Pregnancy is often experienced as a transformative time in a woman’s life. It brings physical, mental, social and emotional changes. While the majority of pregnancies progress smoothly, nearly 22% of women experience a high-risk pregnancy. This designation has implications for the physical health for both the mother and their unborn child. In addition, navigating the emotional toll of a high-risk pregnancy will be essential for being prepared for the transition to motherhood.
If you’ve been diagnosed with a high-risk pregnancy, the initial joy of expecting a baby can quickly shift to anxiety and concern. However, with early and regular prenatal care, many women with high-risk pregnancies go on to have healthy babies and safe outcomes. Managing a high-risk pregnancy often requires lifestyle changes. A strong support system and well-thought-out plan are crucial..
Understanding High-Risk Pregnancies
A high-risk pregnancy means that the mother, baby, or both are at a higher chance of complications. If you enter pregnancy with conditions like diabetes, hypertension, or heart disease you are at increased risk. Other issues may develop during the course of the pregnancy, like pre-eclampsia, gestational diabetes, placenta previa, or preterm labor. Age, multiple miscarriages, or carrying multiples (twins or more) can also contribute to a high-risk diagnosis. Doctors typically refer women to a Maternal-Fetal Medicine Specialist for additional monitoring and care after diagnosis..
Tips for Managing a High-Risk Pregnancy
Stay Informed
Knowledge is power. Understanding the risks associated with your condition can help reduce stress and allow for better decision-making. Ask your doctor questions, keep a notebook for concerns, and rely on credible sources such as The Society for Maternal-Fetal Medicine and The American College of Obstetrics and Gynecology. Don’t allow yourself to be intimidated if you don’t understand something. Speak up and politely, demand explanations.
Build a Strong Support System
Lean on family, friends, mental health experts and medical professionals during this time. Lifestyle changes may mean scaling back on commitments, so having a reliable support network can help ease the transition. Joining a high-risk pregnancy support group can also provide emotional reassurance. Ask your physician for a referral to a therapist with experience working with high-risk moms. If you are on bedrest, ask for a referral to someone who offers telehealth appointments.
Stop the Blame Game
Having a high-risk pregnancy is not your fault. Blaming yourself only adds to the stress and guilt that are already difficult to manage. Instead, take a proactive approach to managing your pregnancy as guided by your medical team.
Develop a Plan with Your Healthcare Providers
Work with your OB/GYN and, if needed, a Maternal-Fetal Medicine specialist. Together, create a proactive care plan. This includes understanding how many prenatal appointments may be required and discussing delivery options. Some hospitals may not have a Level 3 NICU. It’s important to understand the implications of this. If your newborn needs that level of care, doctors will transfer them to an appropriate hospital. Your newborn will stay at one hospital while you recover at another. This can add a tremendous amount of stress to an already emotionally charged situation. Know your options and decide in advance if you’d prefer to deliver at a hospital with a Level 3 NICU.
Prioritize Self-Care
Taking care of yourself is one of the best things you can do for your baby. Though most women are aware of the importance of self care for both themselves and their baby, the reality can be challenging. If you are on modified or full bed rest, exercise may not be advisable or possible. Eating well when you may be dependent on others to prepare your meals may be challenging at times. Your sleep may be disturbed due to a lack of physical exertion. Talk to your physician about what, if any, exercise is allowed. For example, being told to “take it easy” is too vague. Ask if you can take walks, do yoga or engage in stretching. If these are not allowed, engage in meditation, progressive relaxation or tapping to help manage stress.
Listen to Your Body
Pregnancy demands a lot from your body, so it’s important to slow down and pay attention to any warning signs. Even if your doctor has OK’d certain physical activities, if something feels off, don’t hesitate to contact them. If they still approve, but your gut is saying something is not right, listen to your body.
Address Mental Health Concerns
High-risk pregnancies can bring heightened emotions, including anxiety, guilt, and depression. Research shows that women hospitalized for pregnancy complications are at increased risk for depression. Having a safe space to process events, fears, frustrations and loss of the pregnancy you’d dreamed of can be extremely helpful. If these emotions become overwhelming or interfere with daily life, seek support from a therapist or counselor.
Be Open to Exploring Medication
If after working with you your therapist recommends exploring medication for anxiety or depression, don’t be afraid to ask questions. Many women worry about taking medication during pregnancy, but healthcare providers can guide you on safe options. In some cases, the benefits of treating mental health conditions outweigh any potential risks of medication. Seek a consultation with a psychiatrist who is familiar with maternal-fetal medicine to help determine the best course of action. Make an informed decision about medication as an option.
Hospital Bedrest
If you are placed on hospitalized bedrest, your life will come to an unexpected stop. This sudden disruption to daily routines, work, and family responsibilities can feel overwhelming. Many women struggle with the loss of independence on top of the uncertainty of their and their baby’s health, leading to increased stress or even depression. Logistically, it requires major adjustments for household management, childcare, and financial planning, especially if you are unable to work. Partners and family members may need to take on additional responsibilities, which can strain relationships. The hospital environment itself—limited mobility, constant monitoring, and lack of privacy—can add to the emotional burden. Seeking emotional support, staying connected with loved ones, and working with hospital staff to maintain a sense of routine can help ease the challenges of an extended hospital stay
After Pregnancy: The Emotional Aftermath
Once the baby arrives, medical risks to you may decrease, but emotional challenges can persist. If your baby must remain in the NICU, you are facing concerns about their health and progress. You may be being asked to make medical decisions when you are tired, overwhelmed and sad. If your baby is healthy but needs to gain weight, you may travel back and forth to visit them. Interrupted sleep may also be a challenge if you choose to pump milk during this time.
Postpartum hormonal shifts make this period even more challenging. Watch for lingering or new emotional symptoms. Ask a trusted advocate to also be watching to see if they notice any mental health concerns. If sadness, anxiety, or mood swings continue beyond the baby blues phase, don’t ignore them. Postpartum anxiety or depression are real and treatable. Thoughts of self-harm or harming the baby require immediate intervention
You Are Not Alone
Navigating the emotional toll of a high-risk pregnancy can feel isolating, but support is available. Taking care of your mental health is just as vital as your physical health. Recognizing your emotions, reaching out for help, and having a plan in place can help you navigate this journey with greater confidence and peace of mind.