Can Midwives Handle High-Risk Pregnancies?

If you’re pregnant and planning to have a midwife care for you, you might wonder what happens if you’re high risk.

While midwives routinely provide care for low-risk pregnancies, many also care for women whose pregnancies are high risk and partner with physicians who specialize in high-risk cases.

A growing number of women in the United States are choosing midwives to provide prenatal care and deliver their babies. Midwives provide care for all aspects of pregnancy, labor and delivery, as well as the postpartum period. Many women appreciate the holistic, hands-on care midwives provide.

Statistics show that the midwifery model of care — which views pregnancy and birth as natural processes — leads to fewer medical interventions, such as Cesarean sections and episiotomies.

Is My Pregnancy High Risk?

A pregnancy is high risk when either the mother, baby or both have a greater chance of experiencing complications during pregnancy or delivery. Some women are at a high risk of complications before they get pregnant, while others become high risk as the pregnancy progresses. 

Women who are at high risk before becoming pregnant include those who:

• Are 35 or older

• Are obese (BMI of 30 or higher)

• Experienced problems with a previous pregnancy, like multiple miscarriages or preterm labor

• Have pre-existing medical conditions, such as diabetes or high blood pressure.

Factors that may cause a pregnancy to become high risk as it progresses include:

• Birth defects or genetic conditions detected during prenatal screenings

• Carrying multiple babies

• Gestational diabetes

• Preeclampsia, high blood pressure that develops during pregnancy. 

Having a high-risk pregnancy does not automatically mean you or your baby will experience problems. More likely, it means you will require additional monitoring, such as bloodwork and ultrasounds, or may need medical interventions during labor and delivery.

How Midwives Care for High-Risk Pregnancies

Midwives care for women experiencing high-risk pregnancies, such as expectant mothers who are older than 35, are carrying multiples or have pre-existing medical conditions. 

When a high-risk pregnancy requires more medical management, midwives often work with physicians who have special training in high-risk pregnancy care, such as OB-GYNs and maternal-fetal medicine specialists.

Your midwife will work with you and physicians as a team to ensure the best outcome for you and your baby during pregnancy and postpartum. 

When a Low-Risk Pregnancy Becomes High-Risk

If health concerns develop during your pregnancy while under the care of a midwife — like preeclampsia or gestational diabetes — your midwife will consult with physicians who have special training in high-risk pregnancies.

Your midwife will continue to play an integral role as a member of your care team, even if your care is transferred to these specialists. Your midwife and the physicians will work collaboratively to establish a care plan for your pregnancy. This may include additional prenatal appointments, screening tests, prescription medications, or planning a C-section, depending on the factors that make your pregnancy high-risk.