How Maven supports high-risk pregnancies & Maternal Fetal Medicine (MFM) care

Maternity costs are one of the biggest healthcare spend drivers for employers — and those costs only increase when a pregnancy becomes more complex. For benefits leaders, understanding how high-risk pregnancies are identified and managed can help improve outcomes while keeping rising maternity costs under control.

Maternal Fetal Medicine (MFM) specialists are central to this care, yet access and coordination can be challenging for employees navigating an already complicated healthcare journey. In this article, we explore the role of MFM care, where traditional maternity benefits can leave gaps, and how employers can better support high-risk pregnancies.

Just how high are high-risk pregnancy care costs?

High-risk pregnancies are a major driver of maternity-related healthcare costs. Complications can lead to more specialist appointments, additional monitoring, C-sections, preterm births, and NICU stays — all of which can increase the cost of care. Nearly 10% of infants in the U.S. are admitted to the NICU, averaging $58,100 per weeklong stay, while C-sections can cost $1,500–$11,000 more than vaginal births in hospital costs alone.

For employers, these expenses are becoming harder to ignore as clinical risk rises and access to maternity care declines. More people are entering pregnancy with factors associated with complications, including chronic hypertension, elevated BMI, and advanced maternal age. Meanwhile, half of U.S. counties have no practicing OB-GYN and more than five million women live in maternity care deserts, making it harder to access timely support. The impact can extend beyond medical claims: untreated maternal mental health conditions alone are estimated to cost more than $14 billion annually through medical expenses, lost productivity, and downstream effects on children's health. 

And high-risk pregnancies aren't a small subset of the maternity population. New Maven Clinical Research Institute benchmarks found that 63.6% of recently pregnant, privately insured respondents met criteria for a high-risk pregnancy, resulting from conditions including preeclampsia and diabetes. Other factors that may make a pregnancy high-risk include multiple gestation, the use of assisted reproductive technology (ART) like IVF or IUI, kidney or autoimmune disease, obesity, or complications in a previous pregnancy.

For benefits leaders, the combination of greater clinical complexity, limited access, and higher medical and productivity costs makes high-risk pregnancy a workforce issue as much as a healthcare one. But simply providing specialist care doesn't guarantee employees can access or navigate it effectively.

What is Maternal Fetal Medicine, and how does it play a role in high-risk pregnancy care?

Maternal Fetal Medicine (MFM) is a subspecialty of obstetrics focused on complex and high-risk pregnancies. MFM specialists typically work alongside a member’s OB-GYN, providing additional monitoring, managing complications such as hypertension or gestational diabetes, and helping plan for a safe delivery when greater clinical oversight is needed.

Getting referred to an MFM specialist, however, is only part of the equation. Access to specialist maternity care varies significantly across the U.S. A national study found that patients waited an average of 20.3 days for a new appointment with an OB-GYN subspecialist, while additional research found that only 51.6% of commercially insured pregnancies with conditions that might warrant MFM involvement received such support.

Coordination matters, too. High-risk pregnancies can involve an OB-GYN, MFM specialist, primary care team, mental health professional, and other providers, each responsible for a different part of the member’s health. Without a clear connection between them, employees can be left to manage appointments, interpret complex information, and work out where to turn when symptoms change.

These gaps can have clinical and financial consequences for employers. When employees can’t access specialist expertise promptly or can’t find the information they need, opportunities for earlier intervention may be missed, increasing the risk of avoidable emergency department visits and costly complications. 

Where do standard high-risk pregnancy benefits fall short?

Traditional maternity coverage may provide access to an OB-GYN and specialist care, but coverage alone doesn't necessarily help an employee navigate a complex pregnancy. High-risk members may be balancing appointments with multiple providers, new diagnoses, changing symptoms, and decisions about their birth.

These gaps matter because risk can change throughout pregnancy. A member who starts out with a relatively uncomplicated pregnancy may later develop gestational diabetes, preeclampsia, or another condition that requires additional monitoring or MFM involvement. Traditional maternity models weren't built for these changing needs and can miss opportunities to intervene sooner. 

Complex diagnoses and treatment plans can also leave employees unsure what questions to ask or how to advocate for themselves. Without accessible guidance between clinical visits, it can be harder to make informed decisions or recognize when symptoms warrant additional attention.

For employers, these gaps can translate into delayed intervention, unnecessary healthcare utilization, and complications that become more difficult and expensive to manage. The missing piece isn't necessarily more covered services, but better education, guidance, and ongoing, accessible support around the clinical care employees already receive.

How Maven helps close the gap

Maven adds a layer of clinical guidance, navigation, and more easily accessible care around a member's existing maternity care. Care Advocates help members connect with MFM specialists faster, while supporting coordination across OB-GYNs, mental health providers, nutritionists, and other specialists. This enables employees to manage complex care without having to piece the experience together themselves.

For members identified as high risk, Maven's dedicated High-Risk Care Coaching program provides more targeted support throughout pregnancy. Eligible members are paired with a dedicated Care Coach who helps them understand their individual risk factors, prepare for appointments, follow personalized care plans, and navigate changing needs.

Guidance continues between in-person visits. Members have 24/7 virtual access to more than 30 provider types, including MFMs, OB-GYNs, mental health specialists, and doulas, alongside ongoing risk assessments, prenatal checklists, educational resources, and digital tools. Rather than replacing an employee's in-person care, Maven helps fill the gaps between appointments and deliver support sooner, giving members somewhere to turn the moment questions, symptoms, or concerns arise.

This combination of earlier risk identification, targeted coaching, and on-demand access can help prevent complications from becoming higher-cost events. Among high-risk Maven members, those who attended a virtual birth-planning appointment had a 67% lower risk of preterm birth and a 40% lower risk of NICU admission compared with those who did not. By reducing the likelihood of such events, proactive maternity care can improve clinical outcomes while helping contain the most significant costs associated with high-risk pregnancy.

The business case: outcomes and ROI

High-risk pregnancies are already affecting the bottom line: 57% of benefits leaders say they have increased healthcare costs for their organization. And with 50% of Maven Maternity & Newborn Care members identified as high risk and eligible for coaching, the scale of the challenge is clear. Members are engaging with these services, too, with 81% of those eligible enrolled in Maven's High-Risk Care Coaching program.

The results extend across Maven's broader maternity population. Maven has demonstrated up to 27% lower NICU admission rates and up to 15% lower C-section rates, helping organizations reduce costly interventions while improving outcomes for parents and babies. Taken together, these results show how a maternity strategy built around early risk identification, specialist navigation, and continuous guidance can improve clinical outcomes while helping control the rising cost of high-risk pregnancy.

Contact Maven to learn how a more proactive approach to maternity care could support your workforce.

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