.

Meanwhile, underweight pregnant women were more likely to have anemia.

However, BMI is not the only indicator of a healthy person—after all, it’s an equation that doesn’t allow for different circumstances, sex, ethnicity, body tolerances, and muscle tone.

While there is a link between BMI and body fat, it’s not the only method of detecting whether you have a high-risk pregnancy.

What age is high-risk pregnancy?

So, you may be familiar with the high-risk pregnancy age of 35 and over.

But women aged 17 and younger are also considered for a high-risk pregnancy.

Though we loathe the term ‘geriatric’ pregnancy—just one of the targets in our renaming revolution—sadly, being over the age of 35 does come with the risk of pregnancy loss, chromosomal conditions (like Down syndrome), and the potential for the pregnancy to cause harm to the mother.

And they keep increasing from that point.

That doesn’t mean that a person over 35 shouldn’t get pregnant.

It just means that the TTC (trying to conceive) journey could take longer, and the pregnancy would be considered high-risk, so would be monitored more often.

As for people aged 17 and under, their bodies may not be fully developed, which can put both them and their baby in a high-risk pregnancy situation.

Are IVF pregnancies high-risk?

Unfortunately, yes, IVF pregnancies are considered high-risk.

Any pregnancy that’s a result of fertility treatment is considered a high-risk pregnancy with rates of preeclampsia, high blood pressure, placental abnormalities, and premature births often being higher.

And this is more related to the age and risk factors of the women involved than the procedure itself since many who opt for fertility treatments are already experiencing health issues.

For IVF, there’s a slightly higher risk of twin or multiple pregnancies, along with the other risks outlined above.

While these chances are still relatively low, it’s worth being aware of, so speak to your doctor if you’re concerned about ectopic pregnancy with IVF.

Can stress cause high-risk pregnancy?

We’re no strangers to the topic of stress while pregnant—it’s an experience shared by many women on Peanut.

And while you and your baby can withstand moments of stress throughout pregnancy—after all, it’s totally normal—it’s when you hit chronic levels of stress that issues can arise.

High levels of stress have been linked to high blood pressure, which, according to one study could increase your chances of preterm labor or low birth weight.

Outside of this, the main cause of concern with chronic emotional stress during pregnancy is the long-term effects on infant and child development—in particular, the likelihood of infant stress reactivity.

How do you know if you have a high-risk pregnancy?

One of the first things that will be recorded on your medical file is your age because pregnant women under 17 or over 35 are considered high-risk pregnancy age groups.

But there are many other factors that medical professionals take into account when advising if you have a high-risk pregnancy or not.

And what could be a high-risk pregnancy symptom for one mama might not be for another.

But there are some high-risk pregnancy symptoms you can watch out for.

What are the 10 danger signs of pregnancy?

If you notice any of the following danger signs during your pregnancy, speak with your doctor as soon as you can:

• Cramping around baby
  
• Heavy vaginal bleeding
  
• Sudden or severe headaches
  
• Sudden or severe swelling anywhere around your body
  
• Fast or difficulty breathing
  
• Burning while peeing
  
• Lack of movement from the fetus (if they have moved before)
  
• Changes in vision
  
• Abdominal pain
  
• Fever and too weak to get out of bed

What about high-risk pregnancy antepartum symptoms?

As in symptoms of a high-risk pregnancy before you get pregnant?

Well, if you have any pre-existing medical conditions (e.g. diabetes, high blood pressure) or infections, if your BMI is above 30 or less than 18.5, or if you are 17 and under or 35 and under, those could be indicators of a high-risk pregnancy.

If you think you may have a high-risk pregnancy before you start TTC, speak with your doctor beforehand.

Can you get a high-risk pregnancy during your pregnancy?

Sometimes, the amazing work our bodies are doing is complicated by factors beyond our control.

Various issues can arise during your pregnancy that can make it a high-risk pregnancy and are separate from the mama’s health, such as:

• If you are pregnant with twins or multiple babies.
  
• If there are problems with the structure of the uterus or a shortened cervix, then mamas can be at a higher risk of premature labor.
  
• If the placenta has settled into an unusual position over the cervix, it is called placenta previa and can cause bleeding during the pregnancy.
  
• Rh sensitization—which is when your blood group is Rh-negative, and the baby is Rh-positive.
  
• Slow growth of the baby or other concerns, which can be found during an ultrasound or in other tests.
  
• Preeclampsia – high blood pressure can be an indicator and can be dangerous if untreated.
  
• Gestational diabetes is a type of diabetes that develops during pregnancy. It can be managed by your healthcare provider and usually resolves itself after delivery.

Can a high-risk pregnancy be prevented?

You can’t really prevent a high-risk pregnancy, but you can reduce your chances.

This is because there are so many reasons and factors that can cause a high-risk pregnancy.

For example, if your doctor says that you may have a high-risk pregnancy (or be more likely to have one if you’re TTC) due to your current lifestyle, there may be things you can do to reduce your chances.

However, some causes for a high-risk pregnancy, like a blood clotting disorder, for example, aren’t preventable and may be due to pre-existing medical conditions.

And this is why being closely monitored and receiving extra prenatal care is so important.

It’s the bare minimum you should be receiving, just FYI.

What makes a pregnancy high risk for Down syndrome?

There are a few factors that can increase the chances of a high-risk pregnancy resulting in a fetus with Down syndrome, but sometimes it can be random.

If you are over 35, that can also increase your chances.

As can having a family history of Down syndrome.

If you have a Down syndrome pregnancy, you can always find support and advice from our mamas on Peanut with Down syndrome babies.

