High-risk pregnancy, real support: What experts want you to know

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Hearing the words “high-risk pregnancy” can change everything—your care plan, your expectations, and how you feel day to day. It’s a physically and emotionally demanding experience, but you’re not alone.

Here, three experts from Mère Health—a nurse practitioner, a perinatal therapist, and a pelvic floor physical therapist—share what they want every woman to know about navigating this chapter with support and confidence.

As told to Motherly. Lightly edited for clarity and flow.

What it means to carry the high-risk label

Jane Purser, DNP FNP-C: A high-risk pregnancy is defined as an increased chance of health complications for either mother, the baby, or both during pregnancy, birth, or after delivery. It doesn’t necessarily mean something will go wrong, but it does allow us as providers to pay close attention with more care and monitoring.

If we have this “high risk pregnancy”, now what? Managing it can be both emotional and physical—but there are people and protocols that are there to help hold your hand:

Regular Prenatal Visits
These are in place for close monitoring. If and when an OB feels like it is necessary, they may send you to see a Maternal-Fetal medicine specialist. This may seem scary, but these providers are just that extra layer of care to reassure you and closely monitor. You likely see a provider every 2 weeks starting as early as 20-24 weeks, all pending the condition. In addition, there may be additional growth ultrasounds, earlier non-stress tests, Biophysical profiles (BPP), lab work, and blood pressure checks.
Follow Medical Advice Closely
If given diet changes or recommendations, try your best to follow them. If prescribed a specific medication, trust the provider. Try your best to avoid misinformation or sources that aren’t reliable. You’ll easily get lost in the deep dark place of the internet that breeds fear and inaccurate information.
Healthy Diet and Adequate Hydration
I repeat, eat well and drink plenty. All nutrients are critical in pregnancy and especially important in high-risk scenarios. This is where obtaining labs and taking appropriate supplements can come into place. A functional medicine provider (hi, that’s me) would love to guide you through this. Folic acid, iron, calcium, and protein need to become your friends.
Manage Stress
Well of course, but how? Talk it out, and talk it out again. Find those safe people in your life that don’t care about the “I’m super worried“ texts at 1 a.m. This is also where a PMH-C therapist can really equip you with the correct tools to work through it.
Get Enough Rest
Say no to the late night dinner parties or early morning PTA meetings. This is not the season to be overdoing it. Listen to what your body needs and be okay with saying no so you can catch up on rest.
Move Your Body (Unless Advised Otherwise)
The American College of Obstetricians and Gynecologists (ACOG) recommends aiming for at least 150 minutes of moderate-intensity exercise a week. If you are fearful about what is appropriate, this is something to verify with your OB depending on your specific condition. Just because you have been labeled high-risk does not mean bed rest is required. This is patient-specific and will be discussed in detail if told to remain inactive.
Monitor your Symptoms
You are your biggest advocate—trust your gut.

Becca Hamilton, LPC, PMH-C: Hearing the words “high-risk pregnancy” can feel overwhelming. For many women, it sparks fear or confusion especially when everything has felt fine so far. It is helpful to think of “high risk” as a classification, not a sentence. It means that your pregnancy requires closer monitoring because there may be an increased chance of challenges or complications for you, your baby, or both of you.

It’s common to feel anxious or frustrated particularly when so much feels out of your control. Pregnancy is already filled with unknowns, and this label can add a new layer of worry: about your body, your baby, and your future. It can bring up feelings of guilt, frustration, or even grief, especially if you had hoped for a more straightforward or “normal” experience.

Some women feel like their joy is suddenly overshadowed by medical language and monitoring. Others feel isolated, unsure whether their experience still fits into the flowing, celebratory narrative often seen in pregnancy spaces.

Diagnoses and tests you might hear

Advanced Maternal Age Pregnancy: Historically, according to the American College of Obstetricians and Gynecologists, advanced maternal age has been defined as women who are 35 years or older at the estimated date of delivery.
Maternal Fetal Medicine Doctor: A maternal-fetal medicine specialist is a doctor who helps take care of women having complicated or high-risk pregnancies. These doctors are obstetricians who also completed three extra years of training in high-risk pregnancy. They are also called perinatologists and high-risk pregnancy doctors.
Amniocentesis: A procedure where a small amount of amniotic fluid is taken for testing genetic conditions or fetal health.
Non-Stress Test (NST): A test that monitors the baby’s heartbeat to check for signs of distress.
Fetal Monitoring: Continuous or periodic checking of the baby’s heart rate and movements during pregnancy or labor.

What qualifies as a high-risk pregnancy?

Jane Purser, DNP FNP-C: It can be known medical conditions such as high blood pressure or preeclampsia, diabetes (gestational or pre-existing), autoimmune diseases, being overweight or underweight.

It can also be pregnancy-related factors such as being pregnant with multiples, age (under 17 or over 35), having a known history of miscarriage or preterm labor, placenta previa or placental abruption. Other environmental or situational factors may make it high-risk too; smoking, alcohol, or drug use, lack of prenatal care and/or exposure to high-stress situations.

