Understanding Risk Management for Your Midwifery Practice

Risk management is a key component of midwifery. It is the systematic scientific identification, examination, and control of any potential or real risk of any situation that puts individuals at risk of harm. Risks are analyzed, avoided, or managed to ensure a safe environment for giving birth through safety procedures.

Considering difficulties in maternity care, risk assessment, and management has become a major focus in midwifery practice. While studies have examined risk management in the healthcare industry, they have not examined how it affects standard midwifery practice. Key beliefs of maternity care delivery include risk assessment, promotion, and protection of safe childbirth. Midwives must explain to teams that risk and safety are concepts that are closely tied to one another as they work with women as they become moms.

As a midwife, identifying risks in pregnancy is important. It helps to predict which women are most likely to experience adverse health events and enables providers to administer risk-appropriate perinatal care.

Identifying low-risk and high-risk pregnancy

A low-risk pregnancy is defined as: 

• Being pregnant with only one baby, not twins or triplets.
• The baby is growing normally and is in an anterior, or head-down position.
• You have been healthy throughout the pregnancy and have shown no signs of medical or obstetric conditions.
• Labor should happen between 37-41 weeks. No premature or late deliveries.
• No new problems have developed during labor.

Most pregnancies can be considered low risk, meaning most pregnant women can expect a happy and safe outcome for themselves and their babies.  However, even if you are healthy and everything appears normal in the early stages, there is no such thing as a completely risk-free pregnancy.

What Does “High-Risk” Pregnancy Mean?

A “high-risk” pregnancy means a woman has one or more things that raise her — or her baby’s — chances for health problems or preterm (early) delivery.

Several factors can make a pregnancy high risk, including existing health conditions, the mother’s age, lifestyle, and health issues that happen before or during pregnancy.

A woman’s pregnancy might be considered high risk if she:

• is age 17 or younger.
• is age 35 or older.
• was underweight or overweight before becoming pregnant.
• is pregnant with twins, triplets, or other
• has high blood pressure, diabetes, depression, or another health problem.
• had problems with a previous pregnancy, including premature labor or having a child with a genetic problem or birth defect.

Smoking, taking illegal drugs, and drinking alcohol also can cause health problems for a pregnant woman and her baby.

If your client’s pregnancy is considered high-risk, it’s important to work with you and your team to get any health problems that can be managed under control. Whether this is your client’s first pregnancy or third, it might be unsettling for them to hear that their pregnancy is high-risk. The phrase “high-risk pregnancy” can refer to a wide range of common ailments. Many of them have to do with ailments you might have had before getting pregnant or ailments you might have acquired while being pregnant or giving birth.

Nguyen, T. P. (Ed.). (2022, July). What’s a “high-risk” pregnancy? (for parents) – nemours kidshealth. KidsHealth. Retrieved February 11, 2023, from https://kidshealth.org/en/parents/high-risk.html

U.S. Department of Health and Human Services. (n.d.). What are some factors that make a pregnancy high risk? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Retrieved February 11, 2023, from https://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/factors