High Risk Pregnancy Mismanagement

A pregnancy is generally considered high risk when medical factors — either pre-existing or developing during the pregnancy — increase the likelihood of complications for the mother, the baby, or both. This does not mean that complications are inevitable. It means that the standard of care required is elevated, and that your treating team should be identifying, monitoring, and responding to those risk factors throughout your antenatal care.

Risk factors that commonly place a pregnancy in the high-risk category include:

• Gestational diabetes — a condition in which blood sugar levels become elevated during pregnancy, increasing the risk of complications including macrosomia (a large baby), foetal distress, and difficult delivery
• Pre-eclampsia and hypertension — elevated blood pressure during pregnancy that, if unmanaged, can progress to eclampsia and put both mother and baby at serious risk
• Advanced maternal age — women over 35 face elevated risks of chromosomal abnormalities, gestational diabetes, placenta praevia, and emergency caesarean section
• Obesity and high body mass index — maternal obesity is associated with gestational diabetes, hypertension, and increased risk of foetal abnormality, and affects the quality of diagnostic imaging during pregnancy
• Multiple pregnancy — twins, triplets, and higher-order multiples require specialist monitoring and carry elevated risks of preterm birth, growth restriction, and delivery complications
• Previous obstetric history — a history of previous caesarean section, preterm birth, or stillbirth significantly affects the management of a subsequent pregnancy
• Pre-existing medical conditions — including autoimmune conditions, cardiac disease, renal disease, and mental health conditions that may be affected by pregnancy
• Foetal abnormalities — conditions identified during prenatal screening that require specialist assessment, counselling, and careful delivery planning

When a woman’s risk profile is identified — whether before pregnancy or during antenatal care — her treating team has a professional obligation to respond to it appropriately. That may mean more frequent monitoring, specialist referral, modified care plans, or earlier delivery. What it cannot mean is that those risk factors are noted and then ignored.

The mismanagement of a high-risk pregnancy takes many different forms. In our experience, the most common failures include:

Failure to Identify or Acknowledge Risk Factors

Some women enter pregnancy with risk factors that are apparent from the outset — a previous difficult birth, a pre-existing medical condition, or a family history of obstetric complications. Others develop complications during pregnancy that, if caught early, can be monitored and managed.

When a treating team fails to identify these risk factors, fails to take them seriously when raised by the patient, or fails to escalate care in response to them, the woman is being managed as a routine patient when she is not. If that failure leads to injury, it may constitute negligence.

Failure to Properly Monitor a High-Risk Pregnancy

Heightened risk requires heightened vigilance. A woman with gestational diabetes needs regular blood sugar monitoring and careful foetal growth surveillance. A woman with hypertension requires regular blood pressure measurement and assessment for signs of pre-eclampsia. A woman with a history of preterm birth requires careful assessment of cervical length and may need preventative interventions.

When these monitoring requirements are not met — when appointments are too infrequent, when test results are not acted upon, when concerning symptoms are dismissed — the risk to mother and baby is compounded by the failure of the clinical team to do their job.

Failure to Recommend Elective Caesarean Section

For some women, a vaginal delivery carries risks that a clinician exercising reasonable care would not allow a patient to take. A very large baby in a woman with a small pelvis. A previous uterine scar that is at risk of rupture. A placenta lying low in the uterus. A baby in a difficult presentation that cannot safely be delivered vaginally.

In these circumstances, the appropriate advice is to plan an elective caesarean section. When that recommendation is not made — when a woman with known risk factors is allowed to proceed to labour without being properly counselled about the risks, and without being offered the alternative — and when injury results, that failure of advice may support a claim.

Failure to Obtain Informed Consent

A woman with a high-risk pregnancy has a particular need for complete and honest information about her situation. The risks of the conditions she is carrying. The options available to her. The potential consequences of different choices. The monitoring and interventions that are recommended and why.