Common diagnoses that would indicate a high-risk pregnancy

Preeclampsia: A condition marked by high blood pressure and often protein in the urine, usually after 20 weeks. Can affect organs and the baby’s growth.
Gestational Diabetes: A type of diabetes that develops during pregnancy, affecting blood sugar regulation.
Placenta Previa: When the placenta covers part or all of the cervix, which can lead to bleeding and may require a C-section.
Placental Abruption: A serious condition where the placenta separates from the uterine wall before delivery, possibly reducing oxygen to the baby.
Preterm Labor: Labor that begins before 37 weeks of pregnancy. It increases the risk of complications for the baby.
Intrauterine Growth Restriction (IUGR): When a baby is smaller than expected for the number of weeks pregnant, often due to poor blood flow or other conditions.
Cervical Insufficiency: A weakened cervix that may open too early, increasing the risk of miscarriage or preterm birth.

What age is considered a high-risk pregnancy?

Jane Purser, DNP FNP-C; Becca Hamilton, LPC: Why is Advanced Maternal Age (AMA) considered high risk?

Egg quality and quantity start to decline around that age, which can lead to higher risk of miscarriages or abnormalities.
Higher risk of pregnancy-related complications such as Gestatational Diabetes, Preeclampsia, Placenta previa, or delivering preterm.
Increase risk for genetic diagnoses: a risk of having a baby with chromosomal issues rises with age.
Labor and delivery challenges: labor may take longer and could be more complicated.

But rest assured, JUST because it’s high risk does NOT mean it’s unhealthy. Many women in their late 30s and 40s have successful pregnancies.

The emotional toll: Coping with fear, grief, and uncertainty

Becca Hamilton, LPC, PMH-C: The emotional weight of a high-risk pregnancy is often invisible. If you are feeling anxious, overwhelmed, or grieving a pregnancy that looks different than you imagined, you are not alone.

When a pregnancy is labeled, “high risk,” it is not just that your care plan changes, your emotional landscape shifts as well. For many women, this means a constant hum of “what-ifs”, an emotional readiness for bad news, and a protective kind of hope that keeps joy at arm’s length.

It is very common to feel anxious before ultrasounds, to hold your breath during appointments, or to cry afterward, no matter the outcome. The fear is real because the stakes feel so high.

There is also often grief for the uncomplicated experience you hoped for, for the ease you imagined, for the moments you thought would feel different. You might find yourself avoiding baby showers, struggling to connect with your pregnancy, or comparing your journey to someone else’s. These are tender losses, even if they seem invisible to others, and they deserve to be named and honored.

I have heard many women say things like, “I should just be grateful,” or “Other people have it worse.” Minimizing your feelings does not make them go away, it makes you feel more isolated. Your experience is valid, even if it does not match the glossy version of pregnancy we so often see.

It can be both empowering and grounding to hold two truths at once: it is completely valid to feel disappointment or uncertainty in the face of many unknowns, and being labeled “high risk” also means receiving more attentive care, thoughtful planning, and support for you and your baby through every step of the journey.

This journey requires a kind of emotional stamina that often goes unseen. It takes strength to show up to appointment after appointment, to hold space for both fear and hope, and to keep loving a baby while navigating so much uncertainty.

How to care for yourself emotionally during a high-risk pregnancy

Becca Hamilton, LPC, PMH-C: When your pregnancy is labeled “high risk”, it is easy for emotional well-being to take a back seat to medical monitoring. Understandably, the focus shifts to tests, scans, and appointments, but your emotions deserve care, too.

Tending to your mental health during a high-risk pregnancy is not just important, it is essential. Drawn from my work as a therapist supporting women through pregnancy journeys, here are some ways to care for yourself emotionally during this complex time:

Therapy is not just for crisis, it is for support. Speaking with a therapist trained in perinatal mental health (look for PMH-C or perinatal-specialized credentials) can give you space to process fears, grief, and uncertainty in a way that feels safe and validating.
Journal without judgement. Pregnancy journaling is not just for documenting milestones, it can be a powerful emotional release. Write your fears, your frustrations, the questions you are too tired to say out loud. You are not trying to solve anything, you are just giving your inner voice a place to land.
Try simple grounding practices. Practicing mindfulness, engaging your senses, or listening to music can help soothe your nervous system when things feel intense. These practices can help regulate anxiety and restore a sense of connection.
Set boundaries around your energy. You are allowed to say “not right now” and to protect your peace! This might mean skipping certain social events, muting triggering pregnancy content on social media, or letting others know how (and if) you want to talk about your pregnancy.
Talk to your providers about feelings, not just symptoms. Your emotional health matters just as much as your physical health. If you are feeling anxious before appointments, worried about delivery, or just emotionally exhausted, say so. That is not complaining, it is advocating.
Find connections in your community. Isolation is a common experience in high-risk pregnancy, especially if you do not know others who have been through it. Online spaces can be a lifeline. Some supportive communities include:
- Mère Health Journal: Personal journeys and trusted guidance around women’s health and motherhood.
- Postpartum Support International (PSI): Offers online support groups for high-risk pregnancy and NICU parents.
- Peanut App: A social network for moms with groups by pregnancy stage, risk factors, and emotional needs.

