What is a high-risk pregnancy?

A high-risk pregnancy often requires special care. It means the mother and/or baby are in danger of having complications. It’s important to get prenatal medical care right away. This helps you and your baby stay as healthy as possible during pregnancy.

What are risk factors for a high-risk pregnancy?

Some factors for high-risk pregnancy are:

  • Existing health conditions: These may include conditions like diabetes, high blood pressure or being HIV positive
  • A mother’s age: Teen mothers have a higher chance of blood pressure problems. So do those who are 35 and older (this is called a geriatric pregnancy).
  • Multiple births at once: Having more than one baby at one time (for example, twins) can add to the chance of early labor and birth. It can also cause high blood pressure and other complications with delivery.
  • Being overweight or obese: Obesity has been linked to stillbirth, infant heart defects, high blood pressure and Cesarean (C-section) delivery, among other issues
  • A history of pregnancy problems like early delivery

Some factors that cause a pregnancy to be high-risk can’t be avoided. Some of these start in pregnancy (like gestational diabetes). Other factors can be treated before a pregnancy to lower a chance of problems. If you’re thinking of becoming pregnant, talk to your doctor about ways to stay healthy.

Signs and symptoms of a high-risk pregnancy

Meeting with your care provider is the best way to determine if you may have a high-risk pregnancy. However, there are some signs and symptoms to watch for, including:

  • Bleeding from the vagina 

  • Stomach or chest pain

  • A fever over 100.4 degrees

  • Dizziness

  • Fainting

  • A fast or fluttering heartbeat

  • Queasiness and vomiting that is more than just morning sickness

  • Thoughts of self-harm or hurting your baby

  • Trouble breathing

  • The slowing or stopping of your baby’s movement

  • Severe headache or blurry vision

If you’re experiencing any of these symptoms, contact your doctor right away.

Managing a high-risk pregnancy

If you have a high-risk pregnancy, it’s especially important to keep up on your prenatal appointments. Then you and your baby can be monitored for any signs of danger.

Each high-risk pregnancy is treated in its own way depending on the mother’s health condition. This may include medicines for certain conditions you may have or help making healthy life changes. A doctor may also decide if a surgical birth (C-section) is the safest way to deliver, or give you medicines your baby may need after birth. 

Your doctor may create a special care plan that includes:

  • Follow-up appointments closer together and more often
  • Meetings with pregnancy and other medical specialists
  • More ultrasounds
  • Home blood pressure checks
  • Regular checks of medicine used to manage other conditions you may have

You may also need to see a perinatologist, who is a doctor that specializes in high-risk pregnancies. You can lower your chance of complications during delivery by:

  • Thinking about what health risks you have before getting pregnant

  • Talking to your doctor about your medical and family history

  • Quitting smoking or vaping

  • Avoiding drugs and drinking alcohol

  • Managing any other health conditions you have

  • Keeping a healthy body weight

  • Eating healthy foods
  • Practicing safe sex

Serious complications of high-risk pregnancies include:

  • High blood pressure

  • Early delivery

  • Seizures

  • Birth defects

  • Low birth weight

  • Extreme loss of blood during or after delivery

  • C-section

  • Miscarriage or stillbirth

  • Intensive care admission and other medical problems

Newborn care and the neonatal intensive care unit (NICU)

If your baby is born with extra care needs, they may be transferred to the neonatal intensive care unit, or NICU. This is an area of the hospital specifically focused on caring for babies with specialized needs. Doctors and nurses with special training, such as neonatologists and pediatricians, will be caring for your baby.

There may be lots of beeping monitors in the room and machines connected to cribs. If your baby is admitted to the NICU, they will likely be on a regular care schedule and get a special care plan made just for them. It may include feedings, temperature checks, diaper changes and more, every couple of hours. This can feel overwhelming for new parents. NICU staff can answer your questions and direct you to support resources that can help.

Will my baby need to go to the NICU?

Your baby may need to be in the NICU if:

  • They are born before 37 weeks
  • They have a low birth weight
  • They have other special health needs like oxygen, medicine or monitoring

Every baby’s stay in the NICU will be a little different. Your baby’s pediatrician will decide how long they will need to stay in the unit. Many babies treated in the NICU grow into healthy children and adults. But they might also develop some medical problems. Some of these include:

  • Delays in learning

  • Mental health or behavior conditions

  • Asthma

  • Cerebral palsy, an illness that affects movement

  • Problems with the brain or spine

  • Dental issues

  • Hearing or vision loss

  • Problems with intestines

  • Infections

Your baby’s doctor will be able to guide you through the NICU journey. If you are a UnitedHealthcare member, you may have access to Neonatal Resource Services. This program provides a dedicated team of experienced NICU doctors, RN case managers and social workers to help support families during their baby’s stay in the NICU and after they go home. Sign in to your member account to see if this benefit is included in your plan.