Specialties & Services

High-Risk Pregnancy

A high-risk pregnancy is a pregnancy in which a mom, baby, or both have a higher chance of complications during pregnancy, labor, or delivery. With a maternal-fetal medicine specialist, many moms have healthy pregnancies and babies—as well as a typical labor and delivery experience—even when they need extra care along the way. A pregnancy may be high risk due to advanced maternal age, preeclampsia, multiples, and other health conditions. In many cases, higher risk simply means closer monitoring to help support the best possible outcome. BJC HealthCare and WashU Medicine physicians specialize in diagnosing and treating pregnancy complications and fetal conditions while supporting families throughout pregnancy.

Find a maternal-fetal medicine specialist Find a high-risk pregnancy location

Why choose us for high-risk pregnancy?

BJC HealthCare and WashU Medicine deliver expert high-risk pregnancy care. Your pregnancy may be considered high-risk if a medical condition—either preexisting or one that develops during your pregnancy—affects your health or the health of your baby, you are pregnant with multiples, or you’re age 35 or older. If your pregnancy is considered high-risk, it's important to get the right care. At BJC HealthCare, you’ll find:     

  • WashU Medicine maternal-fetal medicine specialists: Maternal-fetal medicine specialists, also called high-risk OB-GYNs or perinatologists, are experts who specialize in caring for women with high-risk pregnancies. WashU Medicine maternal-fetal medicine specialists have been caring for mothers with high-risk pregnancies for more than 50 years. That deep expertise—treating thousands of moms a year, for decades—means they know what to look for, what to expect, and how to care for you with options that are backed by the latest research.  
  • Advanced diagnostic testing: Our diagnostic experts perform thousands of ultrasounds, genetic amniocentesis, and chorionic villus sampling (CVS) procedures each year. We also offer fetal echocardiograms, fetal MRI, and other specialized prenatal tests to diagnose complex conditions quickly and accurately, giving families clearer answers and helping physicians create the best care plan for mom and baby. 
  • Collaborative team: A multidisciplinary team of the region's leading specialists collaborate on your care, so you get the benefit of multiple experts with the confidence that your care is connected. Your team may include high-risk pregnancy providers, sonographers (specialists in ultrasound imaging), genetic counselors, specialized nurses, midwives, and neonatologists (doctors who specialize in newborn care).   
  • Care for complex fetal conditions: At the Fetal Care Center, a collaboration among Barnes-Jewish Hospital, WashU Medicine, and St. Louis Children's Hospital, specialists provide integrated maternal and fetal care—including some of the most advanced and complex fetal surgeries and interventions for rare fetal conditions—in one location.   
  • Care for complex newborn conditions: We have multiple newborn intensive care units (NICUs) across BJC HealthCare hospitals, including St. Louis’ only Level IV NICU connected to labor and delivery. If your baby needs NICU care, you will be right down the hall. 
  • Transport services: The BJC Maternal-Fetal and Newborn Transport Service provides 24/7 specialized ground and air transport for high-risk pregnant moms and critically ill newborns. 

What makes a pregnancy high-risk?

 A pregnancy may be considered high-risk because of: 

  • Maternal age of 35 or older  
  • Preexisting health conditions  
  • Pregnancy complications or loss 
  • Multiple gestation including twins, triplets, or more 
  • Concerns about the baby’s growth or development   
  • Fetal conditions
A pregnant woman talking with a doctor

Expert care for high-risk pregnancy

With specialized expertise and convenient locations across the region, we're here to help you feel confident and supported throughout your journey.

Frequently asked questions

How do I know if my pregnancy is high risk?

Every pregnancy is different. Your OB-GYN will consider your health history, current health, previous pregnancies, and how your pregnancy is progressing to determine whether you or your baby would benefit from care from a maternal-fetal medicine specialist.

What extra care will I receive if my pregnancy is high-risk?

At BJC HealthCare, WashU Medicine maternal-fetal medicine physicians specialize in high-risk pregnancy care and provide advanced expertise, evaluation, close monitoring, testing, and coordinated services for complex maternal and fetal conditions.  

Our high-risk pregnancy services include: 

  • Preconception and prenatal counseling 
  • Genetic screening and genetic counseling 
  • Advanced imaging including ultrasound, fetal MRI, and fetal echocardiogram  
  • Prenatal diagnostic testing, such as chorionic villous sampling (CVS) and amniocentesis 
  • Coordination of care among your primary OB-GYN and maternal-fetal specialists and access to the Fetal Care Center at Barnes-Jewish Hospital 
  • Specialized in-utero procedures, including the only hospital in the region able to perform fetoscopic surgery 
  • Multiple locations throughout the St. Louis area and southern Illinois 

What conditions make a pregnancy high-risk?

  • Advanced maternal age 
  • Autoimmune disorders 
  • Blood disorders 
  • Complex mental health conditions 
  • Diabetes 
  • Epilepsy 
  • Heart disease 
  • Hypertension 
  • Kidney disease 
  • Maternal genetic condition 
  • Multiple sclerosis 
  • Neurologic conditions 
  • Prior abdominal surgery 
  • Prior cesarean section 
  • Prior miscarriage 
  • Prior preterm birth 
  • Thyroid conditions 

What pregnancy complications can make a pregnancy high-risk?

  • Abnormal fetal growth 
  • Abnormal levels of amniotic fluid 
  • Fetal anemia 
  • Gestational diabetes 
  • Hyperemesis gravidarum (severe nausea and vomiting) 
  • Placenta previa 
  • Placental abruption 
  • Preeclampsia 
  • Preterm labor or preterm birth 

What support and resources are provided to moms and families before and after delivery?

We help you face the physical, emotional, and spiritual challenges of a high-risk pregnancy or a baby with a fetal condition. Services include in-person and virtual perinatal behavioral health counselors, a perinatal hospice program, chaplains, and other resources to help you and your family cope and heal.    

What kind of doctor specialized in high-risk pregnancies?

Maternal-fetal medicine (MFM) specialists are OB-GYN physicians with additional training to care for high-risk pregnancies. They work closely with your primary OB-GYN to help manage health conditions, monitor the baby's development and provide specialized care.

Can I have a healthy pregnancy if I am considered high-risk?

Yes, a high-risk pregnancy does not automatically mean that something is wrong. Individualized and specialized care with a maternal-fetal medicine specialist can help manage potential risks. 

Does being pregnant after the age of 35 make my pregnancy high-risk?

Advanced maternal age may come with an increased risk of certain complications, but it does not mean you will have problems during your pregnancy. Your OB-GYN will consider your overall health, medical history, and other factors to determine your risk. If needed, a maternal-fetal medicine specialist can provide specialized care and support you and your baby throughout your pregnancy.

Locations near you.