Supporting your body through a high-risk pregnancy

Dr. Margaret Archer, PT, DPT: When experiencing a high-risk pregnancy, women can have feelings of wanting to “freeze” and “protect” especially if they have suffered prior loss. Staying active during a high-risk pregnancy can feel scary and overwhelming for many women.

This can often lead to women stepping away from exercise that they love for fear of danger to themselves or their baby; however, continuing to move throughout pregnancy has many benefits and for some women experiencing high-risk pregnancies, exercise may be an important piece of care.

During a high risk pregnancy, exercise can help you reduce the risk of pelvic floor symptoms like incontinence, help reduce aches and pains like low back and pelvic pain that are common during pregnancy, and prepare you to be physically as strong as possible moving into postpartum.

Additionally, exercise can be important for women for their mental health in navigating a challenging time, like a high-risk pregnancy. While exercise for most pregnancies is safe, it can be helpful to work with a pelvic floor physical therapist and your medical provider to determine what is safe for you and your unique pregnancy, while recognizing that that may change over the duration of your pregnancy. This may mean that exercise may look different for you than it had in the past, or that you are able to continue with your current exercise.

It is important to gather a team of providers that can give you up-to-date, evidence-informed information about exercise while allowing you the space for you to make choices. Finding providers who can give you an individualized plan when it comes to exercise recommendations for you and your pregnancy can make a world of difference for supporting your body through a high-risk pregnancy.

Lastly, it can be incredibly beneficial to begin pelvic floor physical therapy services prior to delivery. Whether you are having a planned c-section or a vaginal birth, a pelvic floor physical therapist can help you address any pelvic floor symptoms you may be having in pregnancy, prepare your body for your birth, and can help equip you with the tools to begin your recovery process postpartum!

The bottom line

Becca Hamilton, LPC, PMH-C: Managing a high-risk pregnancy can feel physically and emotionally overwhelming, but remember: you are not alone.

The complexities of this experience require immense strength and resilience. There is space for you to feel and name your anxiety, fear, or numbness; these emotions do not define you or signal that you are broken, they point to a need for great care.

Amid the challenges, there is beauty to be found in the moments of growth, connection, and perseverance. Every step of this journey, though difficult, can offer a deeper appreciation for your body’s strength and your ability to navigate these obstacles. The quiet moments of connection with your baby, the small victories along the way, and the support you receive from your care team are all part of the experience.

Even when it is hard to hold onto in the moment, your vulnerability and resilience reflect deep courage, and they are a powerful part of your family’s unfolding story of hope.

Here are a few questions to take away with you & discuss with your provider(s):

What additional providers will I need to see?
Does this shift my appointment frequency?
How might this affect my delivery?

FAQs

What makes a pregnancy high risk?
It can be known medical conditions such as high blood pressure or preeclampsia, diabetes (gestational or pre-existing), autoimmune diseases, being overweight or underweight. It can also be pregnancy related factors such as being pregnant with multiples, age (under 17 or over 35), having a known history of miscarriage or preterm labor, placental previa or placental abruption. Other environmental or situational factors may make it high risk too; smoking, alcohol, or drug use, lack of prenatal care and/or exposure to high stress situations.

At what age is a pregnancy considered high risk?
Historically, advanced maternal age has been defined as women who are 35 years or older at estimated date of delivery. Pregnancies under the age of 17 are also considered high-risk.

Can you have a healthy baby with a high-risk pregnancy?
YES! “High-risk” doesn’t necessarily mean something will go wrong. That said, the diagnosis does allow providers to pay close attention with more care and monitoring.

How often will I see my doctor during a high-risk pregnancy?
This is dependent on your specific reason for being high-risk. It’s a great question to ask in your early appointments.

What can I do to manage stress during a high-risk pregnancy?
Tending to your mental health during a high-risk pregnancy is not just important, it is essential. Seek therapeutic support! Look for PMH-C or other perinatal-specialized credentials, this means your therapist is specifically trained to support you through perinatal chapters.

Is bed rest always required for high-risk pregnancies?
No! Your provider(s) will discuss any need to limit activity based on your situation.

Mère Health offers comprehensive, full-service, virtual care from specialized therapy to functional medicine for preconception, pregnancy, postpartum, and beyond. Available in both Georgia & South Carolina.

Jane Purser DNP FNP-C is a Nurse Practitioner that is Family Medicine board certified and Functional Medicine trained. She is devoted to caring for women holistically with a root-cause approach and deeply desires for all her patients to be heard and valued.

Becca Hamilton LPC, PMH-C is a dedicated psychotherapist who specializes in supporting adult women through the intricate challenges of reproductive health across the lifespan. With a trauma-informed, person-centered approach, Becca creates an environment rooted in trust and emotional safety where clients can experience hope and healing.

Dr. Margaret Archer is a pelvic floor physical therapist who graduated from Medical University of South Carolina in 2016. She is passionate about providing care to all women but specifically loves the pregnancy/postpartum space. She believes in a fitness-forward, evidence-informed approach to pelvic floor rehabilitation.

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