Pregnancy is often celebrated as a magical time, but for some, being labeled “high-risk” can bring uncertainty and fear. In this episode, I’m joined by Amber Matteson (she/they), a highly experienced doula specializing in supporting high-risk birthing people. Whether you’ve just received a high-risk diagnosis or want to better understand your options, Amber shares practical strategies to reclaim your power and prepare for birth with confidence.
We’ll Cover:
What a high-risk pregnancy really means and why the term can be misleading
Tips for unpacking the emotional weight of a high-risk diagnosis
Advocacy strategies to communicate effectively with healthcare providers
How to create a flexible birth plan that aligns with your values
Why doula support is invaluable, especially for high-risk pregnancies
Listen to the podcast now:
Pregnancy is often celebrated as a magical time, but for some, the label “high-risk” can shift the journey into a realm of uncertainty and fear. In the latest episode of our podcast, we tackle this complex topic with Amber Matteson, a highly experienced doula specializing in supporting high-risk birthing people. Whether you’ve just received a high-risk diagnosis or want to better understand your options, this conversation offers practical strategies to help you reclaim your power and prepare for birth with confidence.
What Is a High-Risk Pregnancy?
High-risk pregnancies are often defined by specific medical or situational factors that could complicate birth. But as Amber explains, the term itself can be misleading.
“Risk is so individual,” Amber shares. “For some, it might mean something as simple as advanced maternal age, while for others, it could involve a more complex medical history.” She stresses the importance of understanding the nuances of your situation rather than simply accepting the label at face value.
For example, advanced maternal age (being 35 or older) is commonly cited as a risk factor, but Amber points out that this might not actually increase risks for a healthy individual with no other complicating factors. Similarly, outdated metrics like BMI are still used in some medical settings, even though current evidence suggests they often have little bearing on actual pregnancy outcomes.
Breaking Down the Emotional Weight of a Diagnosis
Amber frequently works with clients who feel overwhelmed by a high-risk diagnosis, often given early in pregnancy without much explanation. The first step, she advises, is to unpack what that diagnosis truly means.
“Ask your provider what your specific risk factor is and how it affects your pregnancy,” she recommends. For instance, what does it mean if you are referred to maternal-fetal medicine (MFM)? Why is additional monitoring needed? This clarity can help reduce anxiety and shift the narrative from fear to informed decision-making.
The Role of Advocacy: Your Voice Matters
Tips on how to communicate effectively with healthcare providers.
Key Advocacy Strategies:
Ask for Real Numbers: If a provider mentions an increased risk, follow up by asking, “What is the actual percentage?” Many high-risk concerns are based on small statistical increases, such as a rise from 0.03% to 0.05%. Knowing this context can help you decide what risks are acceptable to you.
Learn the Language: Don’t hesitate to ask, “What does that term mean?” Medical professionals often use jargon that may feel intimidating, but understanding it can empower you to make more informed choices.
Clarify Recommendations: Frame conversations with your care team around shared decision-making. Instead of accepting “you need to,” ask, “Why is this being recommended, and what are my options?”
Amber highlights that it’s perfectly fine to challenge or seek second opinions if a recommendation doesn’t align with your comfort level. Advocacy doesn’t mean confrontation—it’s about fostering a collaborative relationship with your care team.
Preparing for a Birth Plan That Works for You
The importance of flexibility in your birth plan. While it’s natural to hope for a low-intervention or unmedicated birth, high-risk pregnancies often come with additional considerations. Amber advises her clients to prepare for all possibilities, including inductions or cesareans, while still preserving elements of their ideal birth experience.
Here’s how you can prepare effectively:
Research Induction Options: If induction is on the table, learn about methods like cervical ripening agents, mechanical dilation, and Pitocin. Understanding how these work can demystify the process and reduce fear.
Balance Rest and Movement: During an induction, Amber recommends a “one-third movement, two-thirds rest” strategy. “Don’t exhaust yourself during early labor,” she advises. “Save your energy for active labor when your body needs it most.”
Build a Toolkit: Whether you’re planning for an unmedicated birth or open to medicated options, create a toolkit that includes comfort measures such as hydrotherapy, breathing techniques, and IV pain relief.
The Power of Doula Support
Amber underscores the unique value of doula support, especially for high-risk pregnancies. Doulas act as advocates, educators, and emotional anchors, helping clients navigate a medical system that can sometimes feel impersonal.
“A lot of people think doulas are just for crunchy home births,” Amber says with a smile, “but our support is just as vital in hospital settings, especially for high-risk births.”
Having a doula by your side ensures that you have someone to bridge communication gaps, provide real-time support, and advocate for your preferences. Even in highly medicalized scenarios, a doula can help preserve the sense of agency and autonomy that makes all the difference in how birthing individuals feel about their experience.
How the System Can Do Better
Systemic issues can make high-risk pregnancies more stressful than they need to be. Two key areas for improvement:
Transparency About Risk: Providers should offer patients clear, individualized explanations of their risks rather than relying on generalized labels.
Better Communication: From prenatal visits to emergency scenarios, clearer explanations and a more patient-centered approach can significantly reduce fear and build trust.
Turning High Risk Into High Empowerment
A high-risk diagnosis doesn’t have to define your birth experience. By asking questions, seeking support, and staying informed, you can advocate for a birth plan that aligns with your values while accommodating your unique circumstances.
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