What should I do if I have a high-risk pregnancy?

If you’re advised that you’re carrying a high-risk pregnancy, you and your doctor will probably create a prenatal care plan together that focuses on keeping you and your baby safe.

This plan may include following some of these recommendations for the management of high-risk pregnancy:

• Additional prenatal appointments, tests, or ultrasounds.
  
• An appointment with a genetic counselor or a physician who specializes in high-risk pregnancies.
  
• A plan for a healthy diet and a safe exercise routine
  
• A plan to stop smoking, drinking alcohol, or using illegal drugs
  
• And, if absolutely necessary, then complete bed rest at home or in a hospital

You may also be advised to be aware of the high-pregnancy symptoms we mentioned above, like vaginal bleeding or abdominal pain.

Always call your doctor if you experience these symptoms during your high-risk pregnancy.

How are high-risk pregnancies monitored?

If you have a high-risk pregnancy, you’ll likely have more prenatal appointments and visits to your doctor—mainly to check up on how you and your baby are doing.

Keeping a pregnancy planner is something that our mamas with high-risk pregnancies recommend doing, because you’ll likely be expected to keep track of lots of different things you’re doing during your high-risk pregnancy.

You’ll also likely have more ultrasounds.

Where mamas with low-risk pregnancies may have two ultrasounds, a mama of a high-risk pregnancy may have three or four. Or even five.

So beyond your initial 8-week ultrasound, you may have a nuchal translucency ultrasound, 16-week ultrasound, 30-week ultrasound, or a 40-week ultrasound.

A high-risk pregnancy ultrasound is usually done between 20 weeks and 36 weeks, reviewed by a qualified perinatologist rather than an ultrasound technician.

How often are high-risk pregnancy appointments?

One high-risk pregnancy may have more appointments than another, so there isn’t really a single answer.

A low-risk pregnancy may have around 10-15 prenatal appointments (although it’s worth noting that not all of these will involve an ultrasound), but a high-risk pregnancy could have anywhere from 15-35.

The best thing to do is speak with your doctor.

What should be avoided in a high-risk pregnancy?

So, you know the type of monitoring you can (and should) expect with a high-risk pregnancy, but what about your self-care?

We tackle the scenarios that may need to be shelved or adapted until after your due date:

Can you still work with a high-risk pregnancy?

There’s no easy answer to whether you should work, as there are different reasons for a high-risk pregnancy.

And it also depends on your type of employment.

For some mamas, high-risk pregnancy and work can go well together, and for others, it might not.

If you work from home or in a job that’s very low-impact, you could find yourself in the former camp.

But your job comes with additional risks—like chemical exposure, long hours, or intense physical activity—you may just have to take maternity leave early. 👷🏼‍♀️

Speak with your doctor about your work to see whether you can work with a high-risk pregnancy.

It may be that your employer can make a few changes during your pregnancy to help.

Can a high-risk pregnancy fly?

More often than not, yes, you can fly with a high-risk pregnancy. 🛫

If you’re planning on taking a trip, it’s still best to speak with your doctor beforehand.

Can you workout with a high-risk pregnancy?

A high-risk pregnancy doesn’t always mean that your pregnancy will be more challenging or difficult than anyone else’s.

Much like your work, the amount you can exercise will depend on the specific pregnancy risks you’re being monitored for.

And exercise during pregnancy does come with health benefits, like speeding up labor and reducing the risk of preeclampsia.

That being said, there are workouts to avoid—like contact sports, horse riding, or heavy weightlifting. 🏋🏼‍♀️

Yep, you guessed it, check with your doctor about the pregnancy workouts you can enjoy with minimal risk.

It’s only temporary.

Do I get extra support with a high-risk pregnancy?

What your practitioner offers you will vary, depending on your circumstances and which specific high-risk factors they’re supporting.

With this in mind, you might be recommended:

• Specialized ultrasound: Where pictures of the baby in the uterus can be taken and targeted at suspected problems, such as low fetal growth
  
• Biophysical ultrasound: Where the baby’s well-being is monitored, including fetal heart rate monitoring (also known as a “nonstress test”)
  
• Ultrasound for cervical length: Which can be used to assess your risk for preterm labor
  
• Lab tests: Where your urine can be tested for urinary tract infections, and you can be screened for infectious diseases such as HIV and syphilis
  
• Prenatal cell-free DNA (cfDNA) screening: Where a blood sample is taken from the mama, and the baby’s DNA is screened for specific chromosomal abnormalities
  
• Invasive genetic screening: These tests are called amniocentesis or Chorionic Villus Sampling (CVS). During amniocentesis, a sample of the amniotic fluid that protects your baby during pregnancy is taken from the uterus. During CVS, a sample of cells is removed from the placenta. Your healthcare provider can give you much more detailed info about these tests because they do carry risks.

Can high-risk pregnancy be successful?

With proper care and consistent monitoring, 100% a high-risk pregnancy can be successful.

As saddening as the statistic of preventable pregnancy-related deaths is, the key word to take from it is preventable.

With the right mix of clinical care, attentiveness, and advocacy, there is every chance your pregnancy will be a success.

As will you and your baby’s life beyond the due date.

That’s not to say the journey will be easy.

Going through a high-risk pregnancy can be stressful, worrying, and scary.

But making sure to stay informed, vocal, and on top of your self-care and wellness can make the difference.

That included being unafraid and unashamed to ask your healthcare provider any questions that are bugging you.

And if you need support, your Peanut Community is always there—for a chat, a meet-up, or even a gentle push.

You’ve got this. ❤️