High-risk pregnancy claims examine whether risk factors were identified, monitored and acted on according to the standard at the time. They also ask whether earlier or different management, including birth timing, would probably have prevented the injury that occurred.
Risk identification
Risk assessment usually begins at booking and continues at each visit. It draws on maternal history, blood pressure, blood tests, ultrasound findings and growth measurements. Reviewers check whether known risks were recorded and whether new findings were noticed as the pregnancy progressed.
Conditions such as gestational diabetes, fetal growth restriction and suspected large babies (macrosomia) are treated here as starting points. Each raises distinct questions and may warrant separate detailed review.
Monitoring and referral
Once a risk is identified, care often changes. It may involve more frequent visits, additional scans, specialist referral or transfer from midwifery-led care to an obstetric team. Reviewers ask whether each step happened and when, and whether results were followed up.
Missed appointments, lost referrals and scan reports that were never reviewed are common lines of inquiry. Reviewers will also consider the reasons for any gaps, including system issues and communication between services.
Delivery planning
For many high-risk pregnancies, the timing, place and method of birth are key decisions. Reviewers look at whether a plan was documented and discussed with the mother. They also look at whether it was updated as circumstances changed, and whether the birth facility could manage the anticipated needs of mother and baby.
Causation
Showing that care was below standard is not enough. Experts must consider whether appropriate management would probably have changed the outcome. Some conditions carry risk even with excellent care, and injuries can originate from factors that were not detectable. Causation often requires both obstetric and neonatal opinions, and sometimes others.
Legal review
A solicitor can gather records from every provider involved, including GPs, imaging services and hospitals. They can identify which experts are needed and advise on the time limits applying in your jurisdiction. They will also help assess what losses, such as care costs or lost earnings, may be recoverable.
For your next conversation
- Antenatal card or shared-care record
- All ultrasound and growth scan reports
- Glucose tolerance and other pregnancy blood test results
- Referral letters and specialist clinic notes
- Documented birth plan and any revisions
- Appointment history, including cancellations
Common questions
My GP and the hospital shared my care. Who reviews what?
In shared care, records may be split across several providers. A solicitor will typically request files from each, then a reviewer considers how information passed between them. Responsibility can depend on who held a result or referral at the relevant time.
Do I need a separate review for gestational diabetes or growth restriction?
Often yes. Each condition involves its own testing, monitoring and timing considerations. The relevant expert evidence also differs. A general review may identify the condition as the key issue, then a more specific opinion follows.
Sources & further reading
- Pregnancy, Birth and Baby: labour complications (opens in a new tab)
- RANZCOG: fetal surveillance guideline (opens in a new tab)
These references support the topic’s starting points. They do not determine the facts, standard of care or law applicable to an individual matter.