High-Risk Pregnancies: Drivers, Dollars and Employer Solutions

Fifty-seven percent of benefits leaders are seeing increased healthcare costs related to organizational employees’ high-risk pregnancies, according to a 2026 State of Women’s and Family Health Benefits report by Maven, a global healthcare and benefits platform.

Additional data by medical services and insurance provider Kaiser Permanente found those costs can be steep: Each preterm birth costs an average of $145,000, and birth-related costs increase by 77% when a cesarean section is needed.

Targeted employer benefit programs/resources during and after (and even before) pregnancy can help stem the tide.

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An Awareness Gap

According to Maven, the following factors can make a pregnancy high risk and result in elevated healthcare costs:

Chronic illness
Pregnancy-related health conditions
Weight
Age
Being pregnant with twins or triplets
Using in vitro fertilization (IVF)
Serving as a surrogate

But even though most organizations are taking steps to support these employees, the resources they’re putting into place aren’t always having the intended impact, pointing to a need for greater education and awareness.

For instance, Maven’s research found only 3.5% of surveyed workers in the U.S., United Kingdom, Canada, and India correctly identified all the factors that could lead to a high-risk pregnancy. Among those experiencing one:

28% of people were surprised by the classification.
15% found it difficult to find a provider or schedule appointments.
For individuals whose care didn’t meet their needs, difficulty in accessing care increased to almost 25%.

Approximately 15% of U.S. pregnancies are considered high-risk, and when risks are not identified early on, they’re more likely to lead to complications such as preterm birth or cesarean sections — which can spike healthcare costs, particularly when a newborn intensive care unit (NICU) stay is required, said Angela Dao, Maven’s director of product for maternity.

“These complications are the single biggest driver of maternity spend, especially when those complications could have been prevented or better managed earlier,” she said.

How Employers Can Manage Costs

The Maven report found organizations are taking steps to reduce high-risk pregnancy-related costs by:

Encouraging the use of doulas;
Expanding access to preconception care;
Analyzing maternity outcomes and costs;
Offering virtual or telehealth maternity support;
Expanding mental health or social support for expectant parents; and,
Increasing access to maternity care coordination or case management.

“We’re seeing a shift toward more proactive, end-to-end support rather than just covering care when something goes wrong,” Dao said. “Employers are focusing on identifying risk earlier, supporting employees throughout pregnancy and making it easier to access the right care at the right time.”

She recommended offering holistic care that melds clinical support and day-to-day resources — through a mix of classes, short-form content, community connection or simple tools that will actually reach patients and be utilized.

“What’s different today is that an employer gives workers the option to research what’s available to them to help them plan ahead of time,” said Maria Trapenasso, the senior vice president and national practice leader of talent solutions at NFP, a benefits consulting organization. “There are a lot of wellness initiatives built into benefit offerings, so it’s not just ‘I have complications now.’ It’s how to prevent them, how to plan for them, how to make sure they’re covered from a medical perspective and what options employees have.”

Nima Sheth, MD, MPH, the vice president of health justice at the National Partnership for Women and Families, added continuous, well-rounded care that’s backed with education and access can help reduce the costly cycle of emergency room visits, emergency procedures and hospital stays.

She also noted workplaces can invite doulas, midwives or OB-GYNs to come speak to employees to help educate them on risks, and to invite employees to share their experiences with pregnancy risks and resources with their peers — all can increase visibility, expand awareness and reduce stigma.

“Think about creating a high-risk pregnancy pathway or bundled support within the company to get employees access to various supports,” Sheth said. “Have a single point of contact within HR that they can build rapport with and trust. Folks don’t feel like they can talk about these things. They’re already struggling; there’s a sense of internal shame when the doctor tells you something’s going on with your kid.”

The Value of Accommodations

Providing workplace accommodations to pregnant workers also is a vital component of addressing pregnancy risks, said Sharita Gruberg, the vice president for economic justice at the National Partnership for Women and Families, which was instrumental in the passage of the Pregnant Workers Fairness Act (PWFA) in the U.S.

Beyond the PWFA, the Americans with Disability Act and the PUMP Act, which requires workday breaks and safe places to pump breast milk postpartum, protections and support for pregnant and postpartum individuals are a state-by-state patchwork — so employers should research what is required in their state, Gruberg said.

Beyond the legal requirements, providing accommodations is a low-investment, high-cost reward, she added.

“We estimate there are about 3 million people a year working while pregnant, and the impacts of these accommodations are really important for these workers,” Gruberg said. “If the employer doesn’t offer support, the negative consequences can be very high, costly and impactful.”

Expanding Post-Pregnancy Support

Reducing pregnancy-related healthcare costs, improving health outcomes, and increasing workforce engagement and retention shouldn’t stop with support during pregnancy.

“After birth is where support often drops off, even though the need is still high,” Dao said.

According to the experts interviewed for this article, organizations should explore the following post-pregnancy resources:

Mental healthcare to help treat postpartum depression and other concerns.
Lactation support or pediatric guidance to help with challenges navigating feeding, sleep and recovery.
Improved post-discharge support to help reduce NICU readmissions.
Return-to-work support that’s planned and outlined well ahead of time, including flexible or remote work, lactation rooms, caregiving leave, childcare support and regular check-ins.
Ergonomic tools and access to facilities, gyms or care to support post-pregnancy recovery.
Abortion-related leave and travel support.
Expanded family leave for both the birthing parent and partner; additional leave to cover NICU stays; or safe leave for workers who are experiencing domestic violence.
Expanded bereavement leave for failed IVF, miscarriages, stillbirths or early infant death.

“There are a number of states that require employers to provide extra time off in the case of failed IVF, miscarriage or the death of a child after birth,” NFP’s Trapenasso said. “But some employers are not just waiting for the states to require them to do this; they are expanding their bereavement policies on their own. They realize how important this benefit is because it’s so detrimental to employees going through this type of loss.”

Trapenasso also stressed the importance of pre-planning on the organization’s part to manage an employee’s temporary absence related to pregnancy, childbirth or complications. Doing so can help avoid putting additional strain on the worker and help facilitate a smoother return.

“Employers need to be resilient because it’s going to affect the workforce if an employee is out for a substantial amount of time,” she said. “Employers need to think about how to backfill critical positions while being sensitive to what the employee is going through, [since] the employer needs to continue to be efficient operationally.”

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