Different practitioners define “high risk” differently.  You need to check directly with your chosen provider to find out if you qualify for care under their risk guidelines.

Here are some factors that could affect whether you are eligible for birth at a birth center or at home, and whether you should seek care from a doctor instead of a midwife in the hospital:

  1. You are very thin (body mass index of less than 18) or very overweight (body mass index of over 40).  As an example, a woman who is 5’7” and weighs 260 lbs might be considered at higher risk for complications.
  2. You have chronic, serious medical problems such as heart disease, chronic high blood pressure not controlled by medication, drug or alcohol addiction, diabetes not controlled by diet, liver, kidney, or autoimmune diseases, active HIV positive,  or others.
  3. You’ve had previous obstetrical complications, including two previous c-sections, or a previous c-section with a vertical scar, placental misplacement, or post-partum hemorrhage.
  4. You have risk factors in this pregnancy such as anemia (less than 9 gm hemoglobin concentration and not responding to therapy); complete placenta previa in your third trimester; your baby is not presenting head down (“non-vertex pesentation”) when you go into labor ; pre-eclampsia; twins or other multiples;  high blood pressure (140/90 or an increase of 30 systolic or 15 diastolic over your baseline pressure); or others.

These are just examples.  Again, different providers have different guidelines for what constitutes high risk.  These examples come from the Illinois regulation that lists medical conditions that would make you ineligible to birth at a freestanding birth center.  Click here to see the full text of that regulation.