The rising cost of high-risk pregnancy: the case for earlier maternity support

High-risk pregnancies are among the fastest-growing drivers of employer healthcare costs, and the most effective way to control them is to intervene earlier—through education, navigation, and clinically coordinated maternity care—before complications escalate.

Who this is for: HR and benefits leaders who sponsor maternity coverage and want to reduce preventable complications, control costs, and improve return-to-work outcomes.

Why are high-risk pregnancies a growing cost for employers?

High-risk pregnancies require more intensive monitoring, specialist care, and complications management. That drives up medical spend, lengthens leaves, and disrupts return to work—costs that fall on employees and the employers sponsoring their coverage alike.

Maternity care is now one of the fastest-growing areas of healthcare spend for employers. The data tells the story:

• According to Maven’s State of Women’s and Family Health Benefits 2026 report, 57% of benefits leaders say high-risk pregnancies have impacted healthcare costs for their organization, and nearly one in five report significant increases.
• Maternity-related medical costs have climbed roughly 50% over the past decade.
• Preexisting risk factors—hypertension, diabetes, advanced maternal age—have increased by more than 150% over the last 30 years.

Where the cost concentrates: preterm birth

Preterm birth—often driven by high-risk factors like diabetes and preeclampsia—is one of the clearest examples of where costs concentrate:

• Complications from preterm delivery result in neonatal and intensive care expenses averaging $64,800 per birth.
• Across employer-sponsored health plans, that contributes an estimated $6 to $14 billion in additional medical costs each year.

Costs extend beyond direct care

High-risk pregnancies also mean longer medical leaves, more complex disability claims, and harder return-to-work transitions.

• Only 32% of HR leaders say all or almost all employees return to their role after parental leave.
• A complicated recovery can mean employees need more time, ongoing care, or greater flexibility—increasing both workforce disruption and employer costs.

What is a high-risk pregnancy and what raises the risk?

A high-risk pregnancy is one with a greater likelihood of complications for the pregnant person, the baby, or both—typically requiring more intensive monitoring and specialist care from providers like maternal-fetal medicine doctors. That risk can stem from preexisting conditions, conditions that develop during pregnancy, and the path to conception.

Common factors that elevate pregnancy risk include:

• Preexisting conditions such as hypertension and diabetes
• Advanced maternal age
• Conditions that develop during pregnancy such as preeclampsia and gestational diabetes
• Assisted reproductive technology and alternative family-building paths, including IVF and surrogacy

Conditions like preeclampsia, gestational diabetes, and preterm labor are often managed far more effectively when risk is recognized early. Evidence shows that a daily dose of aspirin between weeks 12 and 28 of pregnancy can reduce the risk of preeclampsia by about 18% and preterm birth by 9%. Preventive strategies like these depend on identifying risk factors in time and engaging clinically before problems arise—not reacting after complications emerge.

Why don't employees recognize pregnancy risk?

A significant awareness gap leads employees to underestimate their risk and seek care late, missing the window for earlier monitoring and preventive care.

Findings from Maven's 2026 report:

• Only 3.5% of employees correctly identified all conditions associated with high-risk pregnancy.
• 28% of women with high-risk pregnancies were surprised by the classification.

Misconceptions are especially common around assisted reproduction and alternative family building:

• 82% of employees do not believe IVF increases pregnancy risk.
• 91% of employees do not associate surrogacy with higher-risk pregnancies.

When employees underestimate risk, opportunities for earlier monitoring, specialist support, and preventive care slip away—raising the odds that complications require more intensive and costly intervention.

How do access barriers make pregnancy risk worse?

Even when employees recognize risk, systemic access barriers—appointment availability, wait times, transportation, and provider shortages—delay care and make it harder to stay on recommended monitoring schedules.

According to Maven's 2026 report:

• 1 in 4 women skipped or delayed routine women's healthcare in the last year.
• 53% delayed or skipped care because they couldn't find an appointment time that worked.
• 40% delayed or skipped care because it took too long to get an appointment.

These delays carry directly into pregnancy care. Comprehensive, consistent prenatal care is proven to improve health outcomes — so the earlier someone can get care for a more complex pregnancy, the better.

The maternity care desert problem

• More than one-third of U.S. counties are classified as maternity care deserts—areas lacking sufficient resources or access to hospitals and birth centers that offer obstetric care.
• Fewer local providers means travel burdens, delayed appointments, and higher indirect costs for employees and families.

Why traditional case management often falls short

Many employers rely on case management services through their health plans. That support is valuable, but high-risk pregnancy typically calls for a more proactive, clinically integrated approach layered on top of it. Two limitations stand out:

• Reactive triggers: These models are often triggered only after a medical claim is submitted, so outreach may not happen until complications have already developed.
• Episodic support: Complex conditions benefit from continuous guidance, coordinated care planning, and easier access to specialists—not episodic triage or phone-based check-ins.

Employers are responding

• 75% of HR leaders are at least somewhat concerned about reduced access to maternity care due to provider closures.
• Half are already increasing or changing benefits to improve access, and another 41% are considering it.

