Maternal and Fetal Specialty Care

Also known as: High Risk Pregnancy

Some pregnancies need a higher level of expertise – and that's exactly what our maternal-fetal medicine (MFM) team is here for. We work alongside your OB or midwife before, during and after delivery, so you have specialized high-risk care and the connected support your family needs, right when it’s needed.

Conditions Treated

  • High-risk maternal conditions, including cardiac disease, lupus and diabetes
  • Fetal complications, including heart defects and growth restriction
  • Placental concerns, including placenta previa and invasive placenta
  • Genetic counseling and testing
  • Pre-conception counseling for high-risk indications
  • Pregnancy complications, including preterm labor
  • Pregnancy with multiples
  • Pregnancies over age 35

Our Maternal-Fetal Medicine Services

Our MFM team provides the full range of specialty services, from your first consultation through delivery and beyond. We accept transfers from outside clinics and coordinate with the intensive care unit (ICU), neonatal ICU and surgical teams for the most complex cases.

Pre-existing conditions don't disappear during pregnancy – they require more careful management. Our MFM specialists care for patients with cardiac disease, severe hypertension, lupus and other autoimmune conditions, kidney disease, seizure disorders, clotting disorders, diabetes and more.

For some conditions, like severe hypertension, we assume full pregnancy management. For others, we provide consultation and close monitoring alongside your existing care team. We’re here to support you and your pregnancy in the way that’s best for you.

Fetal complications include structural birth defects, genetic conditions, growth disorders and problems caused by maternal antibodies. An accurate diagnosis allows us to begin treatment during pregnancy and prepare for delivery.

Our team evaluates and manages fetal anomalies, brain abnormalities, heart defects, growth disorders, genetic conditions and multiple pregnancies. When we identify complication, we coordinate genetic counseling, genetic testing, pediatric specialty consultations, social work, nonstress tests and delivery planning to make sure you and your baby are fully supported.

Advanced imaging is central to how we monitor and manage complex pregnancies. In some cases, treating a baby before birth can improve outcomes after delivery. We offer a comprehensive suite of ultrasound services, including diagnostic ultrasound, detailed fetal anatomic, fetal echocardiogram, biophysical profile, Doppler flow, transvaginal, amniotic fluid index and 3-D ultrasound.

For rare but serious cases, we also provide in-utero fetal therapy: intrauterine blood transfusion, amnioreduction, medication delivery directly to the baby and draining large fluid collections before birth.

Some pregnancy complications arise without warning. Our team manages placenta previa, placental abruption, invasive placenta, preterm labor, preterm premature rupture of membranes (PPROM) and recurrent pregnancy loss.

For patients with severe placental or fetal complications, we may recommend frequent monitoring or prolonged hospitalization. We'll help you understand what to expect and work to make every stage of care feel as manageable as possible.

All pregnant patients are offered standard genetic screening. Depending on your age, family history or findings, we may recommend additional testing. Our perinatal genetic counselors guide you through the full spectrum: carrier screening, non-invasive prenatal screening, diagnostic testing and whole-genome sequencing for unexplained anomalies.

Before any decision is made, our team ensures you fully understand your findings and what they do and don't tell you. Counseling is available for both partners, with resources to support decision-making at every step.

A difficult diagnosis or pregnancy loss is one of the hardest experiences a family can face. In addition to our MFM team, we support patients with social workers, genetic counselors, palliative care specialists, chaplains and bereavement doulas who counsel families for up to a year after a loss or adverse outcome.

We help families make informed decisions, process grief and navigate what comes next at their own pace, with dignity and without pressure. For families who choose to continue a pregnancy with a life-limiting diagnosis, we help create meaningful experiences and prepare for every possible outcome.

Find Care That's Close to You

Providers Specializing in Maternal and Fetal Specialty Care

At Swedish, you'll have access to a vast network of dedicated and compassionate providers who offer personalized care by focusing on treatment, prevention and health education.

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Support Beyond Clinical Care

Your care doesn't end at diagnosis or delivery. These resources are here to support you and your family through every stage.

Newborn baby receiving medical care
NICU and Newborn Care

Exceptional care and programs for premature and medically complex newborns.

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Childbirth and Parenting Classes

Expert-led classes on childbirth, breastfeeding and infant safety to help you prepare.

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Bereavement Support

Grief counseling and bereavement social workers and doulas available after pregnancy loss or adverse outcomes.

Frequently Asked Questions

In most cases, yes. Patients are typically referred to our MFM team by their OB or midwife when a pregnancy becomes complex, or they identify a concern.

However, if you have a pre-existing condition that affects your pregnancy – such as cardiac disease, lupus or diabetes – you can also ask your primary care provider or specialist for a referral before you conceive or early in pregnancy. If you're unsure whether MFM care is right for your situation, your OB or midwife is the best place to start.

Yes. A referral to our MFM team does not mean you leave your OB or midwife behind. Depending on the complexity of your pregnancy, our MFM specialists may provide consultation and monitoring alongside your existing provider, or they may assume a larger role in managing your care. In either case, our team works closely with your OB or midwife to make sure your care stays coordinated.

Absolutely. We encourage partners and support people to be present for appointments, counseling sessions and care discussions. Facing a complex diagnosis or difficult news is a lot to carry, and different people process it in different ways.

Our team is experienced in supporting the whole family – not just the patient – through what can be a stressful and emotional experience. If your partner cannot attend an appointment in person, ask your care team about options for joining remotely.

Yes. A history of pregnancy complications, recurrent loss or a prior high-risk pregnancy is exactly the kind of history our MFM team is equipped to evaluate. Depending on your situation, we may recommend preconception counseling before your next pregnancy to help identify risks, optimize your health and build a care plan before you conceive.

Not necessarily. A high-risk designation means your pregnancy requires closer monitoring and specialized care – it doesn't automatically determine how you'll deliver. Many patients with high-risk pregnancies deliver vaginally. The right delivery approach depends on your specific condition, your baby's wellbeing and how your pregnancy progresses.

Your MFM team will work with you to develop a delivery plan that prioritizes your and your baby’s safety and your preferences.