Navigating the Emotional Impact of a High-Risk Pregnancy

By Jessica Ekhoff, JD, PMH-C

Pregnancy is often portrayed as a time of excitement, nesting, and joyful anticipation. But when complications arise and a pregnancy is labeled “high-risk,” that vision can shift dramatically. Instead of baby showers and ultrasound photos, many parents-to-be find themselves juggling medical appointments, difficult decisions, and overwhelming uncertainty.

Here are a few key truths and gentle reminders to help you care for your mental and emotional well-being during this complex time. 

1. It’s Okay to Grieve What You Expected

You may have envisioned a certain kind of pregnancy—one that felt more carefree, more celebrated, more “normal.” When a high-risk diagnosis enters the picture, that vision can feel like it’s slipping away. It’s natural to grieve the experience you thought you’d have. Give yourself permission to feel that loss. Grieving what could have been doesn’t mean you’re not grateful for your baby; it means you’re human.

2. Fear and Anxiety Are Understandable—But Don’t Have to Take Over

High-risk pregnancies can stir up a constant hum of anxiety. Worrying about test results, your baby’s health, or your own well-being can become all-consuming. These feelings are common, but they don’t have to control you. Grounding techniques, mindfulness, and therapy can be powerful tools to help you hold space for your fears without letting them define your every moment. Some people find it helpful to set aside a “worry hour,” or a specific time of day when they allow themselves to think through their concerns, but try to avoid engaging with anxious thoughts during other parts of the day. 

Another helpful resource is The Pregnancy and Postpartum Anxiety Handbook, which contains evidence-based exercises and worksheets to help manage anxiety symptoms.  

If your anxiety is severe and interfering with your ability to function in daily life, consider discussing medication options with your provider. Many medicines that treat anxiety are safe during pregnancy and breastfeeding. You can learn more at the Organization of Teratology Information Specialist’s MotherToBaby website or hotline. 

3. You Deserve Support—Emotional and Practical

Many people going through high-risk pregnancies feel isolated, especially when others don’t understand the depth of their experience. You don’t have to carry this alone. Whether it's through therapy, support groups, or simply talking with someone who gets it, finding safe spaces to express your emotions is essential. The Society for Maternal Fetal Medicine provides information on numerous support groups and other resources for those feeling alone while navigating a high-risk pregnancy.

Don’t be afraid to ask for help with daily tasks, advocate for your emotional needs at medical appointments, or tell a loved one what kind of support you need (even if it's just someone to sit with you while you wait for test results).

4. Relationships May Be Strained, But You Can Still Nurture Your Bonds

High-stress situations can impact even the strongest relationships. If you are partnered, you and your partner may cope in different ways, and that can lead to miscommunication or conflict. Try to approach each other with compassion and curiosity. Couples counseling or joint therapy sessions can help you reconnect and find common ground during a time when you need each other most.

Relationships with friends and family members can also be strained by the stresses of a high-risk pregnancy. Try to schedule a little time each day – even 20 minutes – to connect with a loved one and talk about something unrelated to the pregnancy. This can help maintain your sense of identity and strengthen your most important relationships. It can also be helpful to go on a date night or night out with friends where you agree in advance that you won’t talk about the pregnancy. This allows you to take a mental break and focus on other meaningful aspects of your life. 

5. Hope and Uncertainty Can Coexist

You might feel like you’re caught in limbo—unsure what each new day will bring. That uncertainty can be exhausting. But hope doesn’t have to be all-or-nothing. It's possible to hold hope in one hand and worry in the other. You can prepare for difficult outcomes and still cherish moments of joy, connection, and anticipation. Both can be true at once. The less you fight against the feelings of uncertainty, the easier it will be to find peace.