A birth can be considered high risk for a variety of medical reasons either that there is an increased risk to either or both the Mum and her baby. All pregnancies have a certain risk but some carry a higher risk of problems with either the pregnancy or the management of your birth. You are likely to be considered higher risk if you:

• Have a history of recurrent miscarriage.
• Are over 40 years of age.
• Have Type 1 diabetes or develop gestational diabetes.
• Suffer from long-term (chronic) hypertension or pregnancy-induced hypertension.
• Develop pre-eclampsia or eclampsia.
• Smoke, drink heavily or take illegal drugs.
• Your baby is small for dates (inter-uterine growth restriction).
• You are carrying more than one baby.
• Your baby is lying in a breech or lying across your abdomen.
• Have had a previous caesarean delivery and want to try a vaginal birth (VBAC).
• Have previously had a preterm labour.
• Develop problems with the placenta, uterus, cervix, amniotic fluid, blood and others.

If you are deemed to have a high-risk pregnancy, you might be moved from your regular antenatal care team to obstetrician-led care with a high-risk specialist, known as a perinatologist, or a maternal foetal medicine specialist. Your medical team work with you to will decide what’s best for your particular situation. It may be that you are high risk only for the pregnancy and not for the birth, in which case you’ll be returned to your original team for the delivery.

You are likely to have more ultrasound scans and, depending on the reason for the high-risk status, your care team will discuss possible tests with you. These include:

• Amniocentesis or chronic villus sampling to tests for abnormalities and some genetic diseases.
• Specialist ultrasound on a particular area of concern, for example, a Doppler scan to assess blood flow from the placenta to the baby.
• Cordocentesis – this tests foetal blood for chromosomal abnormalities.
• Biophysical profile – prenatal test on baby’s heart-rate and general wellbeing.
• Cervical length measurement – via ultrasound to determine whether you are at risk of a pre-term labour.
• Vaginal swab to check for the presence of foetal fibronectin, which can be a sign of pre-term labour.
• Specific bloods test might also be carried out depending on certain diagnosis, such as pre eclampsia or cholecystasis of pregnancy.