But these efforts have to go beyond expanding benefits to address the practical navigation barriers that ultimately shape the employee experience.

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What can HR leaders do to better support high-risk pregnancies?

Closing the high-risk pregnancy gap often doesn't require adding new benefits—it requires making existing maternity and women's health benefits easier to access, better coordinated, and focused on early support.

Step 1: Invest in early pregnancy education. Provide clear, clinically backed resources that help employees understand risk factors and how their fertility journey may have played a role, as well as the steps they can take as soon as pregnancy begins.

Step 2: Simplify maternity navigation. Offer a centralized pathway for care coordination, mental health support, and virtual maternity services, so employees don't have to piece together care across disconnected systems.

Step 3: Extend support beyond birth. Support the employee's journey through postpartum recovery and return to work with ongoing care after delivery—including designated NICU support, mental health resources, and care coordination—so recovery and reintegration aren't fragmented.

Investing earlier in education and care navigation improves clinical outcomes while helping employers control costs and reduce workplace disruption.

How to choose a maternity support vendor

When evaluating solutions, benefits leaders should look for:

• Proactive risk identification that doesn't rely solely on claims-based triggers
• Clinically managed, coordinated care rather than episodic triage
• Continuity across stages—early pregnancy through postpartum and return to work
• Dedicated high-risk and NICU support
• Outcomes data tied to clinical and financial impact
• Navigation support that addresses real access barriers, from appointment availability to provider shortages to travel

How does Maven help employers reduce high-risk pregnancy costs?

Maven provides a clinically managed, coordinated model that identifies pregnancy risks earlier and guides employees from early pregnancy through postpartum and return to work—turning investment in maternity support into measurable outcomes.

Maven's clinically managed model gives employees ongoing access to maternity specialists, mental health providers, and Care Advocates who help identify pregnancy risks earlier and guide the right clinical pathways. High-risk pregnancy support includes:

• High-Risk Care Coaching: Designated 1:1 coaching from licensed clinicians for high-risk members to drive sustained behavior change and improve clinical outcomes.
• NICU Support: Dedicated care for parents of hospitalized newborns for safer discharges, designed to reduce length of stay and prevent readmissions.

Proactive rather than reactive

Rather than waiting for claims-based triggers, Maven identifies and engages members at risk and directs them to the right care before complications arise.

Proven outcomes

This coordinated approach has been shown to drive meaningful clinical and financial impact:

• Up to a 27% reduction in NICU stays
• 94% of members report that Maven helped them return or plan their return to work

For employers, that turns expanded maternity investment into real employee outcomes. Earlier engagement, consistent care experiences, and improved employee health reduce preventable complications and support smoother return-to-work transitions—while helping control costs.

Explore the full State of Women's and Family Health Benefits 2026 report to learn more about rising maternity costs and how employers can use education, navigation, and coordinated care to support better outcomes.

Ready to get started? See how Maven can support working families, retain talent, and reduce costs.

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Frequently asked questions

What are the signs and factors of a high-risk pregnancy?

A high-risk pregnancy carries a greater likelihood of complications. Common risk factors include preexisting conditions like hypertension and diabetes, advanced maternal age, conditions that develop during pregnancy such as preeclampsia and gestational diabetes, and conception through assisted reproductive technology like IVF or paths like surrogacy. Notably, most employees don't recognize these factors—according to Maven’s 2026 report, only 3.5% correctly identify all conditions associated with high-risk pregnancy.

How can early maternity support reduce costs?

Early identification allows conditions like preeclampsia, gestational diabetes, and preterm labor to be managed before they escalate. Low-dose aspirin taken between weeks 12 and 28, for example, can reduce preeclampsia risk and the likelihood of preterm birth. Because preterm birth complications average $64,800 per birth, preventing even a portion of these outcomes meaningfully lowers employer costs and reduces workforce disruption.

Does IVF or surrogacy increase pregnancy risk?

There's a significant awareness gap: 82% of employees do not believe IVF increases pregnancy risk, and 91% do not associate surrogacy with higher-risk pregnancies. Because these paths can be associated with elevated risk, employees who underestimate them may miss opportunities for earlier monitoring and preventive care—which is exactly why education is a core part of effective maternity support.

Is health plan case management enough for high-risk pregnancies?

Case management is valuable, but it's often not enough on its own. Many programs are triggered only after a medical claim is submitted, meaning outreach may not happen until complications have already developed. High-risk pregnancy also benefits from continuous, clinically integrated guidance and easier access to specialists—not episodic triage or phone check-ins. A proactive, coordinated model layered on top of case management closes these gaps.

Do employers need to add new benefits to close the high-risk pregnancy gap?

Not necessarily. Closing the gap often means making existing maternity and women's health benefits easier to access, better coordinated, and focused on early support—through early pregnancy education, simplified navigation, and continued support beyond birth into postpartum recovery and return to work.

What outcomes can employers expect from coordinated maternity support?

Maven's coordinated, clinically managed model has demonstrated up to a 27% reduction in NICU stays, and 94% of members report that Maven helped them return or plan their return to work—alongside reduced preventable complications and smoother return-to-work transitions.

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