Finding out your pregnancy is high risk can be extremely distressing. You may be unsure what that means in terms of the rest of your pregnancy, your baby, and your birth. You may want to know what you can do to decrease your risk, and what the outcome of your pregnancy might be.

The good news is that most people with high risk pregnancies go on to have healthy babies, especially if they get comprehensive medical care from healthcare professionals trained in high risk pregnancies.

Let’s take a look at what you need to know if you’ve been diagnosed with a high risk pregnancy, including signs, symptoms, management, treatment, prevention, and overall outlook.

High risk pregnancy is any pregnancy that comes with increased health risks for either the pregnant parent, the fetus, or both.

People who have high risk pregnancies may have underlying conditions that increase their risk, or they may have developed conditions during pregnancy that put them at high risk of complications.

Getting early and consistent prenatal care increases the chances of a healthy pregnancy, despite being in a high risk category.

Your age may increase your risk of pregnancy complications if you are either very young or over the age of 35.

Teen pregnancies

Being a teenager at the time of pregnancy increases the risk of complications for several reasons:

  • Teens have a higher risk of experiencing high blood pressure and anemia during pregnancy.
  • Teens are more likely to experience preterm labor (going into labor early).
  • Teens are more likely to avoid seeking prenatal care and are more likely to miss doctors’ appointments.
  • Teens are less likely to know they have a sexually transmitted infection (STI) and to seek proper care for it.

Pregnancy over the age of 35

Having a baby for the first time when you are over the age of 35 doesn’t automatically mean you will have a complicated pregnancy. Many parents in their mid-30s and beyond have healthy and problem-free pregnancies.

However, it does increase your risk of certain complications, including:

The signs and symptoms of a high risk pregnancy depend on the condition that puts you at that higher risk. For example, symptoms of preeclampsia include headaches and swelling of the hands and face. Symptoms of miscarriage may include cramping or bleeding.

When to call your doctor or healthcare professional

According to the Centers for Disease Control and Prevention (CDC), anytime you have one of the following symptoms during pregnancy, alert a doctor immediately:

  • a worsening headache
  • feeling dizzy or fainting
  • visions changes, including blurry vision
  • a fever of 100.4°F (38°C) or more
  • labored breathing
  • swelling in your hands or face
  • racing heart
  • severe abdominal pain
  • noticing that your baby’s movements have stopped
  • vaginal bleeding
  • thoughts of harming yourself or your baby
  • extreme fatigue

You may already know you have a medical condition that increases your risk of pregnancy complications before getting pregnant. Or your high risk status may be discovered during pregnancy because of symptoms that emerge or certain test results.

Some diagnostic tests your doctor may order to check your risk of complications during pregnancy include:

The type of treatment you receive will depend on the specific risk factors you have.

For example, people who have gestational diabetes can eat a certain diet or take medication to manage their blood sugar. People with infectious diseases may need to take medications. Special precautions may be needed during delivery to minimize the risk to the infant as well.

Whatever the case, your medical team will be monitoring you more carefully. They may schedule more appointments and diagnostics tests for you than for people who have lower risk pregnancies. This is so they will be able to detect any issues early on.

Early treatment of pregnancy complications increases the chances of having a healthy pregnancy and baby.

All babies are monitored carefully during pregnancy, but if you have a high risk pregnancy, your baby may be monitored more closely.

For example, you may have more frequent ultrasounds or other fetal monitoring tests. It all depends on what your risk factors are and how they may put your baby at risk.

Some diagnostic tests your doctor may use to monitor your baby’s well-being during a high risk pregnancy include:

Many health conditions may put you in a higher risk category during pregnancy. You may have had some of these conditions before pregnancy or during prior pregnancies. Others may be conditions that developed over the course of your pregnancy.

Conditions and factors that increase pregnancy risk include:

You can prevent some of the factors that put you in a high risk pregnancy category. Others can’t be prevented. For example, medical conditions you already have going into pregnancy usually can’t be prevented.

However, certain lifestyle factors, such as smoking, drinking alcohol, and managing your weight, can be addressed before you get pregnant and during pregnancy to lower your risk of complications.

If you’re thinking about getting pregnant and know you have controllable risk factors, consider meeting with a healthcare professional. Together, you can discuss lifestyle changes that will increase your chances of having a lower risk pregnancy.

When to seek emergency care

Contact your doctor if any conditions that increase your risk of pregnancy complications are acting up, or if you’re experiencing any new or worsening symptoms.

Additionally, seek emergency medical care if you:

  • have trouble breathing
  • have developed a fever
  • notice your baby has stopped moving
  • are bleeding
  • have severe abdominal pain
  • have a headache that won’t go away
  • have swelling of the feet and hands
  • have blurred vision

Attending regular doctor visits, participating in any screening your healthcare team recommends, and making certain lifestyle changes during pregnancy can decrease your risks of poor pregnancy outcomes.

A 2020 study with pregnant women in Nepal found that those who are categorized as having a high risk pregnancy were more likely to experience poor pregnancy outcomes.

Still, researchers noted that even lower risk pregnancies are sometimes at risk of serious complications, and that doctors should carefully monitor all pregnant people and offer high quality care, regardless of their risk.

Researchers also note that people in high risk categories should receive referrals to specialists who are trained to manage high risk pregnancies.

How common are high risk pregnancies?

High risk pregnancies aren’t very common, but they’re not rare either. There’s not much research on the subject, but the World Health Organization does note that about 15% of pregnant women will experience a high risk pregnancy.

What kind of doctor treats high risk pregnancies?

If you have a high risk pregnancy, it’s important to work with a specialist. Perinatologists, also called maternal-fetal medicine specialists, are trained to treat people who have high risk pregnancy factors.

Will all my pregnancies be high risk?

It depends. If you have a medical condition that you continue to experience during subsequent pregnancies, you will still be in a high risk category.

But if you’re able to manage one of the factors that increases your risk, such as quitting smoking, you may be able to decrease your risk for later pregnancies.

Receiving the diagnosis of a high risk pregnancy can be scary, but there’s hope. Knowing what’s going on with your pregnancy and health means you can take the necessary steps to prevent the most serious outcomes.

Going to all your prenatal appointments, meeting with specialists when needed, and notifying your healthcare team about any new or concerning symptoms can help reduce your risk of pregnancy complications.