Informed consent is not a box to tick. It is an ongoing process — and it is the foundation of every treatment decision. When women are not told about significant risks associated with their pregnancy or delivery, and when those risks materialise in injury, the failure to inform may itself be a compensable breach of duty.

Failure to Diagnose Foetal Conditions During Pregnancy

Routine prenatal screening — including morphology ultrasounds, blood tests, and specialist foetal medicine assessments — exists to detect conditions that would affect how a pregnancy is managed and how parents can prepare. When those conditions exist but are not detected because the screening was performed inadequately, or the results were misread, or the imaging quality was accepted as sufficient when it was not — families may be deprived of information they had every right to have.

The failure to diagnose a serious foetal condition during pregnancy is a recognised ground for a legal claim in Australia. It is not a simple claim to run — it requires careful expert evidence and a clear understanding of what a competent clinician should have detected and when. But where the evidence supports it, it is a claim we will pursue.

The physical and psychological consequences of mismanaged high-risk pregnancies can be profound and far-reaching. Mothers may suffer severe obstetric injury, loss of fertility, life-threatening complications, or lasting physical disability. Babies may be born with preventable injuries — including brain damage, cerebral palsy, or conditions that require intensive and ongoing medical care. Families may face the loss of a baby they should not have lost.

Beyond the physical injuries, there is the psychological toll: the grief of a loss that should not have happened, the anger of being dismissed when you knew something was wrong, the exhaustion of managing a seriously unwell child or recovering from your own injuries while caring for a newborn.

A successful compensation claim cannot undo what happened. But it can provide the financial foundation to meet the costs that follow — treatment, care, lost income, and the modifications to daily life that serious injury requires.

Where a claim for high-risk pregnancy mismanagement succeeds, compensation may be available for:

• Pain and suffering — the physical and psychological impact of the injuries sustained, past and future
• Medical and treatment expenses — including surgery, specialist care, rehabilitation, and ongoing treatment
• Loss of income — if the injuries have impaired your capacity to work, now or in the future
• Care and assistance needs — if you require help with daily activities, domestic tasks, or childcare as a result of your injuries
• Future care costs for an injured child — if the mismanagement caused harm to your baby, the long-term cost of that child’s care may be recoverable

Every claim is different. The value of a claim depends on the nature and extent of the injuries, their impact on daily life and capacity to work, and the quality of the medical and expert evidence supporting them. We work with the leading medical specialists in obstetrics, maternal-foetal medicine, and related disciplines to ensure that your claim is built on the strongest possible foundation.

In most Australian jurisdictions, a claim for personal injury must be commenced within three years of the date the claim becomes discoverable. For many women, this is the date on which they first understood — or could reasonably have understood — that their injuries were caused by a failure in their care, rather than an unavoidable complication of pregnancy.

If your pregnancy was some years ago and you are unsure whether you are still within time, we encourage you to reach out for early advice. Time limits in medical negligence matters can be complex, and there are circumstances in which extensions may be available.

High-risk pregnancy mismanagement claims require a legal team with deep expertise in obstetric medicine, a thorough understanding of the standard of care expected in complex pregnancies, and strong relationships with the medical experts who can properly assess what went wrong and why.

Anthony Porthouse has 36 years of personal injury litigation experience and 15 years as a specialist medical negligence solicitor. He has litigated high-risk pregnancy claims across multiple Australian jurisdictions and is accredited by the NSW Law Society as a Specialist in Personal Injury Law. He is listed in Doyle’s Guide as a leading medical negligence lawyer in New South Wales.

Birth injury is the only area of law we practise. That focus means we bring greater depth of knowledge, stronger expert networks, and more precise preparation to every claim than a generalist firm can offer.

A lot of women we speak to felt, at some point during their pregnancy, that something was being missed. That their concerns were not being taken seriously. That they were being managed through a system that was not seeing them clearly.

If you were right — and if what was missed caused real harm — you deserve honest answers and proper legal advice.

Contact Birth Injury Lawyers today for a confidential, no-obligation consultation. There is no charge and no commitment. We will listen, and we will give you an honest view of your situation.