What is a high risk pregnancy?

A high-risk pregnancy is when you or your baby has a greater chance of having problems or complications during the pregnancy or birth. 

Your midwife or doctor may consider this pregnancy to be high risk if:

• you had complications in a previous pregnancy
• you have health issues related to this pregnancy
• you have health issues that are not related to pregnancy
• tests show that your baby has health issues

There are many reasons your pregnancy might be considered high risk. Some examples are listed below.

Your health and your background

Some factors related to your health, age or circumstances may increase the chance of complications. These include:

• drinking alcohol, smoking or using drugs in pregnancy
• living with obesity
• being aged under 17 or over 35 years old
• having high blood pressure or high risk of pre-eclampsia
• pre-existing medical conditions (such as epilepsy, diabetes, asthma, kidney disease, heart disease, autoimmune disease or any condition for which you have ongoing care from a doctor)
• mental health conditions
• psychosocial factors such as developmental delays, limited social support or past experiences of violence or social isolation.

Causes related to your baby

Some conditions affecting your baby may also make your pregnancy higher risk. These include:

• having a baby that is measuring small at your pre-natal checks
• multiple pregnancy (twins or more)
• symptoms that suggest you may give birth prematurely (early) to a preterm baby in this pregnancy

Risk factors related to your previous pregnancy

Certain complications in a previous pregnancy may increase the chance of similar issues happening again. These include:

• losing a previous pregnancy
• giving birth to a preterm baby
• having diabetes in pregnancy
• pre-eclampsia

It is recommended to have your first appointment (first antenatal visit) with your maternity care provider before 10 weeks of pregnancy. Early antenatal care may be connected to better health outcomes for both the parent and baby.

If you have a high-risk pregnancy, your midwife or doctor will watch your pregnancy more closely and may be more involved throughout the process. This may mean more blood tests, ultrasound scans or appointments with obstetricians that specialise in high-risk pregnancies, such as maternal-fetal medicine specialists.

You may also need to start taking medicine. If you have high blood pressure, you will need to go to the hospital or health centre for blood tests, blood pressure checks and to monitor your baby's heart rate.

The specific risks to you or your baby’s health change depending on what conditions and risk factors you or your baby have. Some examples of the risks are listed below, but they are different in every case.

Risks to you may include:

• blood clots
• kidney or liver failure
• stroke or seizures
• abnormal bleeding
• gestational diabetes
• high blood pressure or pre-eclampsia

Risks to your baby may include:

• higher rate of miscarriage
• differences in growth — being smaller or bigger than normal
• development problems with the brain or spine
• being born premature
• needing care in a special care nursery in hospital
• stillbirth

The options for the type and timing of your birth will depend on your specific needs. You may need to have your baby in a hospital or birth unit that has the right staff and equipment to care for the medical conditions that you or your baby have.

If your baby needs to be born but you are not yet in labour, your health team may recommend an induction of labour. This may occur if you have a medical condition that means continuing the pregnancy for too long adds to the risk of more problems, such as with high blood pressure.

Sometimes your baby will be born by caesarean section. This may be an elective (planned) caesarean section, for example, if you have triplets. You may need an emergency caesarean if there is concern for your baby’s wellbeing or there is a life-threatening emergency.

Your midwife or doctor will explain to you why they are recommending a caesarean section. They will make sure you understand the risks and benefits of having or not having the operation so you can give informed consent.

Read more about informed consent and your rights when having a baby.

• Mercy Perinatal has information about conditions that can make your pregnancy high risk.
• The Royal Australian College of Obstetricians and Gynaecologists (RANZCOG) has an information sheet about high blood pressure in pregnancy and pre-eclampsia.
• RANZCOG has a patient factsheet about why your weight matters during pregnancy.

Languages other than English

• Diabetes Australia has a range of videos about diabetes in pregnancy in many community languages.
• The Royal Women’s Hospital provides fact sheets about pregnancy and birth in other languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• The Baby Coming You Ready website has information about pregnancy for Aboriginal and/or Torres Strait Islander people.
• The Australian Diabetes in Pregnancy Society has a diabetes in pregnancy brochure for Aboriginal and/or Torres Strait Islander people.