“High-risk.” Hearing it can make a pregnancy feel suddenly fragile. It can also leave you wondering whether you need a different doctor.
Usually, it doesn’t mean either of those things. “High-risk” means you or your baby may need closer watching, extra testing, or more planning. For most people, the best setup isn’t trading their OB for a specialist. It’s an OB who knows the pregnancy closely and works hand in hand with one.
Here’s how that works, and how Dr. David Seil Kim and our partner specialists share your care.
What makes a pregnancy “high-risk”?
There’s no single definition. Common reasons include:
- Health conditions you already have, such as high blood pressure, diabetes, thyroid disease, autoimmune conditions, heart or kidney disease, or a seizure disorder
- Something that happened in a past pregnancy, such as preeclampsia (dangerously high blood pressure in pregnancy), preterm birth, a baby who grew too small, stillbirth, or recurrent loss
- Your age. At 35 and especially over 40, some risks rise. Age alone doesn’t mean something will go wrong.
- How you conceived. An IVF pregnancy is often watched more closely.
- Carrying twins or more
- Something found during the pregnancy, such as a growth concern, a placenta problem, an abnormal screening result, or rising blood pressure
Some pregnancies are high-risk from day one. Others become high-risk at 28 weeks after months of normal visits.
Who is the “specialist”?
The specialist is a maternal-fetal medicine (MFM) doctor, sometimes called a perinatologist. MFM doctors are OB-GYNs with extra years of training in complicated pregnancies, advanced ultrasound, and fetal conditions.
Most of the time, an MFM doctor doesn’t replace your OB. They consult. They do detailed scans, interpret complex findings, and recommend a monitoring plan. Your OB carries out that plan visit by visit and is usually the one who delivers your baby.
That means the real question isn’t whether you need a specialist. It’s whether your OB and the specialist are actually working together, or whether you’re left to connect the dots between them.
How it works at Yunella
Dr. Kim is a board-certified OB-GYN with nearly 30 years of experience and more than 7,000 deliveries. He is not an MFM subspecialist, and we say that plainly. What we’ve built instead is a setup where you get both kinds of expertise without the runaround.
- The MFM team is next door. Our partner is the Center for Fetal Medicine, led by Dr. Lawrence Platt, about a three-minute walk from our office. Your nuchal translucency scan, an early screening ultrasound of the back of the baby’s neck, and your 20-week anatomy scan are done there.
- Dr. Kim scans you at every prenatal visit. He does the ultrasound himself, in the exam room, at every visit, not just at certain checkpoints. For a pregnancy that needs watching, that means changes are seen sooner. See how often high-risk pregnancies need ultrasounds.
- One physician holds the whole plan. Dr. Kim reads the MFM recommendations, adjusts your visits and tests, and explains what each result means for you. You aren’t the messenger between two offices.
- The doctor who follows you delivers you. In nearly every case, Dr. Kim attends his own patients’ deliveries at Cedars-Sinai. He and the MFM team plan the timing of delivery together. Our guide to induction at 39 weeks explains how that decision is made.
What closer care usually includes
What’s added depends on your reason for being high-risk. It may include:
- More frequent visits, especially in the third trimester
- Growth scans to check the baby’s size and the amniotic fluid
- Blood pressure plans, sometimes including home monitoring
- Medication review, keeping you on what’s safe and adjusting what isn’t. Never stop a prescribed medicine on your own.
- Extra lab work, such as glucose testing, kidney function or thyroid levels
- A delivery plan covering timing, the hospital, anesthesia, and what your newborn may need
The goal isn’t more appointments for their own sake. It’s knowing why each one is on the calendar.
Warning signs that shouldn’t wait
Whatever your risk level, call your OB right away, or go to the emergency room if it’s severe, for any of the urgent maternal warning signs listed by the CDC:
- Bleeding, or fluid leaking from the vagina
- A headache that won’t go away, or one with vision changes
- Sudden swelling of your face or hands
- Trouble breathing, chest pain, or a racing heart
- Severe belly pain, or pain under your right ribs
- Your baby moving less than usual
- A fever of 100.4°F or higher
- Regular painful contractions before 37 weeks
- Dizziness or fainting
- Thoughts of harming yourself or your baby
If something feels wrong and you can’t reach anyone, don’t wait. Get seen.
Bring this to your first visit
- Your due date, or the first day of your last period
- A list of medications and supplements
- Records from past pregnancies, especially any complications
- Recent labs, blood pressure readings or glucose logs
- Any ultrasound or genetic screening reports
- Your questions, written down
Bring your partner or a support person too. They’re always welcome at Yunella, and a second set of ears helps when there’s a lot to take in.
Closer care, not scarier care
A high-risk pregnancy should feel more organized, not more frightening. You should always know who to call, what you’re watching for, and what happens next.
If you’ve been told your pregnancy is high-risk, or you think it might be, book a consultation or call (424) 404-8832. Learn more about high-risk pregnancy care at Yunella and our concierge maternity program. Or hear it from patients in their own words.