Have you been labelled as high risk? Or maybe you have had a previous high risk pregnancy... i have experienced both sides. With my first baby Nellie i was low risk and with Aubrey i was high risk due to low papp-a but i was soon signed off from high risk after my scans showed there was no worries with his growth at all! Pregnancy is a time often filled with excitement, but for those labelled as "high risk," it can bring a lot of extra worries. The high risk label brings up questions: What does it mean to be "high risk"? Why do some feel this label takes away from their pregnancy experience?
Understanding the High-Risk Label
The high-risk label encompasses a wide range of situations. Sometimes, it reflects serious health issues, like diabetes or a chronic medical condition, and other times, it's based on factors like age, BMI, or the potential for a large baby. While these factors are well-intentioned as they help healthcare providers identify who might need additional monitoring or interventions they often fail to capture the individuals wants and needs for labour.
For some women, high-risk care is vital, providing essential support that could prevent serious complications. For others, the label can seem excessive and create unnecessary anxiety, especially when the actual risks are low or manageable. In the end, everyone’s experience is unique, and the high-risk label doesn’t always reflect that.
Factors That May Lead to a High-Risk Label
The list of reasons that could place someone in the high-risk category is long... longer than my arm: chronic conditions like high blood pressure, gestational diabetes, having twins or triplets, undergoing IVF, BMI and more. But each of these factors affects individuals differently.
For instance, BMI is often a reason for high-risk care, but some women with higher BMIs have perfectly healthy pregnancies, while women with lower BMIs may face unexpected complications. I was High BMI with both my pregnancies but i had two very healthy straight forward births and pregnancies. The high-risk label sometimes overlooks the broader health picture and instead places people in broad, oversimplified categories.
Questioning and Advocating: Why Asking “Why?” is Essential
The high-risk label often leads to more frequent tests, interventions, and sometimes contradictory guidance. For instance, being told you need an induction due to the risk of a large baby may seem like solid advice, but some research indicates that induction can increase risks of complications like shoulder dystocia or hemorrhage—the very risks the intervention aims to prevent.
Being informed and asking questions can be empowering. Ask why specific interventions or tests are recommended, what evidence supports them, and how they could impact your pregnancy. For example, continuous CTG monitoring is standard for high-risk pregnancies, but evidence on its benefits is mixed. Studies suggest that CTGs can lead to unnecessary interventions without improving outcomes in certain cases.
The Right to Informed Consent and Personalised Care
Too often, mothers are told that certain procedures are mandatory or "musts," but informed consent is a critical right in healthcare. It's reasonable to ask for explanations, second opinions, or alternatives. You can ask for detailed statistics, benefits and risks, and even opt out of specific tests or interventions if they don’t feel necessary for your situation. So many people wont ask as they are worried they will be the "awkward" ones but remember... you only get to birth this baby once and its so important to feel fully supported and in control!
Even if you’re labeled high risk, you have choices. You can decline certain interventions, choose another consultant, or opt for specific monitoring types based on your comfort. If you’re prescribed medication, you have the right to review the patient information leaflet and ask how it might impact your pregnancy, baby, and postpartum journey.
Navigating the High-Risk Journey with Support
For many, being proactive in a high-risk pregnancy can feel intimidating, as though asking questions means undermining the expertise of the healthcare team. But these questions are part of informed, empowered care. Many find it helpful to have an advocate—whether a partner, friend, or doula who can support them in asking questions, voicing concerns, and ensuring they feel heard and respected.
Ultimately, it’s your pregnancy and your journey. You deserve a positive experience and the right to feel informed, confident, and supported. Remember, healthcare providers are there to guide you, but they’re also there to listen. You deserve to understand every step of the process, so you can focus on enjoying your pregnancy and preparing for birth.
In short, no matter the risk level or type of care, every pregnancy journey is unique. Expecting mothers should feel empowered to make the decisions that are best for them, drawing from a foundation of respect, information, and choice. In this way, pregnancy can remain a beautiful journey, one shaped by empowerment and guided by the unique needs of each individual.
If anyone is experiencing the high risk label and not quite sure how they feel or how to navigate it and unsure on what questions to ask then please send me a message and we can discuss.
You are never alone!
Meg x x
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