High Risk Pregnancy Anxiety: Coping with Uncertainty During Pregnancy

Understanding High-Risk Pregnancy

A high-risk pregnancy refers to a pregnancy in which there are increased medical considerations for you, your baby, or both.

This may include:

  • preexisting health conditions

  • pregnancy complications

  • advanced maternal age

  • a history of infertility or pregnancy loss

  • carrying multiples

While high-risk pregnancy is often discussed medically, the emotional experience is just as significant.

Many individuals find themselves navigating ongoing uncertainty, increased monitoring, and a heightened awareness of potential outcomes.

If this is your experience:
Nothing about your response is “too much.” It makes sense in context.

The Emotional Impact of High-Risk Pregnancy

High-risk pregnancy is often associated with increased anxiety during pregnancy, including:

  • persistent “what if” thoughts

  • fear before or after medical appointments

  • difficulty trusting your body

  • hypervigilance to physical symptoms

  • emotional distancing from the pregnancy

  • grief for the experience you expected

These responses are not a sign that something is wrong with you.

They are often protective responses to uncertainty and prior experiences.

Why Anxiety Can Feel So Intense

During pregnancy—especially a high-risk pregnancy—your brain is naturally more attuned to potential threat.

This can lead to:

  • increased scanning for danger

  • difficulty feeling reassured

  • thoughts that feel repetitive or “stuck”

Many people try to cope by:

  • seeking reassurance

  • researching excessively

  • trying to control their thoughts

  • emotionally shutting down

While understandable, these strategies can sometimes increase anxiety over time.

How to Cope with High-Risk Pregnancy Anxiety

1. Allow Anxiety to Be Present

From an Acceptance and Commitment Therapy (ACT) perspective, the goal is not to eliminate anxiety.

It is to change your relationship to it.

Instead of:

  • “I shouldn’t feel this way”

  • “I need to calm down”

You might practice:

  • noticing the feeling

  • naming it (“this is anxiety”)

  • allowing it to be present without immediately trying to change it

This can reduce the additional layer of suffering that comes from fighting your experience.

2. Notice Thoughts Without Getting Stuck in Them

High-risk pregnancy often brings intrusive or repetitive thoughts, such as:

  • “What if something is wrong?”

  • “What if I lose the baby?”

Rather than trying to stop these thoughts, you can practice:

  • “I’m having the thought that something might go wrong”

  • “My mind is trying to protect me”

This creates space between you and the thought, so it has less control over your actions.

3. Focus on What Is Within Your Control

A difficult reality of pregnancy is that many outcomes are outside of your control.

At the same time, there are areas where you do have agency:

  • attending medical appointments

  • following medical recommendations

  • supporting your physical health

  • caring for your emotional well-being

Shifting your focus toward what is within your control can reduce overwhelm.

4. Allow Both Hope and Fear

One of the most challenging parts of high-risk pregnancy is holding uncertainty.

You may feel:

  • hopeful and afraid

  • connected and guarded

  • grateful and grieving

These experiences are not contradictory.

They are part of the same experience.

You do not need to eliminate fear in order to feel hope.

5. Stay Connected to What Matters

Even in uncertainty, you can still move toward what matters.

This might include:

  • allowing moments of connection with your pregnancy

  • letting others support you

  • engaging in meaningful routines

  • caring for your body with compassion

You don’t have to feel certain to take meaningful steps.


When to Seek Additional Support

If anxiety during pregnancy begins to interfere with:

  • sleep

  • daily functioning

  • relationships

  • your ability to feel present

It may be helpful to seek additional support.

Working with a perinatal therapist in California can help you:

  • navigate uncertainty

  • reduce anxiety

  • process prior experiences

  • stay connected to your values


You Don’t Have to Navigate This Alone

If you are feeling overwhelmed, anxious, or consumed by uncertainty during your pregnancy:
You don’t have to navigate this alone.

Healing is possible—even in the midst of uncertainty—with the right support.

I offer perinatal therapy in California, both online and in-person in Pasadena, specializing in high risk pregnancy, postpartum mental health, infertility, and reproductive loss.

I invite you to reach out through my contact page to learn more about working together.


I’m Dr. Carissa Gustafson; licensed clinical psychologist based in Los Angeles

Using evidence-based therapy, I can help you bring presence to pain and find peace on your pregnancy and postpartum journey. 

Previous
Previous

The Mental Load of Motherhood: Why You Feel Overwhelmed—and How to Cope Using ACT

Next
Next

What Are PMADs? Understanding Perinatal Mood and Anxiety Disorders